About Jacob Molyneux, senior editor/blog editor

Senior editor, American Journal of Nursing; editor of AJN Off the Charts.

HCR: Been There, Done That

By Maureen ‘Shawn’ Kennedy, AJN editor in chief

I was doing some research in the AJN archives and came across an editorial written in November 1993 by Virginia Trotter Betts, then-president of the American Nurses Association. “The Best Buy in Health Care” (click through to the PDF option; article will be free until July 18) reads like it was written with the Institute of Medicine’s Future of Nursing report in mind. Here’s an excerpt for those who don’t have access to the AJN archives (a shameless plug: subscribers have full access to ALL the issues of AJN, back to the very first issue in 1900—a treasure trove of nursing history):

“But we must also face the fact that such reform will require significant changes in nursing. Nurses will have to operate with greater autonomy and deliver care to a broader clientele. To foster enhanced roles for nurses as case managers and team leaders, nursing administrators must alert the work environment to offer a continuum of care on site and off site. Nurse educators will need to offer innovative programs, curricula, and clinical placements that prepare nurses for careers characterized by critical thinking and maximum flexibility. Nurse researchers will need to add more health care system, economic and policy studies to their repertoire.”

And another:

“Nurses want to do more in a reformed system to facilitate access at a reasonable cost.  We want to do what we are educated to do – provide […]

The Real Criminals Here: Justice is Served in Winkler County, Texas, Whistleblower Case

Map of USA with Texas highlighted

By Maureen ‘Shawn’ Kennedy, AJN editor in chief

On January 13, news from Texas let nurses everywhere take heart that, sometimes, the system works. According to a report by the Odessa American, the Winkler County, Texas, officials, Sheriff Robert Roberts and attorney Scott Tidwell, who had filed charges against whistleblower nurses Anne Mitchell and Vicki Galle, have been indicted on felony charges of misuse of official information. The hospital administrator who fired the two nurses, Stan Wiley, was also indicted. For more on the story, which we’ve kept a close eye on since October 2009 in our news reports and on this blog, see this ABC World News article; the Texas Nurses Association also has an archive of the case.

In a separate civil suit against the county, Mitchell and Galle were awarded $750,000. Very excellent.

Why is this so exciting and significant? The case outcome supports nurses who raise concerns about unsafe patient care and upholds the nurse’s right—duty, really—to advocate for patients. Hopefully, the nurses’ victory and the award from the civil suit will give pause to those who think they can intimidate nurses who are acting on good conscience and within legal and ethical boundaries.

Kudos to the courts for realizing who the real criminals are.

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The Puzzle of Snowflakes: Treatments May Be Uniform, But Patients Are Not

Julianna Paradisi blogs at JParadisi RN; her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” is upcoming in the February issue.

My patient sits in a chair, watching a DVD presentation about caring for his new, surgically inserted, tunneled catheter. In a few weeks, this catheter will be used for his stem cell transplant. I am teaching him how to flush it and change the dressing. He’s from out in the sticks, too far away from the clinic for our nursing staff to provide the care for him. He doesn’t have family or friends for support. After the DVD, I bring out a chest manikin and dressing kit to demonstrate the sterile dressing change. As I explain the technique of donning sterile gloves, he stops me with a challenging glare.

“I can’t do sterile.”

I stop what I’m doing to explain the dangers of infection if the dressing isn’t sterile. Like a car stuck in a snowdrift, he remains unbudged. “I can’t do sterile,” he insists. I puzzle over what to say next. My coworkers flurry by in their white lab coats. I’m wearing a white lab coat, too. My patient is lost in a health care blizzard. He doesn’t see snowflakes. He only sees snow.

Year-End Reindeer Dreams

By Peggy McDaniel, BSN, RN, infusion practice manager

As a long-time pediatric nurse who’s spent many a Christmas at the hospital, I have special memories, many of which still make me smile years later. Some of these are bittersweet, as suffering and pain do not stop for such days. One of my favorite shifts involved a little boy and some reindeer antlers. 

I was working a 12-hour night shift as a traveler in a small community hospital. We got a call from the ED to admit a four-year-old boy who was extremely anemic due to unknown causes. When this child arrived, I realized he was very ill and probably would only spend Christmas Eve night with us. He needed to be stabilized, then would move on to a regional children’s hospital for further diagnosis and treatment. […]

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