About Betsy Todd, MPH, RN

Former clinical editor, American Journal of Nursing (AJN), and nurse epidemiologist

In Nursing, ‘Joy’ and ‘Work’ Are Not Mutually Exclusive

No shortage of workplace pressures.

Photo by Mark Thomas/Science Photo Library.

In virtually any health care setting today, nurses are under pressure to increase efficiencies, improve quality, and cut costs. The nonstop pressure to always do better comes in the midst of staff shortages, repeated changes in clinical protocols, struggles with EHRs that are incompatible with our workflow, and even concerns for our own physical safety. It’s no surprise that nursing turnover rates are increasing.

With all of this raining down on our heads, is it really possible to experience joy at work?

In “Finding Joy in the Workplace” in this month’s issue (free until May 7), Rose Sherman and Cynthia Blum tell us that it is. And, they argue, the work experience of nurses influences the quality of their interactions with patients:

If clinicians don’t feel hope, confidence, and psychological safety in their work, they can’t in turn offer these to their patients.

An evidence-based framework for improving joy.

The Institute for Healthcare Improvement (IHI) is known to most of us as an organization that focuses on patient safety issues like CLABSIs, surgical site infections, falls, and medication errors. But increasingly concerned about clinician burnout (which is, after all, a patient safety […]

2019-04-24T09:26:18-04:00April 24th, 2019|career, Nursing, wellness|0 Comments

Are Your PCA Pumps Accurate, and Working?

Device malfunction happens.

After orthopedic surgery several years ago, I awoke in the PACU to find nurses working frantically on one side of my stretcher. Simultaneously, I realized that my leg hurt. A lot. And with another moment’s awareness—awake enough now for my nurse’s brain to begin to kick in—I understood that all of the activity concerned my PCA pump.

neeta lind/flickr creative commons

One of the nurses noticed that I was stirring. “Your pump has malfunctioned. We can’t get the replacement to work. A third pump is on the way. I’m so sorry!”

The scramble for a replacement, and then another, probably lasted less than five minutes, but it was a pretty wild ride. My deep breathing in an attempt to control the pain gave me something to focus on, but it was a pretty weak effort up against bone pain in the immediate post-op period. I’m grateful that my nurses—there were at least three involved at that point—regarded the pump failure as an emergency.

But operator errors are more common.

Needless to say, then, I was particularly interested in a new study that appears in this month’s AJN. In “Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study,” Yoonyoung Lee and colleagues […]

What Do Haiku Have to Do with Nursing?

Nurse poets among us.

April is National Poetry Month, and all kinds of excellent poetry will be highlighted in various online and other venues, including, of course, in AJN’s Art of Nursing column, where the poem “Cat-a-tonic” by Shawna Swetech is featured this month (click on the pdf in the upper right corner of the landing page for the best version). I’m not a poet, though there are many nurse poets among us, and I’m not a fan of every poem I meet, but one form that is guaranteed to interest me every time is the haiku.

A short, simple poetic form.

Centuries ago, Japanese poets wrote the first haiku poems. A haiku has a very specific structure:  three lines only, with exactly five syllables in the first line, seven in the second, and five in the third. Five-seven-five. (Though not every haiku today follows these rules strictly.) A haiku might rhyme, or not; it may or may not include punctuation or typical capitalization.

“Scrubs” not “uniforms” –
simpler than we used to wear.
Still, I miss my whites.

Traditionally, haiku have been written to celebrate nature. The best of these paint beautiful pictures in a few simple words. They are often very musical to the ear, […]

2019-04-02T07:57:53-04:00April 2nd, 2019|Nursing, writing|6 Comments

Updating Your Knowledge of the Many Medications for Type 2 Diabetes

According to the latest figures from the CDC, 30.3 million people in the U.S. have diabetes, and another 84.3 million adults have ‘prediabetes.’ Type 2 diabetes accounts for 90% to 95% of all cases. Are you up-to-date on the new drugs? This month in AJN, Patricia Keresztes and Annette Peacock-Johnson help us find our way through the latest information on the many drugs (other than insulin) used in type 2 diabetes.

Lifestyle, of course, is critically important in the management and prevention of type 2 diabetes. Diet, physical activity, weight control, and whether or not we smoke are all factors in managing the disease.

Keeping track of the many newer antidiabetes drugs.

But drug therapy is central to diabetes control for most people, and there has been an explosion of new drugs for diabetes over the last several years. Do you know which currently available antidiabetic drug (or drug class) . . .

  • is the least expensive?
  • is more likely to cause weight gain?
  • is associated with the greatest risk of hypoglycemia among non-insulin agents?
  • should not be used by people who have (or have had) bladder cancer?
  • is associated with an elevated risk of bone fractures in women?
  • can decrease the effectiveness of hormonal contraception agents?
  • may lead to urinary tract infections or genital mycotic infections?

A CE article to update your pharmacologic expertise.

Update your knowledge of medications for type 2 diabetes by reading this month’s […]

2019-03-18T11:02:58-04:00March 18th, 2019|Nursing|0 Comments

Is the Current Nurse Manager Role Attractive to Millennials and Gen Xers?

Image by TeroVesalainen from Pixabay

A perennially challenging role.

I’ve always found the role of nurse manager to be the most difficult one in health care. Crushed between staff nurses begging for enough resources to do the job and administrators pressing for cost containment, nurse managers often find it hard to make any progress at all.

This job comes with 24-hour responsibility, often (incredibly) for more than one unit. This can mean taking responsibility for, say, 50 patients, and 80 or more staff. Just managing payroll for so many people (as many managers still have to do) can take half the pay period! And all this for the princely salary of . . . less than what many of their senior staff nurses are making.

Redesigning the nurse manager role includes greater role flexibility.

Those of us who’ve been in nursing for decades simply accepted that, if you wanted to move up the nursing career ladder, you would have to accept all of the above. Younger generations of nurses, though, see things differently. […]

2019-03-15T10:09:41-04:00March 13th, 2019|Nursing, nursing career|0 Comments
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