About Betsy Todd, MPH, RN

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

Delegating: A Crucial, Sometimes Tricky Nursing Skill

Knowing where you fit in with the team.

Ralph Hogaboom / Flickr

As a new nurse I was entranced with my role. Throughout my schooling, I had worked closely with nurses and nursing instructors I admired, but out in the real world I was only beginning to understand how I fit in with the rest of the team. From those early years, I vividly remember two separate run-ins I had with nurse aides. I was so frustrated that they didn’t simply follow my instructions! Looking back, I think these disagreements were mostly about experienced workers “testing” me and our working relationship.

Delegation is not simple.

In “Delegating as a New Nurse” (free until January 10) in this month’s AJN, Amanda Anderson offers a wealth of practical information to help new and not-so-new nurses learn the art of delegation. I could have used her guidance back then. As she notes, delegation is not a “simple” task:

“It requires an appreciation of nuance and insight, both of which new graduates may lack. Delegation often requires skills that aren’t taught in nursing school and are difficult for preceptors to teach in the clinical setting.”

[…]

2018-12-26T10:34:48-05:00December 26th, 2018|nursing career, nursing roles|1 Comment
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How Can Nurses Identify and Assist Human Trafficking Victims?

Wikimedia Commons/ AlvaroGzP

What do sex workers have in common with nannies, housekeepers, farmworkers, janitorial and restaurant staff, and factory and construction workers? They all work in settings where victims of human trafficking are commonly found.

Human trafficking is big business in the United States.

Our country is reported to be the second-largest market globally for women and children trafficked into sex work. Sex trafficking is the main form of trafficking among U.S. citizens, while forced labor trafficking is more common among foreign nationals living here.

Globally, human trafficking is second only to drug trafficking among criminal industries. Because nurses are “everywhere,” we are very likely to come into contact with human trafficking victims at some point. Would you know how to recognize one?

Possible indicators of human trafficking.

In a 2011 AJN article, Donna Sabella shares several possible indicators of human trafficking that warrant further investigation, including:

2018-12-13T08:10:08-05:00December 13th, 2018|Nursing, Public health|0 Comments
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‘No Illusion of Forever’: A Mother and Nurse Makes Every Day Count

As a nurse in my early twenties, I worked with kids with cystic fibrosis (CF). At that time, we were just beginning to see some teens and young adults in our CF clinic. I was close to them in age, and friendships naturally developed. Some never even reached their twentieth year. I had never seen people my age die, and although as a nurse I knew this was possible and even likely because of their illness, every death was shocking to me.

It’s hard, then, for me to imagine how it must feel to have siblings with a terminal disease. It seems to me that losing just one brother or sister early in life would be devastating. What if you watched six die?

A childhood punctuated with loss.

In this month’s Reflections column, “No Illusion of Forever,” author and nurse Elizabeth Bruno shares her memories of her time with the brothers she lost to agammaglobulinemia. The earliest death was a brother who died at ten years of age; the longest living was her oldest brother, who lived to the age of thirty.

Part nurse, part mother—always remarkable.

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2018-12-06T14:38:20-05:00December 6th, 2018|family caregiving, Nursing|0 Comments
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Managing Movement Disorders: Spasticity, Clonus, and Muscle Tightness

Do you know how to help people with muscle tightness, spasticity, or clonus? And what if someone has more than one of these conditions at the same time?

Little information in the nursing literature.

 

In “Managing Movement Disorders: A Clinical Review,” their CE article in this month’s AJN, Rozina Bhimani and colleagues provide an excellent guide to the assessment and pathophysiology of, and treatment for, each of these conditions. There is very little in the nursing literature on their management, so this article by nurse experts who work with these symptoms every day is particularly enlightening and helpful.

The authors point out that muscle tightness, spasticity, and clonus are not always interpreted accurately by clinicians. This can lead to less-than-optimal treatment.

“Neuromuscular signs and symptoms occur across a multitude of diseases and injuries . . . . Successful symptom management requires effective communication about symptoms, yet there are often discrepancies between patient and provider descriptions of neuromuscular symptoms and manifestations.”

[…]

2018-12-06T14:36:23-05:00December 4th, 2018|Nursing|0 Comments
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‘So Many Things a Pill Can’t Solve’: An Integrative Therapy Nurse in Acute Care

“I don’t think that people realize how powerful human touch can be.”

“This therapy is invaluable to me—not just physically, but for my mental state too.”

“I think that we as Americans need more of this [integrative] therapy because there are so many things that a pill can’t solve.”

This is some of the feedback offered by patients after massage therapy sessions at the Minneapolis Veterans Affairs Medical Center. In this month’s AJN, integrative therapy nurse Hallie Boyd describes how her program has become a vital part of symptom management on the spinal cord injury and disorders unit there.

Help for patients in coping with chronic pain.

As a staff nurse on this unit, Boyd had encountered many patients who were trying to cope with chronic pain. While the hospital had long educated nurses on the use of integrative modalities such as guided imagery, acupressure, and aromatherapy, it was difficult for them to employ these techniques on a regular basis during busy and unpredictable shifts.

So, while continuing her work on the spinal cord unit, Boyd returned to school to focus on hospital-based therapeutic massage for medically complex patients. Training alongside a diverse group of practitioners, she developed and refined the idea of a full-time integrative therapy […]

2018-11-28T11:01:10-05:00November 28th, 2018|Nursing|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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