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In All Nature’s Glory: One Patient’s Presurgical Ritual

‘Join me.’

I walked into the preoperative waiting area one morning, ready to begin my day. Standing outside my first patient’s bed bay, I asked through the drawn curtain if I could enter. Silence. I waited and then called out the patient’s name again. Again, nothing. I peeked behind the curtain. There was the patient standing in all of nature’s glory, arms extended in front of the window—eyes closed.

I stepped back and then heard her say, “Come in, join me.” I felt caught off guard, unsure of what to do. But I was also curious, so I went in.

The patient turned her head towards me and said, “Just stand next to me—the collective mind brings more energy.”

So I did. The view from this patient’s room showed a river running alongside the facility. Like her, I looked out onto the river. The sun was beginning to rise and the sky was a beautiful blend of pink and blue. I closed my eyes and a sense of serenity gently settled over me.

We stood together in silence for just a minute or two. Then the patient turned to me, grabbed her gown, and said, “Now, how can I help you?”

I found that I was smiling as I heard myself […]

2021-10-27T09:46:54-04:00October 27th, 2021|Nursing, nursing stories, patient engagement|1 Comment
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The Essentials for Nurses About Recognition and Treatment of MIS-C

‘A massive systemic inflammatory response.’

While on the whole the United States is seeing a decline in COVID cases, this most recent wave of the Delta variant has seen an unprecedented number of children infected and hospitalized for COVID-19.

While children generally fare better than adults from the virus, infection may make them susceptible to a rare condition known as multisystem inflammatory syndrome in children (MIS-C).

This rare but serious condition was described by Shields and colleagues in our May issue as “a massive systemic inflammatory response that has physiologic correlations to Kawasaki disease, Kawasaki disease shock syndrome, toxic shock syndrome, macrophage activation syndrome, and cytokine release syndrome.”

The CDC reports that, as of October 4, the number of patients meeting the case definition for MIS-C was 5,217 (up from 4,000 reported in June) and the total number of deaths meeting the case definition was 46.

The CDC case definition includes the following:

2021-10-28T10:36:09-04:00October 20th, 2021|COVID-19, infectious diseases, Nursing|0 Comments
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Alleviating Some Pressure for Acute Care Nurses

Holding huddles during a shift helped to keep nurses informed of hospital-wide and unit-based updates and allowed staff to express their concerns and ask questions. Photo by James Derek Dwyer / Beth Israel Deaconess Medical Center.

It’s well-known that nurses are facing relentless pressure and challenges due to the COVID-19 pandemic, and it doesn’t seem to be resolving anytime soon. While we know that short-staffing is a huge problem and needs to be addressed, hospitals also need to adopt strategies in the here and now to alleviate some of these stressors. AJN recently published several articles detailing the creation and employment of such strategies.

One such article, “Supporting Frontline Staff During the COVID-19 Pandemic,” can be found in our September issue. In the article, nurse leaders from Beth Israel Deaconess Medical Center in Boston describe the challenges nursing staff faced during the COVID-19 surge in the spring of 2020 and the actions taken to support them. […]

2021-10-07T09:50:09-04:00October 7th, 2021|Nursing, safe staffing|0 Comments
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Asleep at the Wheel: Night Shift and Drowsy Driving

‘The most exhausting year of my life.’

Photo by Jan Baborák/ Unsplash

In my 25-year-plus nursing career, I’ve had the opportunity to work every shift—days, nights, evenings, 8-hour and 12-hour shifts. Without a doubt, my least favorite was 12-hour night shifts, as I am more of a morning person than night person.

When I was a new graduate, it was hard finding a job on the day shift, since it’s typically more popular and there are fewer openings for inexperienced nurses. Because of this, I accepted a position working from 7 pm to 7 am.

It was the most exhausting year of my life. No matter what I tried, I couldn’t sleep well during the day, and by the end of the 12 hours I was wiped out. Although I was lucky enough to live only a few miles from the hospital, I found it difficult to stay awake for the whole ride home. I would catch myself trying to keep my eyelids from closing, and a few times I briefly fell asleep at red lights.

Close calls on the roads.

I am grateful that nothing bad ever happened during my sleep-deprived journeys. I have a friend who wasn’t as lucky and totaled her car one morning on the way […]

2021-10-04T11:15:27-04:00October 4th, 2021|Nursing|0 Comments
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Are Fall Prevention Precautions Missing the Mark?

Happy first day of autumn! Let’s have some fall talk.

If you spend any time in the acute care setting, you’ll be inundated with signs of fall precautions: yellow alert armbands, yellow nonslip socks, yellow signs on patient room doors, and of course the constant ringing of bed alarms.

It appears that hospitals put a lot of effort into fall prevention, and understandably so—falls cost hospitals money. These costs include tests and procedures that aren’t covered by insurance, increased length of stay while the patient recovers, and lawsuits from injured patients or from their families.

Checking boxes vs. individual patient needs.

However, the current approach of applying all precautions to all patients at risk for falling isn’t supported by research, and may decrease patient satisfaction. Sometimes it seems more focus is put on checking boxes about having prevention strategies in place than on the actual patient’s preferences or needs. For example, a former patient told me about a time she was in the bathroom of her hospital room and felt lightheaded. Rather than risk falling, she eased herself to the floor and hit the call bell for assistance to get back to bed. Upon finding her on the floor, the staff were so focused on filling out an incident report and assessing her for injury that they ignored her attempts to explain what actually happened.

The ‘next era’ in fall reduction.

2021-09-22T09:47:00-04:00September 22nd, 2021|Nursing, patient safety, Patients|0 Comments
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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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