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Caring for Suicidal Children in the ED

By Sylvia Foley, AJN senior editor

Suicidal children and adolescents are often first seen in EDs. At Children’s Hospital Boston (CHB) recently, a boy we’ll call J.J. was one of them. Still in elementary school, he had just started a new school year. J.J. has Asperger’s syndrome (a disorder on the autism spectrum), and new situations are difficult for him. His classmates were teasing him, and it was escalating: one boy reportedly threatened to kill J.J. for being “weird.” Despite efforts by J.J.’s parents and the school to address the situation, J.J. became increasingly depressed and fearful. As September CE authors Alexis Schmid and colleagues explain,

On the morning of the ED visit, as the family members were starting their day, J.J. had gone into the kitchen, found a butcher knife, and held it to his throat. His mother walked in and saw him. Although J.J. willingly surrendered the knife to her, she said she was “rattled to the core.”

Schmid was the ED nurse on J.J.’s case that day (all three authors work at CHB). In “Care of the Suicidal Pediatric Patient in the ED: A Case Study,” the authors describe the course of J.J.’s care and what they did to keep J.J., his family, […]

2016-11-21T13:12:00-05:00September 1st, 2011|Nursing|0 Comments
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Compassion for Those Among Us: Recent Poems in ‘Art of Nursing’

By Sylvia Foley, AJN senior editor

In Carolyn Scarbrough’s poem “A Rose By Any Other Name” (Art of Nursing, August), a nurse sees an “opaque rose, unfurling” on a CT scan of an infant’s brain. Recognizing this as “evidence of violent acts,” she knows the outcome will almost certainly be tragic. Yet when she looks from the scan to the exhausted young father, another memory shifts her thoughts from “trauma to love.” With each reading, this poem reveals more about the intertwining of outrage and compassion. (Art of Nursing is always free online—just click through to the PDF file.)

“I try / to meditate on emptiness, // receive the next lungful, ignore / my prattling mind,” says the narrator of Risa Denenberg’s poem “Three-Part Breath” (Art of Nursing, July). The poem’s title refers to a yoga breathing practice, one built on trust; as the yoga teacher says, “There will always be // another inhalation.” […]

2016-11-21T13:12:09-05:00August 12th, 2011|nursing perspective|2 Comments
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So What? An Invitation to Nurses To Tell Us How They’re Translating Research into Practice

By Inge B. Corless, PhD, RN, FAAN, professor at the MGH Institute of Health Professions, Boston, and Brian Goodroad, DNP, RN, AACRN, nurse practitioner and associate professor at Metropolitan State University in Minneapolis–St. Paul, Minnesota

by centralasian/via Flickr

Crossing the Quality Chasm, an Institute of Medicine report from 2001, bemoans the chasm between our current research knowledge and the current state of care. Back in 2003, Don Berwick, now the Administrator of the Centers for Medicare and Medicaid Services, provided the following pithy codification of the problem in a JAMA article called “Disseminating Innovations in Health Care” (subscription required; click here for the abstract): “Failing to use available science is costly and harmful; it leads to overuse of unhelpful care, underuse of effective care, and errors in execution.” Berwick pondered the slow pace of innovation adoption and attributed it to three factors:

  • the characteristics of the innovation
  • the characteristics of the potential adopters
  • contextual factors

Berwick also made this observation about innovations that do get adopted: “Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all.”

Given these obstacles, what can be done to facilitate the integration of research findings into practice? What can be done to change this situation, and what would this entail?

One step is to […]

2017-05-27T10:28:00-04:00June 17th, 2011|nursing perspective, nursing research|1 Comment
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Tragedy into Policy: A Hepatitis C Outbreak and a Study of Nevada RNs Lead to New Protections for Whistleblowers

By Sylvia Foley, AJN senior editor

In 2008, more than 62,000 people who had undergone procedures at one of two southern Nevada endoscopy clinics were notified that “they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices.” As author Lisa Black reports in this month’s CE–Original Research feature, a subsequent investigation by federal and state agencies found multiple breaches of infection control protocols. Indeed, 115 patients were found to be “either certainly or presumptively infected” with HCV through the reuse of contaminated medication vials.

Especially distressing was strong anecdotal evidence that because of a general fear of workplace retaliation, staff at the two clinics had often failed to report unsafe patient care conditions. At the request of the Nevada legislature, a study was conducted to examine Nevada RNs’ experiences with workplace attitudes toward patient advocacy activities. Black was the principal investigator. […]

2016-11-21T13:12:47-05:00June 7th, 2011|nursing perspective, nursing research|1 Comment
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The Monkey in Room 100

By Karen Gonzol, MSN, RN. Karen is an assistant professor in the division of nursing at Shenandoah University in Virginia. This is her first post for AJN.

I saw him again, just a few days ago. It has been nearly two years since Mother died, but there he was, peering at me from his perch in my sister’s laundry room.

Mother had been placed on hospice care for her congestive heart failure. She settled somewhat reluctantly into the nursing home and waited for the end.

As she discovered that the wait was going to be much longer than she’d planned, she decided to go on with living. Her room was on the first floor, with a window facing out into the courtyard. The staff loved her, and she loved to tease them. She made an effort to learn their names, and when she couldn’t remember she made up nicknames, such as “Bow Lady” for the assistant who always wore a huge bow to tie back her hair. One July day she began asking, “Do you see those monkeys in the tree out there?” […]

2018-03-27T16:36:22-04:00June 2nd, 2011|Nursing, patient engagement|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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