About Guest Author

This author has not yet filled in any details.
So far Guest Author has created 494 blog entries.

Open Medical Records: A Question of Safety

By Christine Moffa, MS, RN, AJN clinical editor

We’ve all watched our health care provider writing or typing while we answered questions or described our symptoms. Before becoming a nurse I used to wonder what they were putting in my chart and if they got it right. And now that I am a nurse I can’t believe how often a medical assistant or nurse will take my vital signs and write them down without telling me what they are. How can it be possible that adults are kept from knowing their own or their children’s health information? Back when I worked on a pediatric floor my colleagues gasped in shock when I allowed a parent of one of my patients to look at his child’s chart. And I actually let them make me feel like I had done something wrong!

Last week this issue was the topic of a column by Dr. Pauline W. Chen in the New York Times, where two related blog posts (here and here) also received much reader commentary. The sudden flurry of interest in the subject was occasioned by an article published in the Annals of Internal Medicine detailing the preliminary findings of a study following a national project called OpenNotes, funded by the Robert Wood Johnson Foundation, in which “more than 100 primary care physicians and 25,000 of their patients will have access to personal medical records online for a 12-month period beginning in summer 2010.” Readers’ comments ranged from one extreme to the other, such […]

On Difficult Truths, Anger, and Compassion: Recent Poems in ‘Art of Nursing’

By Sylvia Foley, AJN senior editor

“Why couldn’t you leave cleanly?” asks the narrator of Ann Sihler’s poem, “Leavings,” featured in the June Art of Nursing. The poem, written in response to a suicide, speaks to the emotions of those left behind. Its central image, a pair of “oxblood loafers lying there / for all to see,” is somehow both mundane and horrifying. It’s a stark poem, suffused with the narrator’s anger; yet its lack of pretension also affords us  relief.

The married man with “schoolboy cheeks” in Nancey Kinlin’s poem, “Practicing at Post Office Square,” has just heard what no one wants to hear: “the result / is positive.” The poem, featured in July’s Art of Nursing, gives us the disclosure—from the nurse’s point of view. It’s a poem about mistakes and compassion, about what it feels like to be the one delivering bad news. Kinlin’s spare, clear writing doesn’t flinch from its difficult subject.

Both poems are free online (you’ll need to click through to the PDF files). We invite you to have a look, sit with them, and tell us what they evoke for you in the comments.

Bookmark and Share

2016-11-21T13:16:20-05:00July 30th, 2010|nursing perspective|0 Comments

Supporting Nurse Practitioners as ‘Priority Primary Care Practitioners’

By Susan McBride, PhD, RN, professor at Texas Tech University Health Science Center School of Nursing

It’s important for nurses to understand the Medicare and Medicaid incentives to implement electronic health records (EMRs) and to move to their “meaningful use,” as well as the purpose of the Regional Extension Centers created to support nurse practitioners and other “priority primary care providers” in the implementation process.

Dr. Mari Tietze, John Delaney, and I are fortunate to be involved in two of the Regional Extension Centers in Texas. We believe that nursing professionals have many contributions to make in the evolving electronic highway in the U.S. We will blog later about our roles as nursing informaticists in the Regional Extension Center program.

What are ‘Regional Extension Centers’? Under the Office of the National Coordinator (ONC) Health Information Technology Initiative to support getting providers to meaningful use on electronic health records, the ONC has established Regional Extension Centers. There are 60 Regional Extension Centers that will furnish assistance to providers in specific geographic services areas covering virtually all of the U.S. A total of $643 million is devoted to these centers.

The purpose of the Regional Extension Centers is to support priority primary care practitioners in priority settings to implement and use EMRs according to the meaningful use requirements outlined in our previous post (below is a screenshot illustrating one example of how an EMR might align with meaningful use requirements; click image to enlarge). The goal of the program is to provide federally subsidized outreach and support […]

2016-11-21T13:16:22-05:00July 29th, 2010|digital health, Nursing|1 Comment

‘Meaningful Use’: What’s It All About, And Why Should Nurses Care?

By Susan McBride, PhD, RN, professor at Texas Tech University Health Science Center School of Nursing. McBride and fellow nurse informaticists Mari Tietze and John Delaney will be blogging here on the intersection of nursing and informatics in the coming days. 

Everyone knows by now that the Obama administration has made electronic health records (EHRs) a high priority and is providing financial incentives to health care providers (and yes, nurses are included in that group) to adopt them. But not everyone knows it’s not just about converting records from paper to digital—its much more than that.

On July 13, the Office of the National Coordinator (ONC) for Health Information Technology (HIT) released the final rules establishing definitions for the “meaningful use” of EHRs. The final rule is 864 pages and contains critical information for nurses to understand about how electronic records will change our lives. 

(No one expects every nurse to read the entire document. That’s why we’re going to be blogging about some important aspects of the topic. In the meantime, click here for a good overview of meaningful use and electronic medical records, as well as links to more exhaustive information. And for a short, useful table breaking down the rule by health outcomes policy priorities such as “improving care coordination,” have a look at this PDF: Stage 1. Meaningful Use Objectives and Associated Measures Sorted by […]

2016-11-21T13:16:23-05:00July 26th, 2010|digital health, Nursing|6 Comments

Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life

The final post in a series by Susan Hassmiller, Robert Wood Johnson Foundation (RWJF) Senior Adviser for Nursing, sent to us as dispatches from her summer vacation spent retracing Florence Nightingale’s influential career. The full series can be found by clicking here.  

My husband has called this trip a “game changer” for me, and indeed it has been.  I see things differently now, including our health care system . . . and the critical contributions that nurses are making, and need to continue making, to improve care for patients. Of course, I always knew this, but somehow this ups the ante for me—and I will use my new education to up the ante for nurses. I have learned so much, but let me share these 10 lessons I gleaned from Ms. Nightingale.


1. Never, ever stop learning.

A broad education in the arts and sciences helps with critical thinking and making important connections that lead to action. I saw how Florence used her knowledge of math, statistics, sanitation, religion, and architecture to put a holistic plan together to improve the systems that care for patients.

2. Ground yourself and your work in facts and evidence.

Make your case indisputable.  Everyone should do this . . . not just those who call themselves “researchers.”

3. Muster the courage to follow your convictions.

Step beyond what you think you can do.

4. Treat every person holistically.

Every person has […]

2026-05-07T12:08:10-04:00July 22nd, 2010|nursing history|10 Comments
Go to Top