About Hui-wen Sato, MSN, MPH, RN, CCRN

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog.

Reexamining Resilience

Words matter.

As I have been presenting at various nursing gatherings and conferences about the topic of resilience in light of work-related grief, I have been struck anew by the definitions of resilience that I find in the literature.

  • The ability to return to a state of normalcy or to “bounce back” from adversity or trauma and remain focused and optimistic about the future (Dyer & McGuinness, 1996).
  • The “ability to face adverse situations, remain focused, and continue to be optimistic for the future” (Kester & Wei, 2018).

While I understand and very much appreciate the intent (and necessity) behind these definitions, I have to ask whether we are adequately exploring the meanings of the words used within these definitions and the implications for what nurses should expect of themselves in seeking to be resilient.

Does short-term resilience look different from long-term resilience?

For example, in the definition presented by Dyer and McGuinness, a resilient nurse should be able to return to a state of normalcy. There is certainly a need for nurses to be able to maintain a steadfast mind and emotional state in the short-term moments of acute crises with their patients. A nurse returning to work after a difficult shift just the day before has to […]

2018-10-23T10:04:47-04:00October 23rd, 2018|Nursing, nursing perspective, wellness|0 Comments
Read More

How a Patient’s Family Heals a Nurse in this Era of Medicine

“This family’s brave, selfless, and clear-minded approach to their daughter’s last days showed me that it is still possible for me and my colleagues to heal in the ways we want to heal, hurt in the ways we accept we will hurt, and not harm in ways we never, ever intended to harm.”

A painful contradiction of pediatric ICU nursing.

One of the things that feels most unfair about pediatric ICU nursing is that with critically ill children, you don’t get the comfort of being able to look back and say, “At least they lived a long and happy life.” You ache that a baby, a toddler, a school-age child, a teenager was supposed to have their whole life ahead. But instead, much of their short life was marked by illness, prods and pokes, lines and tubes, sedation rather than play, a sterile environment full of strangers at all hours rather than a home full of time with friends and family.

The deep desire in both the parents as well as the health care providers to do anything possible to give them a shot at a future is in and of itself right and good. Yet the decision about how much to push both medicine, and the child as the obligatory recipient, in the fight for a future that is neither guaranteed in quantity nor quality can often be wrought with controversy and ethical distress. Clinicians do not necessarily find peace with their work just because a life was physically saved; sometimes quite […]

2018-08-01T10:47:19-04:00August 1st, 2018|Nursing|0 Comments
Read More

What the Patient Knew: Communication and Patient Safety

Anticipating emergencies.

by rosmary/via Flickr

At the start of every shift after receiving report, I take a moment to consider what emergencies I might anticipate for my particular patient in our PICU. Monitor for excessive bleeding in a liver failure patient. Monitor for an altered neurological status in a patient with a head bleed. I try to envision how I would start CPR in the room if required. I try to be thorough in checking that all my emergency equipment is present and working. I try to keep patient safety at the forefront of my mind and priorities.

I came to work one day and received report about my 9-year-old patient who was post-operative day one from a planned craniofacial surgery. He would remain nasally intubated with eyes sutured shut for a few days until the swelling had reduced, and then would return to the OR to be extubated and to have the eye sutures removed. I’d had patients like him before and felt he would be very easy to keep safe, especially given that per handoff report, he was comfortably sedated and not overly agitated when he did briefly waken with nursing care.

A patient’s question.

As I got to know him through the first couple hours of my shift, I found that he was indeed comfortably sedated though […]

2018-05-24T10:08:09-04:00May 24th, 2018|Nursing, patient safety, Patients|0 Comments
Read More

The Nurse’s Temptation to Fill in the Patient Handoff Narrative

The limitations of handoff report

In bedside nursing, the nurse enters the story of the patient’s life at the point where the handoff report ends.

“Pt is an 8 mo old female, history of hypoxic ischemic encephalopathy (HIE), baseline 2L oxygen at home. Admitted to the unit for respiratory distress.”

Handoff report then goes through a systemic description of the patient’s current state: neurological, cardiovascular, respiratory, GI/GU, skin, and finally, psychosocial. The report is thorough but brief, never truly complete.

The oncoming nurse takes report and seeks to develop an accurate picture of her patient’s physiological state in order to anticipate emergencies and prioritize nursing interventions. But as any experienced nurse knows, no report can replace thorough and ongoing assessments—patients can change, and even the most expert nurses who have previously cared for this patient can miss details.

This holds true both in terms of a physiological assessment and a psychosocial assessment. What the nurse receives during handoff in terms of the patient and family’s psychosocial status is typically brief. “The patient’s parents are involved. Dad is a little more anxious and doesn’t stay at the bedside for long. Mom has a lot of questions, and she likes to help a lot with the hands-on care.”

Assumptions rush in to fill empty […]

2018-04-23T10:26:19-04:00April 23rd, 2018|Nursing|2 Comments
Read More

Strong Nursing Management Empowers the Why

“Our managers are effective leaders because they care for us, which empowers us to care for others, and for this we are indescribably grateful.”

I recently had the opportunity to speak at the American Association of Critical-Care Nurses (AACN) UCLA Chapter 2018 Leadership Symposium, which centered around AACN’s current theme, “Guided by Why.” Along with AACN president Christine Schulman, other nurses and I explored the importance of staying connected to our “Why” in the midst of considerable challenges in and to our profession.

I found myself considering not only my original answer to “Why do I want to become a nurse?” but also “Why do I stay in nursing?” I found that a significant part of my answer to the second question has to do with the managers I am privileged to work under. It is their strong management that continually fuels my underlying “Why.”

Genuine care for staff well-being.

Our managers demonstrate to us time and again that they see and value us as people, not just cogs in a wheel that needs to keep turning at all costs.

Self-scheduling allows for flexibility. In our unit, we have self-scheduling: all nurses determine their own shifts, so long as every shift is staffed with the minimum required number of nurses and everyone […]

2018-03-05T08:23:27-05:00March 5th, 2018|Nursing, nursing career|1 Comment
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top