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.

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
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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 meets […]

2018-03-05T08:23:27-05:00March 5th, 2018|Nursing, nursing career|1 Comment
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Tallying Losses and Gains of Being a Nurse, and Finding Profit

I was talking with a dear friend who was telling me how she went through a period when she had wondered whether nursing was destroying her. I can’t say what she actually meant by this for her own self, but the comment stood out to me. I found myself chewing on this notion that we can feel slowly worn down by the overall experience of nursing to a point where we feel the losses are not being offset by the gains quickly enough.

A certain loss of innocence.

Given all of the random tragedy, self-sabotage, and violence that nurses may witness in their patients’ stories, nurses can experience the loss of a more innocent, optimistic perspective about people and the world. Nurses often say there are things you cannot “un-see” in this line of work. Those experiences can darken the lens through which we see the world. The loss of faith in the assured wellness in the world can feel disheartening. It can be difficult to know how to process this in a way that does not simply leave us more fearful or cynical people.

The energy drain.

On a less philosophical level, it is […]

2018-01-18T10:04:58-05:00January 5th, 2018|healthcare social media, Nursing, writing|2 Comments
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Integrating Strong Emotions as a Developing Nurse

Most people, I would venture to say, start off in their profession with a fair degree of idealism, and this certainly holds true for nurses. When I talk with nursing students or new grad nurses and ask their story about why they chose nursing, the most common response runs along the lines of wanting to help others in meaningful ways.

Preparing new nurse grads for nursing realities.

In fact, I will meet with such a group of students this afternoon as I speak on a panel in the ethics class at my nursing alma mater. I, and other colleagues on this panel, want to encourage and inspire. But we will also be telling the students about the challenges we have encountered in situations involving moral distress, ethical dilemmas, and personal burnout. We will present situations when we felt that what we were doing at the bedside was not meaningful because we were only prolonging suffering—or, in other cases, so full of emotion and significance that it felt overwhelming to process.

We want to present the reality of nursing to these students, not to shatter their idealism, but to push them towards meaningful self-awareness from the start of their nursing career so that they are not caught off-guard by the degree to which they will be […]

2018-01-18T10:04:09-05:00December 8th, 2017|Nursing|2 Comments
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Learning New Skills of Supporting One Another as Nurses

I have had a couple of recent conversations with nurse coworkers who have been close witnesses to patient deaths that were particularly difficult. They told me how challenging it was to process the experiences with fellow nurses—even those whom they considered as good friends—in the hours and days immediately following the patient deaths.

Some conversations in the break room or in carpool rides would go into the medical details surrounding the deaths, but stayed away from discussing personal emotions beyond general statements such as “It was just really sad.”

Other conversations, they told me, were comprised of awkward silence—as opposed to a more intentional therapeutic silence, a deep listening. In both scenarios, my coworkers said they’d felt a lack of quality and depth in these encounters. While they hoped for an opportunity to talk with colleagues, who would surely understand the experience and details better than anyone else, ultimately they felt that they were left to sort out their thoughts and feelings alone.

Even in a unit where we constantly express gratitude for a strong sense of teamwork, my colleagues and I still struggle to help each other through the deeper experiences of grief and trauma.

A missed opportunity?

And at times when I’m in the charge nurse role and staff members are responsible for end-of-life care, I […]

2018-01-18T10:02:53-05:00October 20th, 2017|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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