About Shawn Kennedy, MA, RN

Editor-in-chief, AJN

Nurses and Patient Safety: Parallel Histories

Photo from AJN archives.

I’m especially pleased that one of the CE articles in the February issue focuses on nursing’s role in creating a safe environment for patients: “Nursing’s Evolving Role in Patient Safety.” And in full disclosure, I was excited to see that the authors used the AJN archives to chronicle how nursing addressed (or didn’t address) safety issues around patient care.

From the earliest days of nursing through to the current complex systems in which we practice, nurses have been the health professionals responsible for ensuring safe passage of patients through the health care system. From Nightingale’s criteria for creating a healing environment to the “5 rights of medication administration,” patients rely on nurses to act as sentinels.

The authors reviewed 1,086 AJN articles from 1900 to 2015 and conducted a content analysis to identify patient safety themes. Aside from uncovering many fascinating (and sometimes alarming!) details of former health care practices, the authors drew this general conclusion:

“Emphasis on patient safety increased as patient care became more complex. As nurses developed a professional identity, they often put a spotlight on safety concerns and solutions.”

Here’s a quote from a nurse who wrote in 1908 about nurses’ duties: […]

Black History in AJN: From Booker T. Washington To Today’s Influential Voices

Black nurses at Camp Sherman, Chillicothe, Ohio, in 1918.

Acknowledging Black History Month

February is the month designated for remembering the contributions of black people to our nation and our culture. It’s a good reminder that in nursing, too, we have benefited from many strong black women (and at least a few men), who often persevered in the face of discrimination in obtaining education and jobs.

The AJN archives have several articles worth revisiting.

This article from 1976, “Black Nurses : Their Service and Their Struggle” (to read, click on the pdf), describes the struggles of several of our profession’s notable black nurses, including Mary Mahoney (the first black nurse to be licensed).

In a 2010 editorial, Alicia Georges, professor and chairperson of the department of nursing at Lehman College of the City University of New York, writes, “We all stand to benefit from the active participation of black nurses in our communities and our lives.”

A 2013 commentary by Kenya Beard (an AJN editorial board member) and Kellie Voicy speaks to the need for increasing minority representation in nursing.

And a jewel: an article by Booker T. Washington, published in 1910, on nurses’ training at Tuskegee.

The above articles will be free until March 1. Please read them and become informed and inspired.

February 8th, 2017|Nursing, nursing history|0 Comments

Defending Against Moral Distress

A collaborative initiative offers recommendations to build moral resilience.

All nurses have at some point been faced with situations that challenge their values. Whether dealing with families or patients or the actions of colleagues, we may be faced with acting (or not acting) in accordance with our professional or personal values. I can easily recall several situations (which I detail in my February editorial) that involved unnecessary invasive procedures and surgery or removing life support.

Such situations take a toll on the individual and the care team and ultimately have a negative effect on patient care quality. Moral distress is not something that can be entirely eliminated—there will always be situations that provoke angst. But individuals can build moral resilience if they learn to recognize it when it occurs and if their organizations support them in finding ways to manage ethically challenging situations. […]

February 3rd, 2017|Ethics, Nursing|0 Comments

Health Care Terms and Words To Retire and Replace?

This week, two bloggers posted lists of words or terms they felt should no longer be used when referring to health professionals or patients.

  • Harrison Reed, a physician assistant who writes for In Practice, a blog at NEJM Journal Watch, wrote “Seven Medical Terms to Ditch in 2017.” On his list was LFTs (liver function tests); regular rate and rhythm (RRR): little old lady (LOL); AAM or AAF (other potential objections aside, these are often taken to mean African-American male or female, but can just as easily mean Asian-America male or female); and nauseous when one actually means nauseated. He also would like to see an end to the use of the modifier “midlevel,” as when it’s used to refer to NPs or PAs as “midlevel providers.”
  • Over at KevinMD.com, physician Pamela Wible published “Stop saying these 7 shaming words in medicine. Right now.” Her list included phrases to abandon, along with replacements that she believes to be more accurate and/or respectful. For example, she advocates replacing “is bipolar” with “has bipolar disorder.” She also wants to replace the phrase “is the patient noncompliant?” with “is the treatment working?” “Noncompliant,” as she points out, conveys blame. (Nonadherence may now be the preferred term—there are many reasons someone may not be able to adhere to a […]

AJN: Holding the Line on Quality in 2016

In the midst of the day-to-day demands of our lives and the constant multitasking, it’s often hard to step back and think about where the time went. Days and events seem to blur together. During the last week of the year, I like to review my calendar. I find that this exercise helps me put the year in perspective and revisit what I’ve done and who I’ve done it with.

My December editorial, “Taking Care of Business,” addresses how we can sometimes overlook colleagues who go about doing their jobs with little drama or complaint: the volunteers who give their time to free clinics, those who serve in the military or public service, the quietly competent colleagues we work with every day. They can easily become part of the blur of passing days because they show up, do their work, and move on to the next thing that needs to be done.

In the editorial, I briefly mentioned my colleagues here at AJN in that category. The staff works diligently to ensure that all manuscripts are fact-checked for accuracy and are edited to present the content in the best light and form. After a first round of editing, the articles are then copyedited. They’re laid out in page proofs and go through additional proofreading by a copy editor, nurse editors, and the article’s author(s). The process can be painstaking and repetitive, but accuracy and quality don’t happen without careful attention.

While AJN has […]

December 27th, 2016|Nursing|0 Comments