About Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)

Editor-in-chief, (emerita), AJN

Hypertonic vs. Hypotonic, Osmolality, and Other Fun Nursing Concepts

We hang fluids with varying concentrations of electrolytes in response to specific lab results, but how much do we actually remember what is going to happen physiologically?

Revisiting the fundamentals of fluid and electrolyte balance.

I remember first learning about fluids and electrolytes in undergraduate physiology, and then again all throughout medical-surgical nursing courses. When I was in orientation for my first position as an ED nurse, it was included in the critical care course. Sounds like that should have been enough—but it wasn’t.

Understanding the underlying science matters.

The basic concepts underlying the body’s mechanisms for keeping systems functioning are complex processes involving the ebb and flow of fluid and molecules controlled by several systems. It’s a delicate balance and one that we all learn in basic nursing education, but then usually recall little of it when we practice.

We hang fluids with varying concentrations of electrolytes in response to specific lab results, but how much do we actually remember what is going to happen physiologically? We know the protocol of what to infuse when, but we’re hard-pressed to explain the science underlying our practice. This is a concern because nurses are usually the first ones to review laboratory results and need to understand the implications of abnormal results and what might be an […]

2020-01-21T12:02:37-05:00January 21st, 2020|Nursing|0 Comments
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Need Motivation to Write? Submit to the AJN/Nurse Faculty Scholars Mentored Writing Award

You know you should write, and you have several topics running through your mind, but you just can’t quite get it together—how to start, how to choose the topic, where to start . . . .

Well, you don’t have to go it alone.

Mentored writing.

The 2020 AJN/Nurse Faculty Scholars Mentored Writing Awards program is open for submissions. This is an annual program to promote mentorship and develop scholarly writing skills among nurses. It was conceived by the 2012–2015 cohort of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars Program, in honor of the mentorship they received.

This award was created to continue the legacy of mentorship and to support scholarship development for all nurses, and AJN is continuing this program as part of our mission to support excellence in nursing publishing.

The 2019 winner.

The winner of the 2019 award is Sara Wohlford, MPH, RN, from Roanoke, Virginia. She worked with her mentor, Kimberly Ferren Carter, PhD, RN, NEA-BC, to coauthor their winning article, “Nursing Engagement Improves Sustainability Outcomes for Healthcare,” which will be published later this year. […]

2020-01-07T11:52:02-05:00January 7th, 2020|Nursing|0 Comments
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The Burden of Diabetes

It’s exhausting, it is exhausting. It really is, to constantly take care of yourself and have to worry about everything you eat, everything you do, every move you make.

Flickr / Harshit Sekhon

This quote is from the original research article in AJN’s December issue, “Experiences of Diabetes Burnout: A Qualitative Study Among People with Type 1 Diabetes.” (You can read it for free and can also earn CE credits.)

Defining burnout.

The report details the results of interviews conducted by the authors to learn more about diabetes burnout, a phenomenon they define as “a state of mental, emotional, and physical exhaustion following an apathetic detachment from one’s illness identity, diabetes self-care behaviors, and support systems, which is commonly accompanied by a feeling of powerlessness.”

In the interview excerpt above, one of the study participants, a 36-year-old woman with type 1 diabetes, aptly describes the constant attention required to manage the disease. This relentless focus on time, diet, activity, and blood glucose levels are wearying in themselves. When this 24-7 effort is still not enough to control glucose levels, the resulting sense of frustration and lack of control contribute to burnout. […]

2019-12-17T10:05:56-05:00December 16th, 2019|Nursing|0 Comments
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EHRs: Losing the Nuances of Nursing Care, and the Value

Image by mcmurryjulie from Pixabay

Our December issue is out, but before we move on from the November issue I want to highlight the Viewpoint, “Advocating for HIT That Captures Nursing Process.” It’s about something that greatly affects nurses’ work, seems to be the bane of all clinicians, and, I think, often prevents individualized patient-centered care.

I’m referring to the electronic health record (EHR), a system built to capture data important for billing and tracking aggregate patient outcomes—but arguably not designed for what clinicians deem as most important for understanding and documenting patient care.

Dylan Stein and colleagues Jasmine Travers and Jacqueline Merrill write what most nurses know about EHRs:

“The nuances of our care get lost in task-oriented, quantitative drop-down menus and checkboxes, while the qualitative value of our interventions and impressions are not encoded in a useful way.”

Nursing notes devalued.

In the old days BC (before computers), clinicians used some checklists for charting but also relied heavily on narrative notes to describe the patient’s individual story. While there are areas one can add notes in an EHR, nurses tell me that it’s not very easy to do so and that no one really reads them because they’re […]

2019-12-05T12:03:16-05:00December 5th, 2019|digital health, Technology|2 Comments
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Caregivers Home Alone-And Needing Our Support

Family caregivers performing complex care.

When my mother needed care at home in her final days, she was fortunate in that two of her daughters were nurses who were familiar and comfortable in providing her care. We were fortunate in that she did not require complex care like tube feedings or IVs or ostomy care or wound care or dialysis. But many people do, and must rely on family members to do these complex tasks.

I remember how I felt as a nursing student when I had to administer one of these complicated interventions. I remember being anxious, my hands sweating as I desperately tried to recall the list of instructions I had looked up the night before.

And yet I had an instructor with me to walk me through it. Family caregivers have no such support and often don’t even get adequate instruction beforehand.

Family caregivers need more than recognition.

November is National Family Caregivers month and I can’t think of a group more in need of recognition. But while naming a month in their honor is nice to increase awareness of the more than 40 million family caregivers in this country, they need much more than that. Specifically, they need more in the […]

2019-11-18T11:16:45-05:00November 18th, 2019|family caregiving, family caregiving, Nursing, Patients|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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