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

Editor-in-chief, (emerita), AJN

Family Caregivers: Nurses by Default

Caregiver guides family member using safe stair-climbing technique. Photo courtesy of AARP Public Policy Institute.

We all know how compressed hospital stays are. Patients are frequently admitted and discharged within a few days, even for what used to be “big” surgeries. We dutifully send them home with discharge instructions—sometimes, pages of them—and often have only a few minutes to go over them with whoever is taking the patient home. And in many cases, that person is not even the one who will be caring for the patient, so instructions for medications and treatments are given second-hand. And we wonder why there are so many readmissions within 30 days!

Forty million plus unpaid caregivers in the United States.

As I note in this month’s editorial, there are over 40 million unpaid caregivers in this country who are administering complex medical and nursing interventions such as ostomy and wound care,  tube feedings, injections, and tracheostomy care, in addition to taking on bathing, toileting, and other necessary care. Many of these caregivers do so without any real training. Aside from the […]

2017-12-04T12:34:59-05:00December 4th, 2017|family caregiving, Nursing|0 Comments
Read More

Sexual Harassment in Nursing: Where Are We Today?

We have a weekly editorial meeting to review current issues and events that we feel are important to bring to nurses’ attention. Given that the headlines are replete with stories about sexual harassment and assault in various settings and workplaces and that nursing is still a profession with far more women than men, we felt this to be an issue of concern.

Before there were policies.

I’m sure many of us can recount experiences, our own or those of colleagues, that qualify as sexual harassment. Many of us may not have recognized it as such—when I began my career, there was no definition or policy that defined sexual harassment or alerted us to our rights if we were faced with inappropriate remarks or behaviors in the workplace. Now that there are requirements for such policies, nurses—men and women alike—should learn what the policies are and processes for reporting such misconduct.

First topic covered on this blog.

We looked to see how we’d covered this previously, and as it happens, the second post we published on this blog, back in February 2009—the one right after the post welcoming readers to AJN‘s new blog—was about the news that a nurse at a hospital in Queens had won a lawsuit for sexual harassment against a doctor […]

2017-11-21T08:11:27-05:00November 21st, 2017|Nursing|0 Comments
Read More

Are There Veterans Among Your Patients?

When vets get non-VHA health care, some issues may be missed.

Most U.S. veterans—and in 2014, there were approximately 19.3 million—do not get their health care from the Veterans Health Administration (VHA). Overburdened facilities with long waiting times and the fact that many veterans live considerable distance from a VHA facility mean that many get their health care from local and private organizations.

And while this may mean more convenient and timely care, it also might mean that health issues related to their military service might be missed by providers who do not have experience providing care to service members and veterans.

This Saturday, November 11, marks another Veterans Day. It’s been our tradition to include content related to health care for veterans or active duty military in November. This year, we have an original research CE article, “Primary Care Providers and Screening for Military Service and PTSD.”

Few providers screen for military service.

The authors of this article sought to examine whether non-VHA primary care providers were screening patients for military service and PTSD. Based on their survey of providers in western Pennsylvania, they found that most did not ask patients about a history of military service—and of those providers who did, few screened patients for PTSD. […]

2017-11-10T10:21:53-05:00November 10th, 2017|Nursing, nursing research|0 Comments
Read More

Sepsis Perfusion Assessment: A Matter of Seeing and Touching

A heightened level of care.

Sepsis is estimated to strike up to 3.1 million people in the United States each year, and in 2014 resulted in over 182,000 deaths. Patients who develop sepsis are subjected to an onslaught of procedures and interventions, from cardiac monitoring and transfer to the ICU to frequent blood sampling and insertion of central lines and urinary catheters. It is a frightening experience and requires attention to the patient’s experience and interventions to mitigate stress.

According to a clinical feature article in our October issue, “Assessing Patients During Septic Shock Resuscitation,” the revised six-hour bundle from the Surviving Sepsis Campaign includes a recommendation that, after initial fluid resuscitation, patients’ perfusion and volume status should be reassessed.

Noninvasive bedside indicators of perfusion and volume status.

click image to expand

This article focuses on measuring capillary refill time (CRT) and the skin mottling score (SMS; see figure at right) and details the evidence underlying the correct way to perform these assessments and how to incorporate findings into the overall plan of care.

One of the key advantages of these two measurements is that they are noninvasive and require no equipment—just the eyes and touch of an astute nurse—yet they are highly valuable in […]

2017-10-27T10:05:47-04:00October 27th, 2017|Nursing|0 Comments
Read More

Workarounds May Work, But They Perpetuate Dysfunction

Photo © Associated Press

A couple of months ago, we posted a query on Facebook asking visitors to the page if they had ever used workarounds—the improvised shortcuts that may not be the standard practice or the policy, but may allow for more efficient work processes. We were amazed at the uniformity of the responses. No one saw a problem with workarounds, and most responded along the lines of “I love my workarounds—couldn’t do my job without them” and “I’ll never tell—keep hands off my workarounds.”

Nothing new.

Workarounds have probably been around since Florence Nightingale’s day—I can imagine one of her nurses at Scutari hiding lamp oil so she’d have enough to make rounds at night. In my early nursing days, we hid sheets so we’d have some in case we needed an extra bed change for a patient. When I worked in the ER of a busy city hospital, we kept a pretty large supply of IV fluids and medications on hand in a closet. It became a well-known secret that the ER had its own stockpile—in fact, there were occasions when the pharmacy would come to us for meds!

Today, the workarounds I hear about tend to revolve around dealing with the electronic health record and scanning medication bar […]

2017-10-18T09:59:23-04:00October 18th, 2017|Ethics, Nursing, nursing perspective|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