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

Editor-in-chief, (emerita), AJN

The Buzz at Nursing Conferences about Quality and Healthy Work Environments

“I was struck by the preponderance of sessions dealing specifically with incivility and bullying (in both academia and practice settings).”

Recent back-to-back nursing meetings gave me a lot of food for thought. After attending conferences, I like to find the overall theme—not just from the scheduled topics, but from the posters and the exhibits and the general “buzz” from conversations. Here’s my take on the two meetings I attended this month.

ANA’s 2017 Translating Quality into Practice Conference

This conference started with an opening session focused on quality from a consumer point of view. Keynote speaker Harry Greenspun asserted that today “it’s the patient or family’s responsibility that the right thing happens at the right time by the right person.” Nurses, he said, are the group that needs to engage and empower consumers (who, he said, should only be called patients when they are receiving care) in improving care.

ANA president Pam Cipriano added that “nurses are the ones doing the work on quality—all the projects and quality improvement is being done on the backs of nurses.”

While some sessions focused on specific clinical practices (reducing hospital-acquired infections or falls, for example), many focused on broader aspects of quality improvement—how systems can support QI change and integrate new technology (mobile apps, simulation).

There was also discussion relating to staffing strategies and teams (though the cynic in me feels that much […]

Women’s History and Nursing’s History

This year’s theme of Women’s History Month, which we celebrate each March, is focused on women’s achievements in business and the labor force, but we don’t need this reason to take time out to remember the strong women who have shaped nursing. We certainly have many of them.

As I wrote in an editorial marking women’s history month in 2015:

Most people still don’t understand all that nurses have done—and continue to do—to improve health care. Most would likely recognize the name of Florence Nightingale. But I wonder if any other nurses would come to mind. I wonder how many nonnurses know that Lillian Wald developed the community health system (she founded New York City’s Henry Street Settlement), pioneered public health and school nursing, and helped establish the National Association for the Advancement of Colored People; or that Florence Wald (no relation to Lillian) brought hospice care to the United States; or that it was Kathryn Barnard’s research that established the beneficial effects of rocking and heartbeat sounds on premature infants, which is why most neonatal ICUs and newborn nurseries contain rocking chairs.

Lillian Wald and other notable nurse pioneers, 1923 March 2015 cover showing Lillian Wald and others at Henry Street Visiting Nurse Service, 1923.

Despite gains in professionalism and education, nurses still are […]

Why You Need to Know about the Proposed Health Care Plan

Rep. Paul Ryan, Wisconsin/Flickr/Gage Skidmore

AHCA Release Ignites Concerns from Right and Left

The administration’s plan to replace the Affordable Care Act (ACA) was released earlier this week and has ignited a firestorm among Republicans and Democrats alike.

Democrats claim the American Health Care Act (AHCA) will create havoc and hardship for millions of the most vulnerable.

Many Republicans are worried about the plan’s effect on their constituents, while more conservative members of the GOP feel it doesn’t go far enough in repealing the ACA.

While there is a stated push by the new administration to “sell” the plan and implement it quickly to keep campaign promises, legislators in both parties are calling for time to examine the plan and analyze the cost of the plan, which has yet to be determined.

As almost everyone knows, finding a way to provide affordable health care in this country is very complicated and requires a delicate balance of funding by the federal government and states. It’s likely that there will be several changes before a final plan is in place.

What seems to be clear is that the changes coming down the road will have a direct impact on nurses, patients, and the institutions in which we […]

ANA’s Cipriano, AARP’s Reinhard Comment on ACA’s Undoing

President Obama signing the ACA in 2010/via Wikimedia Commons

Nurses and the Undoing of the ACA

Many in the nursing community supported the Affordable Care Act (ACA) when it was first introduced. This is understandable, given our firsthand experience of patients who didn’t seek care until they were gravely ill because they lacked health insurance. We know how disease management can change outcomes for those with chronic illness and how preventive care can make the difference between having a treatable cancer or a metastasis.

In the years since, as both supporters and detractors continued to argue over the law and its need to be improved (or scrapped, depending on your viewpoint), over 20 million people gained health insurance and access to care.

Now as Congress moves to repeal and replace the ACA with a yet-to-be-determined plan, many are concerned that major gains will be lost and once again it will be the poor and vulnerable who will suffer. (I touched on some of the concerns in my March editorial.)

To get a little more insight, I spoke with two very policy-smart nurses about what might happen and what they feel should happen.

What ANA president Pam Cipriano said:

I asked ANA president Pam Cipriano what she thought was the most critical aspect […]

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’ […]

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