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

Editor-in-chief, (emerita), AJN

Killing Traditional Nursing Duties #1

By Shawn Kennedy, MA, RN, AJN editor-in-chief

We recently had a lot of feedback to a question we posted on our Facebook page: “We know old habits die hard and nursing has a lot of them. What old habits do you think we should kill? NPO after midnight? Routine temps on every patient?”

We got several good responses:

– Waking patients up at 4am for blood drawing, routine vital signs

– Measuring intake and output on every patient

– Taking routine temps

– Giving dorsogluteal IM injections

– Doing a skin prep for an IV by swabbing the site in a circular motion, inside to out (some manufacturers of products are instructing that skin prep be done by a scrubbing motion)

– Enemas before childbirth

– Double documenting

– Rushing to give medications right on time (which makes one prone to error)

– NPO after midnight

Choosing from the above, we then asked this: “Survey question #1: Do you routinely wake patients up at night to check their vital signs? If not, when would you?”

This question received many comments, from “Of course not” and “only when necessary” to “If a doc orders q 4 vs and you don’t do it and something happens to the patient, that would not be good for you AT ALL.” Also this: “Orders are orders which we must follow.”

Commenters cited several stories of recent postoperative patients (who, I agree, should have vital signs frequently monitored) who could have suffered grave consequences had the nurse not woken them […]

2016-11-21T13:12:04-05:00August 24th, 2011|healthcare social media, nursing perspective|6 Comments
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Thoughts After an INANE Editors Conference

By Shawn Kennedy, AJN editor-in-chief—I just returned from 10 days out of the office, a long time for me. The first three days were in San Francisco at the annual conference of the International Academy of Nursing Editors (or INANE), a group that steadfastly declares itself a non-organization, with no officers, no dues, and no bylaws.

Begun almost 30 years ago, the group depends on the goodwill of its 200+ members, who volunteer for Web site operation, take turns organizing the annual meeting, and contribute when needed to support small expenses like mailings, Web site fees, etc.

It’s simple and it works. This year’s conference covered things editors of nursing journals find interesting—copyright, impact factor, ethics, and the like (see INANE’s blog, From the Editor’s Pen—“Cherry Ames” blogged from the conference!), plus a lot of great networking. (Full disclosure: the conference was sponsored by the specialty nursing journals of Lippincott Williams & Wilkins, AJN’s publisher.)

I’m always struck by the breadth and variety of nursing knowledge among the members of this group—there’s everything from skin and wound care and infusion practices to broader topics like oncology and home health. (Not to mention a few broad-based journals, like AJN, that cover all of nursing.) The editors of these journals are passionate about meeting the needs of their readers—for some association journals, this […]

2016-11-21T13:12:08-05:00August 16th, 2011|Nursing|4 Comments
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New Medical Residents and Patient Mortality – Does the ‘Nurse Effect’ Lessen the ‘July Effect’?

Last week, a post on the New York Times Well blog discussed whether mortality rates in hospitals are worse during July when new interns and residents begin their clinical training. It described findings from three studies, with the final conclusion, “Though the debate continues, most studies have not found a spike in hospital mortality rates in July.”

It was common thinking in hospitals when I worked clinically—“Never be sick enough to have to go to a hospital the first two weeks of July, and NEVER, EVER need surgery during that time”—and I’d venture that many people still believe it, despite what studies may report. (And, as I write, I see that ABC News is reporting on a new review of 39 studies, published in the Annals of Internal Medicine, that does support the existence of the July Effect. Click the image below for the ABC article and videos.)

I remember working in the ED when the new residents on call would come to see patients, their “whites” impeccably spotless and starched, with new blank index cards in their pockets, looking eager and anxious to finally be getting to the real work of their profession. By mid-August, they all seemed a bit haggard, the whites rumpled and the pockets torn […]

2018-04-26T10:16:40-04:00July 12th, 2011|nursing perspective|2 Comments
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Bullying Wars: Theresa Brown vs. ‘the entire physician profession’

By Maureen Shawn Kennedy, AJN editor-in-chief

On May 11, an op-ed piece written by nurse and New York Times blogger Theresa Brown on bullying by physicians caused some physicians to protest (full disclosure: Brown’s honest and moving ethical meditation on a very different topic, “Right Treatment, Right Patient?”, was just published in our June issue).

Notable among her critics was Kevin Pho of the popular blog, Kevin MD, who wrote that Brown “unfairly blames doctors for hospital bullying.” He claimed that Brown uses her writing outlet to “metaphorically bully the entire physician profession.” Another commentary (by physician Ford Vox, writing in The Atlantic Monthly) accused Brown of publicly “drawing and quartering” her colleagues.

Spare me, please. Brown used a recent personal encounter to illustrate a problem that is, unfortunately, commonplace in hospitals.  She used it as a lede and parlayed the story into an insightful piece about bullying in hospitals.  (From experiences I had and witnessed during my clinical years, I actually thought it was a fairly mild example.) Ironically, the strong language used to counter Brown’s commentary made it seem that physicians were trying to bully Brown into silence because she’d spoken out. As if to say: how dare a nurse challenge physician behavior?  […]

2016-11-21T13:12:51-05:00June 1st, 2011|career, healthcare social media, nursing perspective|6 Comments
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Same Boat, Different Ocean

By Shawn Kennedy, AJN editor-in-chief

Since the Robert Wood Johnson Foundation/Institute of Medicine Future of Nursing report was released six months ago, we’ve heard a lot about how nurses need to have more representation on boards of health care institutions and be more active participants in decisions about redesigning health care delivery systems. (See our online resource page for a variety of information about the report.)

To me, it’s a recommendation that’s so intuitive and simple that it’s almost embarrassing—and the need for it only drives home how absurd our health care system can be. It’s mind-boggling to me that organizations feel they can plan effective health care without the input of nurses. Imagine aircraft manufacturers designing a plane without input from the primary group—pilots—who will be responsible for flying it safely.

I suppose many health care entities and boards  feel that they have this input from physicians—but really, in most hospitals physicians aren’t involved in the nitty-gritty operations details that either make or break workflow processes or can impede the delivery of safe, cost-effective care.  How many times have hospitals planned patient care units or purchased equipment without nursing, input only to find that the systems aren’t workable or create more work? […]

2016-11-21T13:13:34-05:00April 12th, 2011|health care policy, nursing perspective|12 Comments
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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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