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

Editor-in-chief, (emerita), AJN

Why Didn’t Physicians Know What Nurses Know?

By Shawn Kennedy, AJN interim editor-in-chief

A recent post on our blog highlighted the experience of AJN’s associate editor Amy Collins in trying to get someone to diagnose the underlying reason for acute confusion in her grandmother. Over a two-week period, Amy’s grandmother was seen by various private and ED physicians, none of whom seemed to have an adequate diagnosis or a suggestion for treatment. Finally, nurses suggested that a urinary tract infection (UTI), fecal impaction, or some other infection might be a factor. It was a fecal impaction and yet none of the five physicians who previously evaluated Amy’s grandmother had thought about or assessed for it.

What the nurses said. Amy’s post generated many comments, both on the blog and on our Facebook page. What was interesting to me was how many nurses knew to first check for a UTI, electrolyte disturbance, or fecal impaction as a reason for confusion. Here are a few samples:

“Though not conclusive, in every case I have seen a change in cognition or behavior it was either a UTI or fecal impaction. I work in home health as a CNA and I am a nursing student.”

“The first thing I think to check is infection (UTI) with elderly, confused patients.”

“I’m a senior nursing student…and this material is on our exam that we are taking Friday. With acute confusion, always check for UTI and constipation.”

“Possible UTI. Possible dehydration &/or  constipation. Poor nutrition. All can (and do) manifest as “altered mental status.” Think I’d start with […]

2016-11-21T13:15:35-05:00September 27th, 2010|healthcare social media, nursing perspective|1 Comment
Read More

Searching for the Evidence? AJN Series Demystifies EBP

By Shawn Kennedy, AJN interim editor-in-chief

Trying to get evidence-based practice (EBP) implemented in your hospital or nursing home? Running into problems or just not quite sure how to proceed? Well, AJN has the answer.


EBP should be the basis for any clinical practice. Since last November, AJN has published a series of articles by the faculty at Arizona State University College of Nursing and Health Innovation’s Center for the Advancement of Evidence-Based Practice. Articles are published every other month and are designed to take the reader, step-by-step, towards implementing EBP. The current article describes the beginning steps to appraising the evidence; or go here to read the first article and follow in sequence.

Listen to a podcast with series leaders Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, and Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN, the authors of Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. And we’ll have a second “Ask the Authors” call in November (check our home page for details after November 1).

If you’ve had problems or hit snags on your journey to EBP, e-mail me (shawn.kennedy@wolterskluwer.com) so we can address these issues on our next call.

Bookmark and Share

2017-05-27T10:32:54-04:00July 21st, 2010|Nursing|0 Comments
Read More

Tech, EBP Buzzwords Among Nurse Researchers

By Shawn Kennedy, AJN interim editor-in-chief

As a lover of history, especially nursing history, I’ve been following Sue Hassmiller’s posts retracing the steps of Florence Nightingale with great interest and a bit of envy.

Well I went on a trip, too—to Sigma Theta Tau International’s 21st International Nursing Research Congress in Orlando. I was astounded by the truly international aspect of the meeting—many meetings say they are international if there’s a few hardy travelers from abroad, but there were many presenters, poster presenters and attendees from outside the United States.

What AHRQ does. Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHRQ), was the good choice for keynote. She shared some interesting data—like the fact that AHRQ is the leading funder of patient safety research in hospital and ambulatory care, or that the U.S leads the world in rates of hysterectomy. (While our rates are comparable with other countries for hysterectomy for endometrial cancer, they are “all over the map” for hysterectomy for noncancer diagnoses.) She also spoke about the agency’s research priorities—patient safety and quality of care, comparative effectiveness research, and reducing disparities in access to care for minorities and women (she acknowledged that “lack of health insurance is the biggest barrier”).

If there was a catchphrase from this conference, it was “evidence-based practice”—how to do it, teach it, evaluate it, and use it to transform practice, education, leadership style, and workplaces.

Using technology—virtual technology, simulation, social media, and Web technology—was another major theme, and presenters focused on […]

2016-11-21T13:16:35-05:00July 19th, 2010|Nursing, nursing perspective, nursing research|0 Comments
Read More

Nurses Under the Influence of Pharma—Not Just an NP Problem

The danger of an NP succumbing to influence is obvious—she or he may prescribe for reasons (which may be on an unconscious level) other than clinical ones. The issues for nurses who do not prescribe medications are subtle and different. AJN's ethics columnist Doug Olsen did a two-part series exploring this last year—in January and February 2009. And AJN's editor-in-chief emeritus Diana Mason wrote on this even earlier, in an editorial in December 2000, noting, among other concerns, that "it's not unusual to see drug company underwriting of speakers at nursing conferences; of course, the topic addressed is almost always related to one of the company's top drugs."

2017-02-02T12:17:38-05:00July 1st, 2010|career, Ethics, Public health|1 Comment
Read More

‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses

By Shawn Kennedy, AJN interim editor-in-chief

After I last wrote to you from the NTI (the American Association of Critical-Care Nurses’ annual National Teaching Institute and Critical Care Exposition), I headed back to the exhibit hall to check out the helicopter and the Army’s mobile operating tent. But I didn’t get to either one, because I met a young critical care nurse from a regional hospital in Missouri. We chatted about her workplace, and it was obvious that she was very proud of the work she and her colleagues did. When I asked her, “What’s your biggest issue?”, she said that it was probably staffing. I expected her to cite the shortage and the difficulty of finding qualified critical care nurses. But that wasn’t what she meant—rather she was talking about  bare-bones staffing because of tight budgets. Her hospital routinely switches between two tactics: it sends nurses home when the patient census is low (when this happens, the nurses are paid only $2 an hour to be on call, but must still use a vacation day to retain full-time benefits, a tactic that rapidly depletes their vacation time); or, when the patient census is higher, the hospital imposes mandatory overtime, creating havoc in nurses’ schedules, finances, and personal lives. And people wonder why there’s a nursing shortage! […]

2017-03-28T13:15:48-04:00May 20th, 2010|career, Nursing, nursing perspective, nursing research, safe staffing|33 Comments
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