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

Editor-in-chief, (emerita), AJN

Decreasing ED-Acquired Pressure Injuries

Perfect candidates for developing pressure injuries.

The photos of EDs crowded with patients waiting for admission at the height of the COVID-19 surges brought back many memories of clinical days in Bellevue’s ED. But even on our worst evenings, it was never like what I saw in those photos in the news media. And in some places, the ED hallways still have lines of stretchers with patients waiting to be sent to units.

In busy hospitals, patients can wait hours, sometimes a full day, on stretchers in the ED, waiting to be sent to a patient care unit. And we know that if they are being admitted for inpatient care, they usually have complex medical needs—many of these patients may be unable to ask for help, be incontinent, or unable to move themselves. These patients are perfect candidates for developing pressure injuries (PIs).

PIs can develop in a matter of hours.

As an article in the February issue of AJN notes, pressure injuries can develop in a relatively short time (the authors cite studies that found hospital-acquired PIs can “occur in as little as two hours of unrelieved pressure”).

The article, “Pressure Injury Prevention in Patients with Prolonged ED Stays Prior to Admission,” details how a nurse-led evidence-based practice (EBP) team sought to decrease hospital-acquired […]

2021-02-16T14:23:23-05:00February 16th, 2021|Nursing|0 Comments
Read More

AJN Articles from 1910 to 2020 for Inspiration and Perspective During Black History Month

Bernardine Lacey (middle) and classmates in 1961 at Gilfoy School of Nursing, Jackson, MI. Photo courtesy of Bernardine Lacey.

February is the month designated for remembering the contributions of Black people to our nation and our culture. It’s a good reminder that in nursing, too, we have benefited from many strong Black women (and at least a few men), who often persevered in the face of discrimination in obtaining education and jobs.

The AJN archives have many articles worth revisiting.

This article from 1976, “Black Nurses : Their Service and Their Struggle” (to read, click on the pdf), describes the struggles of several of our profession’s notable Black nurses, including Mary Mahoney (the first Black nurse to be licensed).

This article from our August 2020 issue, ‘You Don’t Have Any Business Being This Good’: An Oral History Interview with Bernardine Lacey,” shares Black nursing leader Bernardine Lacey’s experiences with racism in her education and career and explores some of the difficult truths about racism and the culpable role of nursing in this history:

Building on this perspective, read a conversation from our September issue with nurse, activist, […]

2021-02-03T09:54:28-05:00February 3rd, 2021|Nursing|1 Comment
Read More

DNR Does Not Mean Do Not Treat

Nurses and the meaning of DNR.

I recall a patient I had as a very new nurse who was designated as do not resuscitate, or “DNR.” The patient had suffered an intracranial bleed and because of his advanced age and untreatable cancer, his family had agreed that no CPR should be used. I remember the nursing supervisor asking me why the patient didn’t have a footboard and foam heel protectors on (that’s what we did back then); my answer was that he was a DNR patient. She basically handed me my head and said that his DNR status had nothing to do with good nursing care.

I never forgot that incident, and when I spoke with the authors of a mixed methods study with direct care nurses on three different units that found that “varying interpretations of DNR orders among nurses were common,” I immediately said yes. Their article is the original research article in AJN‘s January issue, “Nursing Perspectives on Caring for Patients with Do-Not-Resuscitate Orders.”

Families and providers may understand DNR differently.

And it’s not just nurses who may have different ideas and think differently about what should or shouldn’t be done for these patients who hover between life and death—other health care providers and families need to be clear on what that […]

2021-01-27T11:35:45-05:00January 27th, 2021|Nursing, nursing research|1 Comment
Read More

Getting Our House in Order

Nurses Address Structural Racism

In a webinar hosted by AJN, participants discussed nursing’s history and what nursing can do to eliminate structural racism in the profession. The first female dean of the George Washington University School of Law, along with nursing deans, educators, and clinicians offered  their insights and recommendations.

These are well worth considering as we pause to honor the legacy and work of Dr. Martin Luther King on Monday. We hope you’ll take a listen. (It’s free and you can earn CE credit. If the above link doesn’t work for you, try this one to register and view the webinar.)

2021-01-15T14:28:49-05:00January 15th, 2021|Nursing|0 Comments
Read More

Hospital Visiting Policies in the Days of COVID-19

Last month, I watched a YouTube video with two physicians, ZdoggMD (Zubin Damania) and Vinay Prasad, both active on social media, discussing Prasad’s perspective that allowing patients “to die alone is a human rights violation.” He argued that clinicians should not accept blanket rules from administrators and believes there are ways around what seems to have been standard practice in hospitals during the COVID-19 pandemic.

So when we asked on AJN’s Facebook page (December 13), “Should hospitals allow patients with Covid-19 to have visitors?”, I was surprised that the comments were split. Many respondents supported the need for patients to be able to have loved ones with them, but many others felt visitors shouldn’t be allowed because PPE was scarce or because visitors didn’t follow rules and, as one commenter noted, “We don’t have time to be the PPE police.”

No one should die alone.

Nurses have been assisting patients to connect with family members by tablets or mobile phones, or in many cases filling in as surrogate family at the time of death. A colleague told me that in her ICU, nurses decided no one would die alone and made sure that one member of the staff was there with the patient. And while this was comforting to many families, I know from a […]

2021-01-08T09:49:53-05:00January 8th, 2021|family, family experience, Nursing, Patients|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