Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.
While attending this year’s American Association of Critical-Care Nurses National Teaching Institute meeting, AJN editor-in-chief Shawn Kennedy heard a story that she felt all nurses needed to hear as a reminder of the impact a nurse’s advocacy can have on a patient.
Critical care nurse Katie George, just a few years into her career when the events in the story took place, was caring for Ms. A., a young woman whose spinal cord had been nearly severed in a car accident.
Faced with a prognosis suggesting that Ms. A.’s quality of life would be poor and that she would have to remain on a ventilator, Ms. A.’s family made what they felt was the humane decision to have her removed from life support. But Ms. A.’s fiancé—and her nurse Katie George—were convinced that Ms. A., who seemed to be able to communicate by blinking in response to questions, should at least be given the chance to make the decision for herself.
Ms. A. was suffering from locked-in syndrome, a condition in which the patient is conscious and eye movement is functional despite full body paralysis. Giving her a chance to decide her own fate would require finding a way to legally validate Ms. A.’s mental capacity, although her physicians felt that this might not be possible. […]
Towards a Safer Health System
Ever since the famous report To Err is Human: Building a Safer Health System was issued by the Institute of Medicine (now the National Academies of Sciences, Engineering, and Medicine) in 1999, health care institutions have been pushed towards reducing errors and increasing safety.
Changes have been spurred by accrediting and government organizations like the Joint Commission and the Centers for Medicare and Medicaid Services, by independent and professional initiatives like the Institute for Healthcare Improvement and the Magnet Recognition Program, and by consumer advocacy groups like the The Leapfrog Group and the National Patient Safety Foundation.
Nursing Education and Quality Improvement
Nursing, as the largest department in hospitals and the one tasked with shepherding patients through the system, is a key player in any system redesign and many nursing departments are playing an active role in improving the safety and quality of care.
Nursing education has also embraced the QI movement, adopting the Quality and Safety in Nursing (QSEN) program in many curriculums and also making it a hallmark of its doctor of nursing practice (DNP) programs. Developing and implementing QI projects is frequently a requirement for completing these programs. […]
By Linda MacIntyre, PhD, RN, chief nurse of the American Red Cross
The Clara Barton Tour officially began last evening. Participants gathered for dinner and conversation. Annie Bartholomew, long a student of Clara Barton, gave a brief overview of Barton’s life, with teasers for her upcoming presentation on the bus. Annie has stories to tell that might best be revealed over a glass of wine.
Reasons given for coming on the tour included
- not having heard of Clara Barton and thinking it was time to learn about her,
- over 40 years of studying Clara’s life,
- a birthday gift from a husband.
And many came because of their connection with Sue Hassmilller, long-time volunteer and board member. It is Sue’s vision and energy that made the Clara Barton Tour possible and we are saddened that she’s not able to participate due to a family emergency. Sue’s wish for us is to enjoy the tour and to send prayers. We’re committed to doing both. […]
Most eventually learn the skills and knowledge they need to succeed in the profession. But some may struggle more than others with the emotional intensity of the work. A question that seems to come up a lot when nurses write about their work goes something like this: How do you keep caring as a nurse and not get burned out? How do you develop a resilient professional persona?
This month’s Reflections essay, “How I Built a Suit of Armor (and Stayed Human),” by Jonathan Peter Robb, enumerates the challenges faced by a sensitive new nurse and the ways he found to protect himself over time. Here Robb, a district nurse for the National Health Service in London, England, describes one kind of challenge he faced:
The weight of being responsible for a person’s health wasn’t one I had prepared for. Sitting in lectures doesn’t train you for the moment when you’re standing at the end of a bed looking at a patient who is struggling to breathe, semiconscious (but who just last week was sitting up and talking), and thinking: Did I miss something? Is this my fault?
As Robb writes, “caring hurts.” Gradually he found himself building defenses that helped him to continue doing the work. Robb calls the development of these defenses “building a suit of armor,” one he can take off when he goes home to his family—but as he describes the process, it seems clear that he’s never allowed himself to slide into callousness about his patients. […]
Yesterday was the 15th anniversary of the September 11 attacks. On my way to work in Manhattan on Friday, I listened to a radio program about the lives of some of those who were involved one way or another in the tragedy of that day.
I heard the shaky voice of a Boston airport ticket agent who had assisted one of the hijackers to get on one of the flights that struck the World Trade Center. He’s met some of the victims’ family members and say that he still feels tremendous guilt and suffers from bouts of depression, especially on anniversary dates. He now works for Homeland Security. […]