Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Designing Nurses: Make Your Ideas Reality

“At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher…”

Earlier this month, the New York Times published an article, “Design Thinking for Doctors and Nurses.” In it, the author describes a simple solution designed by a nurse to identify who was in charge of a resuscitation team: whoever was wearing the orange vest was the leader.

As a former ED nurse who participated in many codes and trauma emergencies, I could easily picture the chaotic scene that led to this innovative solution. In a large urban teaching hospital, cardiac arrests and trauma calls draw many physicians and medical students, respiratory therapists, and of course, at least two to three nurses. It wasn’t unusual to have conflicting orders shouted out by physicians, residents chiming in with questions and suggestions, and the medication nurse making the decision as to which order she/he would process. At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher—only the physician in charge and resuscitation team were allowed inside the box. All other onlookers (mostly medical students and residents) had to stay outside the box and be silent. It did wonders for instilling a quiet, organized atmosphere into a highly charged event.

Left out […]

2017-08-16T09:22:11+00:00 August 16th, 2017|Nursing, nursing perspective|0 Comments

When Brokenness Transforms Nursing

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” appeared in AJN‘s August issue.

photo by Karen Roush/all rights reserved

I’ve had opportunities to sit in peer interview panels for new grad nurses looking to start their career in our unit, an experience which prompted me to consider what it takes to be a good nurse.

The obvious qualities were, well, obvious: critical thinking skills, strong communication, compassion, teachable, team player. But I’ve had a sense for a while that we nurses have been missing something when we consider what it takes to be a good nurse. While this something is strongly tied to empathy, it’s still a bit different. I tend to think of it as the nurse’s recognition and embrace of his/her own brokenness, even as the nurse looks to take care of others who are in some manner broken.

By brokenness, if the term is unfamiliar, I simply mean the awareness that we all know what it is to suffer, to struggle, to feel lost or wounded or weak. So in speaking of brokenness, I don’t mean it as a condescending lens through which we view everyone as objects to be fixed. I […]

2017-08-10T16:30:09+00:00 August 9th, 2017|Nursing, nursing perspective|3 Comments

AJN Facebook Readers on Influences, Public Attitudes to Nursing, Practices of Yesterday

We loved readers’ contributions to AJN’s celebration of Nurses Week.  For those who missed our Nurses Week Questions of the Day on Facebook, here are some highlighted responses to some of the questions:

What nurse has most influenced your nursing career?

There were many shout-outs to mentors by name, lauded for their grace, commitment, integrity, vast knowledge, and patience, or described as nurses who “role-modeled intelligence, compassion, and professionalism.”

Moms, grandmothers, and wives were often mentioned, as were instructors in both RN and LPN schools, and charge nurses. One nurse described being mentored by a paramedic, who “showed me how to remain caring in a system that so many times does not have time for the small things.” Another cited “every nurse I’ve ever worked beside” as a mentor, because other nurses model both the best and worst of nursing practice.

What do you think the general public doesn’t understand about nurses and nursing?

The number one frustration expressed in these answers was that we are often thought of as caring but not intelligent—that “we don’t know what to do until a doctor tells us.” But as one nurse succinctly put it, “We know what’s going on with you before you or the doctors know what’s wrong.”

Also high […]

When a Family’s Faith in Healing Collides with a Busy Hospital Unit’s Pressures

Illustration by McClain Moore for AJN/all rights reserved.

What happens when a family of strong religious faith is determined to continue praying for a young father’s healing even after he dies of a terminal brain tumor in the MICU? The room is needed for other patients; a nursing student and her preceptor cared for the patient during his final hours of life and are now expected to provide postmortem care.

It’s a tricky, somewhat tense situation, and initial reactions among the nurses in the hospital vary. Melody Sumter, the author of this month’s Reflections  (“A Place for Faith: My First Experience of Cultural Competence in Nursing“), was the nursing student assigned to the patient, who left behind a young wife and 10-month-old child.

Looking back on the event, Sumter recalls her competing sympathies at the time, and the way she was gratified to learn that the nursing staff at last found a way to honor the wishes of the patient’s family and also see to their responsibilities to other patients. Writes Sumter:

Seeing this family practice their faith was encouraging for a young nursing student like myself—as was the nursing staff’s acceptance and support of a belief that most of them didn’t understand.

The author […]

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 work. Will staffing be cut if states lose federal reimbursements? […]