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

AJN in February: Rapid Response Teams, Complications of CHD Repair, Managing Type 2 Diabetes, More

AJN0215 Cover OnlineAJN’s February issue is now available on our Web site. Here’s a selection of what not to miss.

Rapid response teams (RRTs) are teams of expert providers who can be called on in an emergency to treat patients before their condition deteriorates. The success of an RRT depends on whether it is activated properly, a task that often falls to staff nurses. The original research article, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis,” describes the factors affecting nurses’ decisions to activate RRTs. This CE feature offers 3 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Long-term complications after congenital heart defect (CHD) repair. Nurses often encounter patients with complications that occurred years after CHD repair. “Long-Term Outcomes After Repair of Congenital Heart Disease: Part 2” reviews four common CHDs, their repairs, common long-term outcomes, and implications for nurses in both cardiac and noncardiac settings. This article offers 2.5 CE credits to those who take the test that follows the article.

Making nurses full partners in reforming health care. The Institute of Medicine’s report, […]

2016-11-21T13:03:07-05:00January 29th, 2015|career, Nursing, nursing perspective|0 Comments
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Nursing Perspective: Why I Work in Corrections

By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.

Michael Coghlan/Flickr Michael Coghlan/Flickr

When I go to work, I go through a metal detector (did you know Danskos contain metal?), and all my belongings are scanned or gone through. I check out keys and a radio, and then I go through a series of sally ports to get to the medical area. I count every needle and pair of scissors I use. I never see patients without an armed guard nearby, and a good portion of my patients are cuffed and shackled. I’m on camera from the second I get out of my car.

Welcome to prison, nursing style!

“Why?” people ask me. “Couldn’t you get another job? Aren’t you scared? Didn’t you like the ER?” I worked in critical care/emergency nursing for a long time, and yes, I did like it. I brought those skills with me to corrections, where they are a lock-and-key fit. A surprising number of corrections nurses are ex-ER nurses. The same personality types work well in both settings.

Corrections nursing involves phenomenal nursing autonomy and uses many of the skills I honed in the ER:

  • quick triage
  • multitasking
  • sorting out who is lying from who is sick
  • knowing which assessments are the most important for each situation

The atmosphere tends to be quirky to chaotic and requires imagination, flexibility, and an ability to string […]

2016-11-21T13:03:08-05:00January 23rd, 2015|career, Nursing, nursing perspective|21 Comments
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Cassandra’s Refusal of Chemo: Nurse Ethicist Ponders Ethics of Forcing Treatment

Douglas Olsen is an associate professor at the Michigan State University College of Nursing in East Lansing and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

scalesThe case of Cassandra, a 17-year-old female in Connecticut being compelled by the court to undergo chemotherapy for Hodgkin’s lymphoma, has aroused interest in the media and among bioethicists, who have offered mixed conclusions. (Here’s a recent update on Cassandra’s legal status.) For example, Ruth Macklin concludes that the actions taken to force the treatment were not justified, while Arthur Caplan concludes that compelling her to have the chemo is justified. Both are scholars of the highest order.

I agree with Caplan that she should be given the chemotherapy, but my purpose here is to illustrate that perspective plays an often unacknowledged role in ethical analysis. When feelings and personal perspective go unacknowledged, the analysis loses credibility and depth.

The principles in conflict in this the case are straightforward for ethicists: respect for autonomy versus beneficence.

As a society, we value control over personal choice, that is, autonomy, which would mean honoring Cassandra’s decision to forgo the chemo. The chief justification for overriding a patient’s autonomy is that the patient lacks decision-making capacity because she is a minor.

However, we also value doing what is best […]

2016-11-21T13:03:09-05:00January 21st, 2015|Ethics, Nursing, nursing perspective, patient engagement, Patients|1 Comment
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Calling All Nurses to Address Health Disparities

Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action.

The author with nursing students at the Rhode Island Nurses Institute Middle College, the first charter school in the country for high school students who want to major in nursing. The author with nursing students at the Rhode Island Nurses Institute Middle College, the first charter school in the country for high school students who want to major in nursing.

The research on health disparities is stark and continues to increase. The Centers for Disease Control and Prevention’s Health Disparities and Inequalities Report–2013 found that mortality rates from chronic illness, premature births, suicide, auto accidents, and drugs were all higher for certain minority populations.

But I believe passionately that nurses and other health professionals can be part of the solution to addressing these disparities. Nurses are privileged to enter into the lives of others in a very intimate way—lives that are often very different than our own.

I understand that it is human nature to be more comfortable with the familiar, but this is not what we are called to in nursing. More […]

2016-11-21T13:03:11-05:00January 16th, 2015|career, Nursing, nursing perspective, Patients|3 Comments
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A Brief Meditation on Love, Loss, and Nursing

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Manicure, by Julianna Paradisi, 2014 Manicure, by Julianna Paradisi, 2014

As a child, I remember being afraid to fall in love, because I didn’t want to experience the pain of losing people I loved when they died. I don’t know why I thought about this; I only know that I did.

Becoming a nurse has done absolutely nothing to alleviate this fear, but life experience has, to some degree.

Nursing is hard not only because we are there for the dying, but also because we are there for the illnesses and deaths of our own, the people we love, too. Making a living by caring for the sick and dying does not exempt us from personal loss. We grieve and mourn like everyone else.

Recently, I sat in a chair in an emergency department, noticing the sparkly red polish of a woman’s holiday manicure as she rolled past on a gurney. Clearly, she hadn’t anticipated an ER visit as part of her holiday celebrations either. On another gurney, next to my chair, lay my husband, getting an EKG, labs, and IV fluids. The prayer, “Please, don’t let it be a heart attack or a brain tumor,” wove silently through my thoughts.

We were lucky. There was no […]

2016-11-21T13:03:11-05:00January 14th, 2015|Nursing, nursing perspective|4 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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