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

A Physician Finally Gets Nursing

RelmanArticleCaptureBy Shawn Kennedy, editor-in-chief

Earlier this month, the New York Review of Books published an article by a patient who described his hospital stay following a life-threatening accident. This was no ordinary patient—the author, Arnold Relman, is a noted physician, emeritus professor of medicine at Harvard, a former editor of the New England Journal of Medicine, and along with his wife Marcia Angell, well known as a critic of the “medical–industrial complex.” His account is very detailed and gives a good example of how it can look when the system works (and when one has access to it).

His understanding of his condition and treatment, his knowledge of the system, and also his relative prominence as an individual, all undoubtedly helped him avoid some pitfalls and make a remarkable full recovery. However, as a number of others have pointed out recently, one comment in his account was surprising.

In reflecting on his hospitalization and recovery, he wrote, “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.” After all his years in medicine, he only realized the value of nursing as a 90-year-old trauma patient.

This week, Lawrence Altman, another physician and author, wrote an excellent

2016-11-21T13:05:23-05:00February 14th, 2014|career, nursing perspective, patient safety|13 Comments
Read More

More Than a Headache: Migraines and Stroke Risk for Women

Photo by author. All rights reserved. Photo by author. All rights reserved.

By Karen Roush, MS, RN, FNP, clinical managing editor

I used to think I was lucky. Most of the women in my family have migraines—awful, vomiting for three days, intense pain migraines. Not me. Oh, I have migraines. But no pain, no vomiting, just a visual aura—squiggly lines and loss of part of my visual field for about 45 minutes and then I’m good to go.

I was thankful that I just had the aura instead of the pain and vomiting. But now the evidence shows that migraine with aura, especially when there is no vomiting involved, is an independent risk factor for stroke, as much as if I were overweight, smoking cigarettes, and walking around with my blood pressure through the roof.

And it’s not just having migraines that places me at greater risk for a stroke. […]

2017-07-11T14:42:45-04:00February 12th, 2014|nursing perspective|1 Comment
Read More

The Hospital as Foreign Country

Capture“A Foreign Place,” the February Reflections essay by Barbara Sosman, delves into one patient’s experience of the sometimes inscrutable, sometimes terrifying, sometimes humorous events and encounters in one small corner of a hospital.

Below are the first two paragraphs, but as always, it’s worth clicking through and reading the entire essay (the PDF version is best). This one would be particularly hard to summarize; it takes us to unexpected places.—Jacob Molyneux, senior editor

The flow of life and death in a hospital is mysterious, like the sound of a foreign language, and the mysteries that bring us here are profound. Stretched out in an unfamiliar hospital bed, I suppress realities, aware that tomorrow a scalpel will remove an enlarged node for a biopsy. The biopsy will show what I sense, a cellular chaos that threatens my life. Soon my disease will be presented like an offering. What will I do with it?

A room can become a universe and time there an infinity. This room is inhabited by women, of whom I am the youngest by decades  . . .

As always, comments are welcome.

Bookmark and Share

2016-11-21T13:05:27-05:00February 7th, 2014|nursing perspective, patient engagement, patient experience|0 Comments
Read More

Not Compatible With Nursing

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN.

photo 1-1 Photo by the author

“His family knows this is not a survivable injury, right?”

This question, posed to me in the doorway of my patient’s room by a trauma surgeon I regard as brilliant, caught me off guard.

“No,” I said. “They don’t know that.”

He frowned at me, mumbled something about false hopes, then moved away to continue his rounds.

This wasn’t the only physician who’d expressed a strong opinion regarding my patient’s mortality—a consultant had deemed his injuries “not compatible with life.” But I’d been caring for this man, as a 1:1 assignment because of his high acuity, for every shift for weeks. It seemed obvious to me that my patient’s continued presence in the ICU—and his relative stability on that particular day—directly opposed the dire predictions. The man’s family did not see his situation as hopeless, and neither did I.

And yet days after the surgeon uttered those words, my patient suffered a complication and became so unstable that for hours he teetered between life and death. The resuscitation effort was massive—and no one mentioned survivability. No one behaved like there was even a shred of futility in bringing to […]

2016-11-21T13:05:28-05:00February 5th, 2014|career, nursing perspective|5 Comments
Read More

Take a Walk: American Heart Month, for Nurses and Everyone Else

By Shawn Kennedy, MA, RN, AJN editor-in-chief

By Eric Hunt/via Wikimedia Commons By Eric Hunt/via Wikimedia Commons

So we all know what we need to do to prevent heart disease: eat a healthy diet (such as the highly touted Mediterranean diet, which has been “consistently effective with regard to cardiovascular risk”), get regular exercise, and don’t smoke. But most of us—and I’m guilty—don’t quite follow the advice we may give our patients or family members. It’s difficult to carve out time for oneself in addition to working all day (and for most nurses, we’re not talking a nine to five day—many work 12-hour shifts, or at least a 10-hour day if in administrative positions), plus commuting and then spending time with family. If you have school-age children in activities, there are also car pools and homework.

We need to find 30 minutes—or even 20 minutes—daily to jump-start our own engines. According to the National Heart, Lung, and Blood Institute, heart disease kills one in four women and is the leading cause of death for both women and men in the United States. And while genetics certainly plays a part, cardiovascular health is mostly about prevention. So make a 30-minute appointment with yourself and stick to it.

The American Heart Association (AHA) initiative highlighting heart disease in February is a good reminder to us all, especially in the […]

2016-11-21T13:05:31-05:00February 3rd, 2014|nursing perspective, personal health practices|0 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