A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN By Annelisa Ochoa for AJN

“A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health. […]

2016-11-21T13:01:02-05:00August 3rd, 2016|Nursing, nursing stories, patient experience|2 Comments
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Dark Water, Wild Winds: Notes of a Flight Nurse

I must see new things
And investigate them.
I want to taste dark water
And see crackling trees and wild winds.
—Egon Schiele

IMG_2650Repatriation

I’m standing on the tarmac in Manaus, Brazil, where there is indeed a wild wind; it blows debris across the runway yet does nothing to stave off the nearly intolerable heat. Sweat soaks my back and drips down the center of my chest. My limbs are heavy with lethargy. The heat index is 110 but it feels much hotter—even the Learjet fails to provide a haven from the equatorial sun.

We’d come to Brazil to repatriate an Englishman who’d been visiting family and was struck down by sudden and severe seizures. He’d spent weeks in the hospital, sustaining scans and diagnostics to pinpoint the cause, and endured the addition of one antiepileptic medication after another.

While the seizures finally ceased, he was left disquieted and uncomfortable, unsure which symptoms were due to the 7 cm brain mass that had been discovered and which were side effects of the myriad of antidotes. By the time we were dispatched for this mission, he was medically stable and ready to go home to deal with the ominous findings. Biopsies awaited and treatments would […]

2016-11-21T13:01:03-05:00July 27th, 2016|career, Nursing, nursing stories, patient experience|0 Comments
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AJN News: A Role for Nonmedical Workers, Adult Vaccinations Revisited, Teen Pregnancy Drop, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue (news articles in AJN are free access):

A community health worker meets with a patient in Baltimore, Maryland. Photo by Francis Ying / KHN.

Nonmedical Workers: A Growing Asset to Communities

Outcomes improve, costs drop, and nurses’ workloads benefit when nonmedical community health workers are available to serve as liaisons between health systems and patients. Programs to train more of these workers are gaining attention in states across the country.

Revisiting the Adult Vaccination Schedule for Tetanus and Diphtheria

Results of a new study reveal that most adults remain protected from the two diseases for 30 years without booster vaccination—and call into question the potential benefits of a modified adult booster vaccination schedule.

Teen Pregnancies, Births, and Abortions Slow

Two new reports show that the birth rate among U.S. teens has dropped to its lowest point in three decades; the percentage of teen pregnancies ending in abortion also reached a historic low. Researchers attribute the downward trend to teens using birth control more often and waiting […]

2016-11-21T13:01:06-05:00July 7th, 2016|Nursing, nursing perspective, nursing stories|0 Comments
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The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

“The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, […]

2016-11-21T13:01:07-05:00June 27th, 2016|narratives, Nursing, nursing stories|0 Comments
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Patients Change Us: A Formative Nursing Experience

From boliston, via Flickr From boliston, via Flickr

Many years ago, I was given the greatest gift by a patient who had no idea he would change my life and define my professional outlook as a nurse. While not every nurse will be fortunate enough to have such an explicit experience of the effect of the care they provide so early in their career, I believe that each patient you come in contact with is changing your life as much as you are changing theirs.

Quantity of Care vs. Quality of Care

Nursing has evolved into a highly technical profession grounded in scientific evidence, a profession that works to improve patient outcomes and shorten hospital stays. Research and technology support this work in innumerable ways.

But while nurses must be technical experts, drug experts, and efficiency experts, they must also do their best to alleviate the suffering of those in their charge. These many concurrent demands can result in high burnout rates among nurses as well as fragmented care for patients.

The quantity of care today’s nurse provides must go hand in hand with the quality of care. My own definition of quality care is focusing on patients as more than just a set of signs, symptoms, numbers, and processes in need of monitoring and adjustment. Recognizing […]

2016-11-21T13:01:07-05:00June 22nd, 2016|career, Nursing, nursing perspective, nursing stories, patient experience|1 Comment
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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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