Cast Into the Shadows: COVID-19’s Power Over Non-COVID Cases

As a pediatric ICU nurse in a hospital that has not experienced an overwhelming surge of COVID-19 patients, it has taken me some time to register the ways this pandemic has affected my perspective and practice.

Non-COVID diagnoses left in the shadows.

Photo by Unjay Markiewicz/ Unsplash

I recently took care of two young patients, each with acute and unexpected conditions. One was under post-operative care after a brain tumor had been removed the day before. The other had been newly diagnosed with acute lymphoblastic leukemia. What stood out to me as I interacted with their families was that these were some of the only people I would interact with in this period who did not have COVID foregrounded in their mental and emotional space. This feeling was followed by the sobering realization that this was only because they found themselves dealing with something just as insidious, if not more so.

In both cases, the families observed confusing symptoms in their children and had to wrestle with whether or not to go to the ED in the midst of a pandemic. Only when the symptoms became so severe and concerning did these families decide they could no longer avoid the ED. Now facing an inpatient hospital […]

2020-06-02T09:32:44-04:00June 2nd, 2020|family experience, infectious diseases, Nursing, nursing stories, patient engagement, Public health|1 Comment
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Far from Home, a Flight Nurse Cares for One of COVID-19’s ‘Peripheral Victims’

‘Deemed stable to fly home.’

Our fixed-wing air ambulance was recently dispatched to Spain to bring 87-year-old John and his wife of 62 years, Rose, home to the US. They’d traveled to Spain for their annual vacation before “COVID-19” or “coronavirus” were household terms, but John had fallen early on in the trip and broken a hip. He’d spent four weeks in a local hospital and had his injured hip surgically repaired, and then was deemed “stable to fly home” by a doctor. And so he’d been transported back to his hotel two days prior to our arrival. The crew deposited him in the bed, bid farewell to his wife, and left.

Spain’s deserted beaches seen from author’s hotel room, March 2020

And now John was dying. He lay on the twin bed in his hotel room. His eyes were closed. His breathing was rapid and shallow. My partner and I stood, stunned into momentary silence. We had come straight to his hotel from the airport, and his condition was far worse than we had anticipated.

We’d left our equipment in the aircraft, as John’s transport was planned for the following morning to allow time for our pilots to rest. John’s respiratory rate was 60 with frequent pauses, his pulse weak, heart rate about 95 and irregular. He wouldn’t open his eyes or respond to us verbally, but he fought us when we tried to move him. He was covered in feces.

No room at […]

2020-04-09T10:25:10-04:00April 9th, 2020|infectious diseases, Nursing, nursing stories|3 Comments
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Will your ‘RN’ Name Tag Protect You from Violence?

When I stepped into the entryway, I was met by a group of men, crouched on the floor over a game of craps and shouting excitedly. One of them stood up when he saw me come through the door . . . He dropped the dice, pulled a gun from his waist, and pointed it at my face.

Workplace violence prevention training has become the latest mandatory education module in many hospitals. But what about nurses who work in non-hospital settings? In this month’s Viewpoint, “Workplace Violence Outside the Hospital Setting,” NP and visiting nurse Joanne Schmidt describes the terrifying situation she walked into one day at the start of her morning home visits.

In many community settings, no cameras or security staff.

Schmidt points out that nurses who work in home care, mobile medical vans, school clinics, and other community-based settings may be considerably less safe every single day than those of us who work in relatively protected hospital environments. At least in acute care there are cameras and security staff! […]

2020-02-20T10:55:11-05:00February 20th, 2020|Nursing, nursing stories|1 Comment
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Putting Down Her Burden: A Patient’s Final Choice

‘goodbye, inhaler!’

Chronic illness as a Sisyphean bargain.

Sisyphus was a legendary king of ancient Greece who was condemned by the gods to eternally roll a rock up a hill, only to have it roll down again each time as it neared the top.

Many people with chronic illness today may be able to relate. Chronic illness can mean years or even decades of worsening symptoms and ever more complex medication and treatment regimens, side effects of treatments, treatments for side effects, monetary pressures, activity limitations, a sense of separateness from the legions of the merely ‘walking worried’ around us, and the subtle pervasive tension and vigilance of never quite knowing what might come next.

The ironies of advanced medicine.

The assumption, of course, is that all the effort is worth it. And it is: many of us benefit from, or know people who benefit from, drugs that keep them alive when 50 or 100 years ago they would have died long ago, or keep them able to walk, or breathe without a struggle, or sleep without excruciating nerve pain or the itching of terrible skin sores, and so on. Life has always been about compromise; these are simply new refinements of a universal equation.

2020-01-23T10:03:01-05:00January 23rd, 2020|Nursing, nursing stories, patient experience|1 Comment
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A Nursing Way with Meaning

“I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.”

Despite our seriously malfunctioning health care system, sometimes we are lucky enough to be reminded of the richness of our practice. Most of us experience a bright spot or two on most days—a patient’s condition finally improves, and we know we had a hand in that; we are able to spend some “quality time” to help a patient cope with her illness; a discharged patient returns for a happy visit.

Thriving, not just surviving.

A few of us, though, are lucky enough to have nursing work in which we can thrive, and not merely survive, every day. In this month’s Reflections column, “The Way of Johnson Tower,” nurse practitioner Mark Darby describes his work in an unlikely setting: a medical clinic located in a public housing high-rise. Resources may leave something to be desired—occasional leaks from the laundry above seem to target the clinic’s centrifuge—but his practice is rich and fulfilling.

“All these people, despite their circumstances, teach me more about generosity, perseverance, and hope than I could learn anywhere else.”

[…]

2019-12-02T12:57:58-05:00December 2nd, 2019|Nursing, nursing roles, nursing stories, Public health|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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