Nursing as an International Profession

For much of my nursing career, I functioned as a 100% American-minded nurse.

Even though the Ebola epidemic had trickled right into my city, before I attended a global health day at the United Nations (UN) during Nurses Week in 2015, I’d neglected to really consider nursing at the international level.

Until I listened to non-governmental organization (NGO) subject matter experts’ briefings and toured the restricted areas at the UN where global decisions were made, my view of nursing had been largely consumed with understanding things in my own backyard: my day-to-day struggles as a new nursing leader at work, the evolving Affordable Care Act (ACA), and finding ways to apply the IOM Report on the Future of Nursing to my own clinical and academic practice.

My mono-continental nursing mind began to open that day.

The briefings, and most importantly, the subsequent friendships I kindled with nurses involved in international policy work through NGOs like Sigma Theta Tau International (STTI) and the Nightingale Initiative for Global Health, began to help me realize how interdependently we all practice together on a global stage and how attainable international involvement actually is.

Earlier this winter, a new nursing friend, Holly Shaw, PhD, RN, chair of the UN Advisory Council for STTI, asked me if I was attending the International Council of Nurses (ICN) Congress in Barcelona (May 27–June 1). I said I hadn’t even thought of it, […]

2017-05-23T14:22:21+00:00 May 23rd, 2017|Nursing|0 Comments

Chemical Exposure: A Preventable Cause of Harm to Children’s Health

“Children are often exposed to. . . contaminants through their behavior—when they crawl on the floor or explore their environment by touching and tasting objects indiscriminately. In addition, because they are young, there is the potential for environmental exposures to negatively impact their health for a long time.”

Photo © Associated Press

Chemicals are ubiquitous

In “Project TENDR,” an article in this month’s issue of AJN, author Laura Anderko, PhD, RN, a professor at the Georgetown University School of Nursing and Health Studies, discusses why children are particularly susceptible to environmental exposures to chemicals.

Aside from children’s vulnerability to chemical exposures as still developing individuals, Anderko observes that chemicals are also especially hazardous to children simply because they are everywhere: “ . . . in health care supplies and equipment, the food we eat, the water we drink, the air we breathe, and the cosmetics and personal products (such as shampoos, baby bottles, toys, and thousands of other consumer products) we use.”

Developmental harms of children’s exposure to chemicals

Anderko summarizes the concerns raised by a growing body of evidence linking environmental exposures and pediatric health outcomes:

“ . . . widespread exposure to toxic chemicals can increase the risk of cognitive, behavioral, and social impairment in […]

Night Watch

Editor’s note: In this tightly observed guest post, a nurse visiting a sick family member experiences the hospital as a kind of foreign country.

Eileen McGorry, MSN, RN, worked as a registered nurse in community mental health for over 30 years. She currently lives in Olympia, Washington, with her husband Ron.

The walkway is hard, the concrete cold, and I am immersed in darkness. Then there is the swish of the hospital doors and whispery stillness. The light over the reception desk shines on a lone head, bent over a book. A clipboard is pushed toward me. The paper on it is lined with names, some boldly printed, others scribbled, the letters unrecognizable. The spacious lobby is filled with individual groups of soft stuffed chairs and love seats. All of it quiet and empty. Over the chairs and sofas, the black of the midnight hour is changed into twilight.

I remember the bustle of the area at midday. Families gathered together, eyes searching the crowd for the green scrubs of surgeons. “She will live,” they say to some, and to others, “We will wait and see.” The frenzy of the day over, the empty chairs wait for tomorrow.

I sign my name in script. I use the old Catholic school script. The script preached by my mother, who is upstairs recovering from heart surgery. I walk past the chairs along walls so white they gleam. I […]

Should Adults Experiencing In-Hospital Cardiac Arrest Be Intubated?

Photo by A.J. Heightman / Journal of Emergency Medical Service / PennWell Corp.

Although it’s commonly practiced, results from a large new study call into question the effectiveness of intubating adults who experience in-hospital cardiac arrest.

As we report in a May news article, researchers analyzed data for 108,079 adult patients who experienced cardiac arrest in the hospital between 2000 and 2014—and found that patients who were intubated within the first 15 minutes of arresting were less likely to survive than patients who were not.

Among other findings, intubated patients were less likely to experience a return of spontaneous circulation and had a lower rate of good functional outcome (defined as either mild or no neurological deficit, or only moderate cerebral disability).

The researchers concluded that the study results do not support early intubation for adults who experience cardiac arrest. However, they noted that their analysis was unable to eliminate potential confounders like the skills and experience of health care professionals, the underlying cause of the cardiac arrest, and the quality of chest compressions. Additional clinical trials are needed to yield useful results and to better understand the influence of confounding factors. […]

2017-05-15T09:13:26+00:00 May 15th, 2017|Nursing|2 Comments

Establishing the Evidence for Clinical Ladder Programs

Nursing Advancement Before the Clinical Ladder

When I took my first job as a hospital staff nurse, pretty much the only path to advancement in the clinical setting was moving into an administrative position. Nurses moved up by becoming nurse managers, then supervisors, and eventually nursing directors. It was considered unusual for someone to stay at the bedside for many years.

Benner’s Novice-to-Expert Model

Then along came the clinical ladder—a way for nurses to advance clinically. Patricia Benner’s landmark work on identifying the hallmarks of novice-to-expert practice laid the foundation for identifying the different stages of acquisition of skills (see her article on the topic published in AJN in 1982; free until May 22).

Evolving Competencies Require New Paths to Advancement

But while the competencies nurses need to practice effectively are vastly different today, many hospitals haven’t updated their clinical advancement programs to reflect the knowledge, skills, and attitudes (KSAs) that nurses need to practice effectively in today’s complex health systems. Moreover, there’s been little research to provide the evidence for identifying the various competencies and the associated KSAs. Our original research article in the May issue provides that evidence.

Creating an Evidence-Based Progression

The authors of “Creating an Evidence-Based Progression for Clinical Advancement Programs” used the […]

2017-05-12T10:50:46+00:00 May 12th, 2017|Nursing, nursing career|0 Comments