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

When a Family’s Faith in Healing Collides with a Busy Hospital Unit’s Pressures

Illustration by McClain Moore for AJN/all rights reserved.

What happens when a family of strong religious faith is determined to continue praying for a young father’s healing even after he dies of a terminal brain tumor in the MICU? The room is needed for other patients; a nursing student and her preceptor cared for the patient during his final hours of life and are now expected to provide postmortem care.

It’s a tricky, somewhat tense situation, and initial reactions among the nurses in the hospital vary. Melody Sumter, the author of this month’s Reflections  (“A Place for Faith: My First Experience of Cultural Competence in Nursing“), was the nursing student assigned to the patient, who left behind a young wife and 10-month-old child.

Looking back on the event, Sumter recalls her competing sympathies at the time, and the way she was gratified to learn that the nursing staff at last found a way to honor the wishes of the patient’s family and also see to their responsibilities to other patients. Writes Sumter:

Seeing this family practice their faith was encouraging for a young nursing student like myself—as was the nursing staff’s acceptance and support of a belief that most of them didn’t understand.

The author […]

Why You Need to Know about the Proposed Health Care Plan

Rep. Paul Ryan, Wisconsin/Flickr/Gage Skidmore

AHCA Release Ignites Concerns from Right and Left

The administration’s plan to replace the Affordable Care Act (ACA) was released earlier this week and has ignited a firestorm among Republicans and Democrats alike.

Democrats claim the American Health Care Act (AHCA) will create havoc and hardship for millions of the most vulnerable.

Many Republicans are worried about the plan’s effect on their constituents, while more conservative members of the GOP feel it doesn’t go far enough in repealing the ACA.

While there is a stated push by the new administration to “sell” the plan and implement it quickly to keep campaign promises, legislators in both parties are calling for time to examine the plan and analyze the cost of the plan, which has yet to be determined.

As almost everyone knows, finding a way to provide affordable health care in this country is very complicated and requires a delicate balance of funding by the federal government and states. It’s likely that there will be several changes before a final plan is in place.

What seems to be clear is that the changes coming down the road will have a direct impact on nurses, patients, and the institutions in which we work. Will staffing be cut if states lose federal reimbursements? […]

Just a Nurse, or a Bedside Leader? Mental Models Can Be Changed

If you haven’t read the Viewpoint column in the March issue of AJN, “Just a Nurse, or a Bedside Leader?“, we recommend it. The author, Amy Constanzo, director of nursing administration at University of Cincinnati Medical Center, puts into eloquent words one of the central “unthought knowns” in the daily experience of many nurses. Constanzo writes:

“Despite the Institute of Medicine’s Future of Nursing report that calls for nurses to be ‘full partners, with physicians and other health professionals, in redesigning health care in the United States,’ the mental model of ‘just a nurse’ is still out there, inhibiting potential.”

But she’s not pessimistic. She believes “just a nurse” is a mental model like any other, and mental models can be changed—but only if you make it your quest to do so. Constanzo proposes an alternative mental model for nurses: “I am a nurse.” On the surface, it’s a simple statement, but it’s also, she believes, a statement of both strength and possibility:

“When you say ‘I am a nurse,’ you are claiming the values of nursing and your contribution to assisting patients in achieving their best level of health. To do so requires a clear vision of nursing as a profession and of nurses’ contribution to the health care team.”

How do you describe your work as a nurse—to yourself, and to others?

2017-03-03T13:18:26+00:00 March 3rd, 2017|Nursing, nursing perspective|2 Comments

ANA’s Cipriano, AARP’s Reinhard Comment on ACA’s Undoing

President Obama signing the ACA in 2010/via Wikimedia Commons

Nurses and the Undoing of the ACA

Many in the nursing community supported the Affordable Care Act (ACA) when it was first introduced. This is understandable, given our firsthand experience of patients who didn’t seek care until they were gravely ill because they lacked health insurance. We know how disease management can change outcomes for those with chronic illness and how preventive care can make the difference between having a treatable cancer or a metastasis.

In the years since, as both supporters and detractors continued to argue over the law and its need to be improved (or scrapped, depending on your viewpoint), over 20 million people gained health insurance and access to care.

Now as Congress moves to repeal and replace the ACA with a yet-to-be-determined plan, many are concerned that major gains will be lost and once again it will be the poor and vulnerable who will suffer. (I touched on some of the concerns in my March editorial.)

To get a little more insight, I spoke with two very policy-smart nurses about what might happen and what they feel should happen.

What ANA president Pam Cipriano said:

I asked ANA president Pam Cipriano what she thought was the most critical aspect of the gains from the ACA that need to be preserved. Her answer:

“We must […]

Health Care Terms and Words To Retire and Replace?

This week, two bloggers posted lists of words or terms they felt should no longer be used when referring to health professionals or patients.

  • Harrison Reed, a physician assistant who writes for In Practice, a blog at NEJM Journal Watch, wrote “Seven Medical Terms to Ditch in 2017.” On his list was LFTs (liver function tests); regular rate and rhythm (RRR): little old lady (LOL); AAM or AAF (other potential objections aside, these are often taken to mean African-American male or female, but can just as easily mean Asian-America male or female); and nauseous when one actually means nauseated. He also would like to see an end to the use of the modifier “midlevel,” as when it’s used to refer to NPs or PAs as “midlevel providers.”
  • Over at KevinMD.com, physician Pamela Wible published “Stop saying these 7 shaming words in medicine. Right now.” Her list included phrases to abandon, along with replacements that she believes to be more accurate and/or respectful. For example, she advocates replacing “is bipolar” with “has bipolar disorder.” She also wants to replace the phrase “is the patient noncompliant?” with “is the treatment working?” “Noncompliant,” as she points out, conveys blame. (Nonadherence may now be the preferred term—there are many reasons someone may not be able to adhere to a […]