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

Magnet Hospitals: It’s About the Process, Not the Designation

By Shawn Kennedy, AJN editor-in-chief

When I had a recent medical emergency, I went to the local community hospital near my home in northern New Jersey. I had been there before for outpatient testing or to the ER with a child and found the care attentive and efficient and the staff friendly and professional. Besides, it was a Magnet-designated hospital, so I was confident that I’d receive good care.

The ancillary staff was wonderful, but I found myself disappointed with the nurses on the acute med/surg unit where I was located. There was no rounding that I was aware of, and they seemed to only show up when it was time to administer meds. Only a few nurses introduced themselves, and only two nurses over three days really engaged me in any conversation. Nurses seemed to respond to call lights only for those patients to whom they were assigned. The unit clerk who promptly answered the call light intercom would say, “I’ll let your nurse know and she’ll be in soon”—when I asked for pain medication, she told me “your nurse is giving report; I’ll let her know when she’s finished.” I waited uncomfortably for more than half an hour.

There were whiteboards, but often the information—especially regarding the date and the name of the nurse—was unchanged from day to […]

2016-11-21T13:10:53-05:00January 23rd, 2012|nursing perspective|6 Comments
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Poll: What Can We Actually Do About Hospital Room Noise?

By ArtsieApsie, via Flickr

Fierce Healthcare reports this week on the latest findings about hospital room noise: “hospital rooms can be as noisy as chainsaws, according to a new study [subscription required] published this week in the Archives of Internal Medicine….The average noise level in patient rooms was close to 50 decibels….The noise disruptions mostly come from staff conversation, roommates, alarms, intercoms and pagers….Loud hospital rooms are associated with clinically significant sleep loss among patients and even may hinder recovery.”

So, nurses (and patients, MDs, others): can anything be done about this? Does your hospital do anything? Take our poll, and also of course feel free to leave a comment on this post.—JM, senior editor

[polldaddy poll=5850198]
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2016-11-21T13:10:56-05:00January 17th, 2012|nursing perspective, patient engagement, Patients|1 Comment
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Critical Care: Where’s the Evidence for Central Venous Pressure Monitoring?

Editor’s note: This post is by Anne Dabrow Woods, MSN, RN, CRNP, who is AJN‘s publisher and chief nurse and publisher of Wolters Kluwer Health Medical Research. It was originally published on the blog of Lippincott’s Evidence-Based Practice Network.

I read with interest the article “Central Venous Pressure Monitoring: Where’s the Evidence?” (purchase required for nonsubscribers) in the January issue of AJN. It’s part of a series called Critical Analysis, Critical Care, which will appraise the evidence regarding common critical care practices. So much of what we do in nursing is not based on evidence but on how we have always done things in practice—or on research that was not credible.

This article looks at the evidence supporting the use of central venous pressure (CVP) monitoring alone to guide treatment decisions for patients. According to the article, a 2008 systematic review by Marik and colleagues concluded that CVP is not an accurate indicator of intravascular volume, nor is it an accurate predictor of fluid responsiveness (whether a patient will respond to a fluid bolus with an increase in stroke volume). The authors of the AJN article critically appraised the evidence and determined the following:

2016-11-21T13:10:59-05:00January 13th, 2012|nursing perspective, nursing research|0 Comments
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Nurses Know

It happened back in 1976, but I still remember the sound of the distant ambulance. Why was I lying in the grass and the weeds? Hadn’t I been in the car, driving home from the Visiting Nurse Association along the country road?

So begins the January Reflections essay, “Nurses Know.” By Lois Gerber, it’s one patient’s vivid story of the many crucial roles that nurses played in her care—and it’s free, so have a look and let us know what you think. For those of you who write or who think you have a strong story to tell about nurses, nursing, or some aspect of health care, Reflections submission guidelines can be found here.—JM, senior editor/blog editor

2016-11-21T13:11:02-05:00January 6th, 2012|nursing perspective|1 Comment
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Second Chances

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

by patchy patch, via flickr

I first met Ella (name and some details have been changed) when she was my patient in the intensive care unit. She’d been riding in a car she wasn’t supposed to be riding in, heading to a party she wasn’t supposed to be going to, high on drugs and not wearing a seatbelt when she was involved in a high-speed crash that left her with broken bones and internal injuries. She was in the ICU for more than a month.

Her situation wasn’t that remarkable. Ella could easily represent a common category of ICU admissions—the young adult who is often described by her parents as a “good girl,” yet who lives wildly, fearless and flip, taking risks as if consequences will never apply. I feel particularly protective of these patients, mostly because I relate to them, on some level. I remember the sense of invincibility that came with youth, and when I’m caring for these girls I often marvel at consequences I avoided in my own life. I shake my head at my younger self, alternating between […]

2016-11-21T13:11:05-05:00January 3rd, 2012|nursing perspective, Patients|5 Comments
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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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