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

Autumn Leaves and Colorful Lives

By Julianna Paradisi, who normally blogs at JParadisi RN and has written for this blog before. Her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” was published in the February issue.

autumn leaves between sun halos and flashlight
by oedipusphinx—theJWDban via Flickr

The autumn leaves are particularly beautiful in Oregon this year. An arborist interviewed on the evening news attributed the extraordinary orange and gold to an unusually cold, wet spring, which lasted until July, followed by the intense heat and warm evenings of a brief Indian summer. According to the arborist, the combination caused a greater than normal amount of sugar in the leaves, resulting in the brilliant colors. I think about this on my morning run, as my feet scatter fallen leaves along the sidewalk.

The Season of Eating is, however, not the only messenger of the approaching holidays in a nursing unit. There is something about the holiday season that signals Death to harvest a higher than normal number of the patients we have grown to love through the course of their illnesses. Some of the deaths are expected, but not all of them. I don’t know why more people seem to lose their battles with illness around the holidays than at other times of year.

When I first began working in outpatient oncology, it took me by surprise that my coworkers […]

2016-11-21T13:11:26-05:00November 14th, 2011|nursing perspective|2 Comments
Read More

Nurse Practitioners Are Not ‘Physician Extenders’

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

“Physician extender.” It’s way past time to kill that term.

A study published in the October issue of Surgery found that adding an NP to the surgical team decreased the number of unnecessary ED visits by 50% and increased the use of visiting nurse, physical therapy, and occupational therapy services. A Medscape article (registration required) on the study explained the importance of the findings in this way: “According to the researchers, physician ‘extenders,’ such as NPs, help maintain continuity of care while resident work hours are kept at a maximum of 80 per week. . . .”

Sure enough, the stated purpose of the study was to determine if “integrating this physician extender into the surgery team” would improve outcomes and resource allocation. Ouch.

Experts in our own right. Nurse practitioners are not physician extenders. We are highly skilled and educated nurses who provide evidence-based care grounded in the nursing model. We are not “extensions” of anyone. We are colleagues and collaborators, independent clinicians and experts in our own right. Our purpose is to provide comprehensive care, promote health, educate, and advocate. It is not to relieve interns, supplement physician education, or be the low-cost alternative when physicians have to “do more with less,” as Medscape quoted one […]

2016-11-21T13:11:27-05:00November 11th, 2011|career, nursing perspective, nursing research|6 Comments
Read More

On Protocols, Shortcuts, and the Unforgettable Smell of Ether

By Linda Johanson, EdD, RN, associate professor of nursing at Appalachian State University, Boone, NC

In nursing school my professors warned us of the dangers of taking shortcuts when performing procedures. They cautioned that deviations from protocols could lead to serious error. I had to learn this lesson the hard way, and although it’s been about 30 years since I made this mistake, I still remember the occasion like it happened yesterday.

The patient was in ICU bed #10, a glassed-in isolation room across from the nursing station. He was in his mid-60s, but he was mentally handicapped, so he appeared and acted younger. He was in the unit recovering from a respiratory arrest, and on the day I was caring for him he was still intubated, but breathing spontaneously.

I was completing an assessment on him when the charge nurse called to me from the nursing station, and I stuck my head out the door to see what she wanted. She told me there was a new order to remove the patient’s indwelling urinary catheter. I checked my pockets for a 10 mL syringe to perform the procedure but didn’t find one.

When I complained about having to go all the way to the supply room to collect one, the charge nurse queried, “Well, […]

2016-11-29T13:29:41-05:00November 9th, 2011|nursing perspective|9 Comments
Read More

Realizations of a New Nurse #1: I Am Now the Educator

image via Wikipedia

By Kinsey Morgan, RN. Kinsey is a new nurse who lives in Texas and currently works in the ICU in which she formerly spent three years as a CNA.

In nursing school, there is a growing push to educate future nurses on the amazing breadth of roles within the nursing profession. As a student, you are in some way exposed to the role of nurse as leader, advocate, healer, educator, team player, and researcher. Even this list is not exhaustive. These roles are certainly vital and important and worth teaching about in school.

As a brand new nurse, I haven’t personally encountered all of these roles yet, but there is one in particular that I encounter—and embody—every day: that of educator.

One of the most humbling realizations I’ve had since recently becoming a nurse is that I am now the educator. I’m glad to know that there are other nurses around me, as well as many resources from which to glean knowledge, but I am daily faced with the fact that people now look to me for answers. There are times when I feel outside myself, for while I give correct answers, hearing myself giving them is a little surreal. I’m sure these feelings subside with time, but I hope that I always remain somewhat in awe of the amount of trust my title elicits.

Bookmark and Share

2016-11-21T13:11:31-05:00November 7th, 2011|career, nursing perspective, students|4 Comments
Read More

Staff Nurses at the Center: Joyce C. Clifford’s Still Radical Notion

By Katheren Koehn, MA, RN, who is a member of the AJN editorial board

It was with great regret that I read of the passing of Joyce C. Clifford last week. She was a nurse whose career as a nurse administrator and leader was spent empowering nurses, from the bedside to the boardroom. Much has been written since her passing about her nursing leadership at the administrative level. I would like to take some time to recognize her as a nurse leader who empowered nurses at the bedside.

I first learned of the work of Joyce C. Clifford from a staff nurse who’d moved from Boston to Minneapolis in the late 1980s. The entire time this nurse and I worked together she was in mourning for the hospital and job she’d left behind in Boston. Almost every day she talked about how wonderful Beth Israel was and how great it had been to be a staff nurse there. She talked about primary nursing, nurse autonomy, and interdisciplinary respect. At the time, none of these terms were familiar to me, but I knew she was telling me that “my” hospital, where she now worked, could never measure up to the fabulous BI.

I next learned of the work of Dr. Clifford through the book Code Green: Money-Driven Hospitals and the […]

2016-11-21T13:11:32-05:00November 4th, 2011|career, nursing perspective|7 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top