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

Bad Economy Breeds a New Era of Discontent Among Nurses

By Shawn Kennedy, AJN editor-in-chief

Nurses are taking to the picket lines, again. On Sept 22, an estimated 23,000 nurses in California struck at Kaiser Permanente facilities and also at Sutter Health hospitals and Children’s Hospital Oakland. The one-day strike was organized by the California Nurses Association/National Nurses United (CNA/NNU) to protest what they say are unfair rollbacks to nurses’ health coverage and retirement benefits, and was also intended as a show of support for striking coworkers.

But it’s not just U.S. nurses who are engaging in job actions—for example, in the United Kingdom, the 400,000 member Royal College of Nursing is contemplating the first strike in its nearly 100-year history and is soliciting the views of its members as to what action should be taken. The issue is nurses’ pensions and job cuts—according to Nursing Standard, “almost 10,000 NHS [National Health Service] posts in England alone have been earmarked for cuts.”

The poor economy is putting pressure on hospitals and health systems everywhere to reduce costs. One way to do this, of course, is to make cuts in what is traditionally the biggest expense in running the hospital—nursing. While this is a quick fix to the bottom line, it’s also one that doesn’t solve the problem. In fact, evidence shows that inadequate nurse staffing is linked to poor outcomes, which ultimately cost more in the long term—for the patients, for the health care system, and for nurses, who […]

What One Thing Will Make Today Better for You?

As I entered Mr. Ricker’s room, I remembered that the night nurse had mentioned that his wife had been with him overnight. I knocked very lightly and opened the door a crack. The two of them were cuddled up closely in the bed.

“What One Thing Will Make Today Better for You?” That’s the title of the Reflections essay in the September issue of AJN, in case you thought a genie had materialized out of the steam from your afternoon coffee mug. A simple question, but one that author Susan Goff has used since the 1970s with her patients. Sometimes the answer is surprising—that is, sometimes we shouldn’t assume we know what patients want . . . or need. Sometimes, in the case of the patient she describes in this essay, there’s something that should trump NPO. We hope you’ll read the essay and let Susan know your thoughts in our comments section below.—JM, senior editor


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Remembering 9/11: Nurses Were There

By Shawn Kennedy, editor-in-chief

One can find many commemorative events for the 10th anniversary of 9/11 being held in those places (New York City, Washington, DC, and Shanksville, Pennsylvania) where planes hit, and in other cities as well. Some are appropriate and done well and others are (at least to me) over-the-top and tactless—like one New York City radio station playing tapes of the confusion and chaos from first responder radio transmissions; families and friends of victims don’t need to hear that and think of what their loved ones were going through in their final moments.

How we saw it then. AJN’s offices are located in New York City. In 2001, we could see the burning World Trade Center from our windows and we wrote about about our experiences and thoughts. We knew nurses would be in the forefront of responding to help, so we reached out to nurses here in New York and in the Washington, DC, area in order to report on what nurses there were doing. And we also carried a Viewpoint essay, in which one of our Muslim colleagues reported on the backlash that she was experiencing and made a plea for tolerance.

Our current coverage. In planning this September issue, we wanted to acknowledge the events in some way—hence our cover (thumbnail illustraton above) by artist and nurse Charlie Kaiman, who witnessed the events (see also his artwork from 2001 conveying that […]

Killing Traditional Nursing Duties #2

This 2006 image depicted an adolescent female ...

Editor’s note: In early August, on our Facebook page, we asked if there were “old nursing habits” that should be killed off. We received a lot of feedback, which we described in a blog post, “Killing Traditional Nursing Duties #1.” We’re back now with feedback from our second question: “When you give IM injections, what site do you most often use—dorsogluteal (upper outer quadrant of
buttocks), ventrogluteal (lateral hip), or deltoid (upper arm)? Why?”

Hands down, the deltoid injection site was preferred for intramuscular (IM) injections, especially for immunizations and if the patient was an adult. (“People don’t have to drop their drawers” was my favorite reason cited.) A few of those who favored that site noted that, if they didn’t use the deltoid (because of the volume of the injection), they would then go to the ventrogluteal site. One person preferred the vastas lateralis (the outer middle third of the thigh), which wasn’t listed as a choice, but is certainly a site that’s used, especially in infants. And several respondents said they prefer the dorsogluteal site. Reasons given were “more comfort” and “more muscle.”

This is actually contrary to current evidence and teaching, which is that the preferred site is the ventrogluteal site. As noted in an article we did in February 2010, evidence indicates we should avoid the dorsogluteal site because “it poses unnecessary and unacceptable risks of […]

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