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

Getting Osteoarthritis on Nurses’ Radar

Many providers and patients alike feel arthritis is inevitable and there’s nothing that can be done aside from taking pain medication—but that’s wrong. There are measures that can slow progression and make joint replacement a less inevitable outcome. The key is getting patients on regimens early on, before there is significant damage in the joint.

The Five Most Popular Articles at AJN

Amanda Geer, AJN administrative coordinator—We look at the statistical views and visits of users at AJN‘s home page to determine our most viewed articles, how many visitors listen to our podcasts, what day of the week we get the most traffic, and a number of other categories to make sure we keep up to date on what matters to our readers. We also look at what our users search for. Some of the most common keyword(s)/phrases are evidence-based practice, research, diabetes, cancer, and stroke. We also look at our most popular articles. For the last few months, the following five articles have dominated our top 10 chart (in an upcoming post, we’ll look at the most popular articles on this blog):

Patient and Family Cell Phone Use Can Seem Intrusive, Until It’s Not

Oh no, here comes another Dad with a Bluetooth.

My colleague and I roll our eyes at each other in frustration. Another self-important junior executive who must be in touch with everyone in the world while his wife labors unsupported, I mutter with dismay as I rise from my chair to greet our newest birthing couple.

I have to coach myself: Change your attitude. Change your attitude, as I weigh the mom and escort the couple to the birthing room. Dad-to-Be proceeds to spread out his equipment on the dresser in front of the window while Mom-to-Be, in obvious distress, changes into a gown in the bathroom.

That’s the engaging beginning of “Before the Signal Fades,” this month’s Reflections essay in AJN. The essay traces an unexpected path from complaint to something much deeper. Click the link to read the entire essay (and click through to the PDF version for a nicer reading experience). What’s your take on patient use of cell phones, cameras, smartphones, and the like?—JM, senior editor

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New Medical Residents and Patient Mortality – Does the ‘Nurse Effect’ Lessen the ‘July Effect’?

Last week, a post on the New York Times Well blog discussed whether mortality rates in hospitals are worse during July when new interns and residents begin their clinical training. It described findings from three studies, with the final conclusion, “Though the debate continues, most studies have not found a spike in hospital mortality rates in July.”

It was common thinking in hospitals when I worked clinically—“Never be sick enough to have to go to a hospital the first two weeks of July, and NEVER, EVER need surgery during that time”—and I’d venture that many people still believe it, despite what studies may report. (And, as I write, I see that ABC News is reporting on a new review of 39 studies, published in the Annals of Internal Medicine, that does support the existence of the July Effect. Click the image below for the ABC article and videos.)

I remember working in the ED when the new residents on call would come to see patients, their “whites” impeccably spotless and starched, with new blank index cards in their pockets, looking eager and anxious to finally be getting to the real work of their profession. By mid-August, they all seemed a bit haggard, the whites rumpled and the pockets torn a bit, bulging […]

Giving Noise a Red Light

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN. She’s a frequent writer  for this blog.

This stoplight noise meter showed up at the nurse’s station last week.

I have to admit—we didn’t take it too seriously, at first.

It looks like something you could buy in a novelty shop, shelved next to lava lamps and strobe lights. And it’s modifiable; buttons and dials on the back of the gadget allow not only for sensitivity adjustments, but also give the option of changing the type of alarm that sounds when a noise infraction is detected. The default alarm warning is a soft-spoken, female “quiet, please!” that can be translated into Spanish, French, or German—but there’s also an option for a shrill siren, which seems ridiculous, considering that much of the cacophony of critical care is owed to noisy alarms and ringing phones.

We even discovered how to record our own admonishments (which opened the door to countless mischievous possibilities . . . not that we’d indulge in that sort of thing, of course).

In seriousness, noise reduction is vital to promoting a healing environment. In a recent article in Critical Care Nurse, the links between sleep deprivation and altered physiologic processes specific to the critical care population are reviewed. Noise reduction guidelines and recommendations from both […]

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