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

Career Change in 2011? Ask the God of Gates, Doors, and Beginnings

Bust of the god Janus, Vatican museum, Rome

By Peggy McDaniel, BSN, RN, infusion practice manager

I’ve never been much for New Year’s resolutions. I guess it’s because I know I won’t keep them—or at least recognize that my track record has been less than stellar. I’ve made the usual promises to myself: eat less, exercise more, learn a new craft, spend more time reading and less time on the Internet . . . and so on.

It seems as if such promises are made with tongue in cheek—even, possibly, made to be broken. So many resolutions are about self-improvement; I suppose that’s a good thing, except we don’t tend to follow through. The yoga classes I attend are always packed from January 2 through approximately March 15, then attendance slowly tapers back to the usual attendees. Do we feel we’ve been successful if we hang in there for a month, two or three months?

I’m not sure I’ve ever made a New Year’s resolution I really planned on keeping.

According to Wikipedia, the Roman ruler Julius Caesar changed the celebration for New Year’s from March to January 1 in 46 B.C. The day was “dedicated to Janus, the god of gates, doors, and beginnings,” who happened to have a face on both sides of his head. This signified the ability to look back and forward at the same time.

That’s something worthwhile—looking back at what we can and should change while […]

2016-11-21T13:14:29-05:00December 30th, 2010|career, nursing perspective|5 Comments
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Year-End Reindeer Dreams

By Peggy McDaniel, BSN, RN, infusion practice manager

As a long-time pediatric nurse who’s spent many a Christmas at the hospital, I have special memories, many of which still make me smile years later. Some of these are bittersweet, as suffering and pain do not stop for such days. One of my favorite shifts involved a little boy and some reindeer antlers. 

I was working a 12-hour night shift as a traveler in a small community hospital. We got a call from the ED to admit a four-year-old boy who was extremely anemic due to unknown causes. When this child arrived, I realized he was very ill and probably would only spend Christmas Eve night with us. He needed to be stabilized, then would move on to a regional children’s hospital for further diagnosis and treatment. […]

2016-11-21T13:14:30-05:00December 29th, 2010|nursing perspective|2 Comments
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‘At the Night Camp’: How Assumptions About Patients Can Blind Us

The entire time he was with us he kept looking around, eyes darting back and forth and toward the truck he’d driven, which he told me wasn’t his own. He shifted uneasily in his chair, and I felt the impulse to try to comfort him and tell him we could help.

That’s an excerpt from “At the Night Camp,” the December Reflections essay in AJN. The essay, by Meg Sniderman, a student in the MSN program at Emory University School of Nursing in Atlanta, takes a wry, honest look at the ways we can imagine whole lives for those around us based on their cultural identifiers, yet often miss the most obvious things about these patients . . . the things that make them just like us, despite apparently vast cultural differences.—JM, senior editor/blog editor

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2016-11-21T13:14:39-05:00December 17th, 2010|nursing perspective, patient engagement, Public health, students|0 Comments
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Amazing and Disheartening: How We Continue to Fail Family Caregivers

By Shawn Kennedy, AJN interim editor-in-chief

Recently, as part of an ongoing collaborative initiative on supporting family caregivers with AARP (see the comprehensive, and free, AJN supplement called State of the Science: Professional Partners Supporting Family Caregivers), I listened to a group of family caregivers talk about what it’s like to care for sick parents and relatives at home. 

Most of the caregivers were in their 60s and retired, and now found themselves doing the back-breaking work of being on call 24/7, attending to everything from bathing and feeding to chauffeuring to health care appointments, paying the bills, and running the household—sometimes two households, if they lived apart from the person for whom they provided care.

It was amazing and disheartening to listen to them—amazing in terms of the lengths they went to make sure they were doing the right things, and disheartening because they were mostly on their own, with little support from the health care system. And this was right from the start; all said that information to prepare for the transition from hospital to home had been lacking. For the most part, families looked to the family physician to answer questions about what they would need to do at home—nurses were hardly mentioned.

What They Said

2016-11-21T13:14:40-05:00December 15th, 2010|nursing perspective|11 Comments
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When They Can’t Tell You About the Hurt: Assessing Pain in People with Intellectual or Developmental Disabilities

By Sylvia Foley, AJN senior editor

When S.M., a 47-year-old resident at a facility for people with intellectual or developmental disabilities, started hitting himself in the left eye, his caregivers weren’t sure why. S.M., whose developmental quotient is equivalent to that of a two- or three-year-old, couldn’t tell them. Some thought he was frustrated at not being allowed to drink as much coffee as he wanted; others thought a recent decrease in his medication—quetiapine (Seroquel)—might be a factor. But a chart review revealed that both his father and brother had a history of cluster headaches. Was S.M.’s behavior an indicator of headache pain? How could clinicians best assess him?

In this month’s CE feature, authors Kathy Baldridge and Frank Andrasik provide an overview of pain assessment in people with intellectual or developmental disabilities, summarize the relevant research, and discuss the applicability of the American Society for Pain Management Nursing practice guidelines for assessing pain in nonverbal patients. The guidelines describe various behavioral pain assessment tools, some of which might be useful with S.M. and others like him. Other assessment methods include

a search for pathologic conditions or other problems or procedures known to cause pain; the observation of behaviors that might indicate pain; and the use of proxy reports (also called surrogate reports) by people who know the person best, whether family caregivers or professionals.

S.M. was encouraged to draw himself and what the “hurt” felt like; two […]

2016-11-21T13:14:41-05:00December 14th, 2010|Ethics, nursing perspective, pain management|3 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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