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

No Country for Old Women

By Amy M. Collins, associate editor

For the past few weeks, my family has been living a health care nightmare. My 85-year-old grandmother, physically fit and as beautiful as an old-time movie star, but suffering from the first stages of Alzheimer’s disease, had a major meltdown. Her assisted living facility called to say she was harassing the residents and staff, claiming her belongings had been stolen, shouting at people at random, and even calling the police. Clearly not equipped to handle this level of agitation, the facility turned to us to pick her up and keep her for a few days.

The week that followed proved arduous—nobody seemed to know what to do with her. Her GP was at a loss, suggested that we bring her to the ED. Her neurologist prescribed Seroquel (after having to tackle and physically restrain her from the subsequent episode of screaming and pounding her fists on the wall, we called to tell the neurologist that the pill wasn’t working; he said to give her more; four pills later, she was still mildly agitated.) This went on for over a week. She came to live with us, where we listened, exhausted, to constant chatter that didn’t make sense. The talking never stopped—her voice grew hoarse […]

What Nursing Independence? And Other Notes from the Nursosphere…

Here’s some stuff we’re reading online this week:

In one of the health systems that I interface with nurses can no longer document that they held a patient’s medications based on ‘nursing judgment’. Such an instance might be when a patient had hypotension from pain medication and thus the morning anti-hypertensive is held. Instead, they need an order from a physician to hold such medication. Further, something like ‘Tylenol’ on a patient’s medication record ordered for fever could not be administered by the nurse for a headache if the patient requested it because that would be ‘practicing medicine without a license’.  A nurse cannot order a social services consult, flush a urinary catheter should it become clogged, refer a patient for diabetes education, etc., etc., without an order from the supervising physician.

That’s from a smart, if somewhat depressing, blog post at Nurse Story called “Independent Nursing Practice: Reality or Still the ‘Physician’s Hand’?” The writer, Terri Schmitt, goes on to wonder just how nurses can carve out areas of independent practice, even in the most basic matters. Good questions.

And here’s a question of interpretation raised by an incident in Colorado involving a nurse and the policeman who stopped her for speeding:

When Colorado Springs cardiac nurse Miriam Leverington was stopped for speeding, she grumbled to the police officer.

“I hope you are not ever my patient,” she reportedly told him.

What happened next has become a topic of widespread debate in Colorado and on the blogosphere. The police officer, Duaine Peters, complained to the […]

A Nurse Cartoonist Worth Checking Out

Drawing on Experience is a blog run by a student who’s been completing an accelerated BSN program in nursing and who illustrates his education and personal life with remarkably subtle and witty cartoons. Hat tip to a recent Change of Shift blog roundup at Emergiblog for letting us know about his work. It would be wrong to reproduce this artist’s work here without permission, and he might not like it, so I’m just including a really really tiny version of a recent cartoon illustrating his induction into the nursing honor society. It links back to his original Web site, where you can see this and many other cartoons in full, legible size (and of course, upon request, we’ll gladly remove the thumbnail image here!).

What makes this artist’s work so much fun? The tongue-in-cheek, martial-arts-disciple-and-wise-man narrative? The humility and sense of pleasure in life’s ironies and challenges? The quality of line? The attention to apparently trivial details? The way his mini-narratives play with genre conventions? At any rate, it’s a welcome addition to the nursosphere; I don’t see any contact info on this artist’s blog, but we hope he’ll find time to continue (and consider letting us publish one of his drawings on the blog or in AJN).—JM, senior editor/blog editor

After the Angels: In Search of A ‘Knowledge-Based’ Professional Identity

If you’re looking for angels, you’ve come to the wrong place. So says GuitarGirlRN in her latest blog post.

One stereotype of nursing (and it’s perpetuated by nurses as well as by those not in the medical or nursing fields) that bothers me is that of nurses as “angels of mercy.”

We’re expected to smile while up to our elbows in bloody shit and vomit, be pleasant to rude and sometimes violent people, put up with crap from doctors, managers, patients, their families, nurse techs, and janitors yet keep our cool, never cry, never sweat, never lose our tempers with each other, always be prepared and be right there when we are needed.

Her point is that nurses are human; they do the best they can with scant resources, but they aren’t superhuman. They aren’t saints, they have lives of their own, and they can’t always be all things to all people. Back in 2005, noted author Suzanne Gordon wrote, with Sioban Nelson, an article for us called “An End to Angels.” In it, they presented the idea that nursing is a profession with a serious image problem, one that undercuts recruitment efforts and ill prepares new nurses for the reality of their work. The arguments in the article are subtle and thought provoking, and impossible to summarize. Here, anyway, is the introduction:

Nurses often disagree on the causes of and possible solutions to the current nursing shortage. Mandatory staffing ratios versus Magnet hospitals? Sign-on bonuses […]

Tubes Don’t Kill Patients, Errors Do

By Peggy McDaniel, BSN, RN. Peggy is an infusion practice manager and an occasional contributor to this blog.

by Lars Plougmann/via Flickr

The headline for a recent article in the New York Times caught my attention: U.S. Inaction Lets Look-Alike Tubes Kill Patients. For me, this conjured up pictures of giant tubes with teeth, wrapping around weak patients in their hospital beds and squeezing them. Although I knew exactly what the article was going to discuss, it bothered me that the tubes were given the reputation of being “killers.” Can tubes kill? I think not. Can they contribute to errors? Certainly.

The article explains that numerous patients have been harmed and some have died because clinicians have connected tubing that should not have been connected. These errors run the gamut from enteral feedings being given intravenously and blood pressure inflation devices being attached to IV lines, to administration of intravenous medications into epidural lines.

However, it remains the clinician’s responsibility to provide safe care. […]

2018-03-13T10:51:09-04:00September 10th, 2010|nursing perspective|4 Comments
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