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

Nightingale as QI Expert and Hospital Designer

By Sue Hassmiller, PhD, RN, FAAN (this is the 4th in a series of posts by Hassmiller retracing Florence Nightingale’s influential and innovative career) 

Seeing the famous St. Thomas’ Hospital today, I thought Florence Nightingale would roll over in her grave with disgust! What were they thinking, I asked the tour guide? Well, she said, it was the ‘60s. No excuse, I barked back! Prince Charles doesn’t like it either, if that makes you feel any better, she responded.

Applying best practices. The most visually prominent buildings in the hospital now consist of a couple of plain, brown, nondescript, blocklike structures—not anything like Nightingale, once the most famous hospital designer in the world, would have had it. Or, rather, did have it. Her friend, Queen Victoria, laid the first stone and Florence Nightingale contributed to the design and relocation of the St. Thomas’ Hospital of the mid-1800s, with the intention of applying best practices she had brought back from the Crimean War as well as her own research and statistics. 

Nightingale was much sought after as a master designer of hospitals; architects, physicians, and royalty from around the world asked her advice. And here was supposed to be her masterpiece . . . but her version of St. Thomas’ is just about gone.

Physical, spiritual, mental health needs. Nightingale envisioned the relocated and rebuilt St. Thomas’ as […]

2016-11-21T13:16:45-05:00July 13th, 2010|nursing history, nursing perspective|8 Comments
Read More

Reflections on the Freedom to Harm Yourself

By Marcy Phipps, RN

(Identifying details of the patient and clinician mentioned in this post have been changed to protect their anonymity.)

Last week I took care of a woman who’d shot herself in the abdomen. This was the third suicide attempt she’d survived. She was physically compromised, to say the least, and was looking at a long recovery. Her despondence was palpable. 

A clinical psychologist came to evaluate her and determined that she was experiencing major depression with suicidal ideations. 

Usually, such patients are “Baker Acted.” In accordance with the Florida Mental Health Act, commonly referred to as the Baker Act, individuals who are deemed to be a danger to themselves or to others are held involuntarily and transferred to a treatment facility.

But because this patient stated to the psychologist that she was not only willing to seek mental health treatment, but also planned on checking herself into a facility near her home, she didn’t qualify to be involuntarily hospitalized. She was free to leave at any time.

As the psychologist explained to me, the first criterion of the Baker Act only considers whether or not the person in question is refusing treatment. According to Florida Statute 394.463, as long as said person does not refuse to be examined, the Baker Act does not apply.          

Although the psychologist assured […]

2016-11-21T13:16:51-05:00July 8th, 2010|Ethics, nursing perspective, Patients|3 Comments
Read More

Health Care Reform: What’s In It for Nurses?

A relaxing and safe Fourth of July weekend from the AJN editors to all nurses in the U.S., whether you’re taking it easy or on the job!

A recent poll conducted by the Kaiser Family Foundation shows rising popularity for the health care reform law. Many hard decisions still need to be made; innovation is more crucial than ever. Nurses who’d like a clearer sense of how the health care reform law may affect them in the coming years should have a look at “Health Care Reform: What’s In It for Nursing?” in our July edition. Written by AJN‘s emeritus editor-in-chief Diana Mason, it points out some of the new models of care the law promotes, models in which nurses play an increasingly important and vital role at every level. As often in the dynamic history of this country, there will be new kinds of opportunities for those who are ready for them.—JM, blog editor

Bookmark and Share

2016-11-21T13:16:55-05:00July 2nd, 2010|career, health care policy, nursing perspective|1 Comment
Read More

Checklist, Please!

Christine Moffa, MS, RN, AJN clinical editor

It’s embarrassing to admit how many times I’ve either locked myself out of my apartment or arrived at work and realized I’d left either my wallet or cell phone at home. That is, until someone very close to me taught me to say, “wallet, keys, cell phone, Metrocard” before walking out the door. Little did he know he was using a very powerful tool, the checklist.

As part of my money-saving strategies this year, I’ve resorted to using the New York Public Library to support my reading habit, instead of going to the various megabookstores in my neighborhood (I always fall for the “buy-two-get-one-free” deal!). That’s why I’m late to the party for The Checklist Manifesto, by Atul Gawande. After three months on hold, my turn finally came up—and boy was it worth the wait. There are so many great anecdotes about success stories (and some failures) of checklists—including patients surviving accidents and surgeries against all odds, averted airplane crashes, and well-orchestrated rock concerts—that it makes me want to start implementing checklists in every aspect of my life (including some at AJN). In fact, if I’d had a checklist for packing my bag for this weekend, I’d have remembered my flat iron, amongst other necessities. Now I’m forced to go the next 48 hours with serious frizz! 

My favorite part of the book, though, is that Gawande gives credit to nurses for being the originators of checklist usage in hospitals, citing vital sign charts, […]

2016-11-21T13:17:00-05:00June 28th, 2010|nursing perspective|2 Comments
Read More

Notes from the Nursosphere: Blogging Ethics, Tar Ball Vacation, Treating the Whole Person

Here’s a few things that got our attention late this week:

Chronic Disease Expert: U.S. Health Care Needs to Treat the ‘Whole Person’: At Kaiser Health News, a Q & A with a Stanford University chronic disease expert (who started her health care career as a registered nurse) focuses on the fragmentation of our health care system. Here’s a sample:

Q. Could the health care system do a better job addressing chronic disease?

A. The system would probably need to be totally reorganized if it was really going to do that. Right now, it addresses diseases or even parts of diseases or small sub-parts of the body. It does not address the whole, complex person with multiple chronic diseases. So, right now, what happens, if you’re lucky, you go to a primary care doc who kind of does the day-to-day stuff and then you see four or five specialists each of which do their little specialty part — none of whom really talk to each other except maybe to look at your laboratory tests on an electronic medical record if you’re really lucky.

It is totally uncoordinated. It’s chaotic. It serves pieces of people, not whole people.

Mental Health Impact of BP Spill Multiplies: Feel depressed and hopeless about the Gulf Oil Spill? At Covering Health, an article sketches out some of the journalistic work being done to look at what some people have actually begun calling “Gulf Oil Syndrome.”

Speaking of the oil spill, Sean Dent, a nurse who blogs at My Strong Medicine, has a recent post called 

2016-11-21T13:17:01-05:00June 25th, 2010|healthcare social media, nursing perspective|1 Comment
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