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

Notes from the Web

Here are a few items of interest on today’s Web as these huge wet snowflakes actually start to accumulate on rooftops here in NYC and the horizon (New Jersey, that is, across the thin wedge of the Hudson River you can see from AJN offices) closes steadily in:

Kim at Emergiblog has a nice post dealing with changing her mind about whether or not she wanted to get a BSN.

And this post by Anne Dabrow Woods at In the Round (excerpted below) got our attention for its honesty about the difference between treating a condition in the hospital and treating it at home in a family member—and also because it put a human face on an article we ran in our February issue about ostomy complications and management.

My oldest daughter was diagnosed with ulcerative colitis when she was 7 years old and despite aggressive treatment for her disease; she required a total colectomy, temporary ileostomy, and an ileo-anal anastamosis when she was 12. As a nurse I thought I was equipped to care for her ileostomy; was I ever wrong. I had experience taking care of hospitalized patients with ostomies, but I quickly learned caring for someone who is active is a totally different story.

In his most recent post, Anonymous Doc is as usual thoughtful and honest (except for that anonymity thing, of course . . . which does, whatever its drawbacks, kind of free him up as a writer). He moves from […]

2016-11-21T13:19:09-05:00February 25th, 2010|health care policy, nursing perspective, students|0 Comments
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‘Jenny’s Daydream’: February’s ‘Art of Nursing’ Disturbs the Quiet

By Sylvia Foley, AJN senior editor

“Stuck to the chair, locked door, locked window, / watching for wrens and sparrows, Jenny closes her eyes.” These lines open “Jenny’s Daydream,”  the poem featured in this month’s Art of Nursing (please click through to the PDF). The daydream is no idyll; though Jenny “remembers sparse blue and yellow flowers” and “herring gulls sunning on the pier, peaceful,” she’s also “waiting for / God’s voice to disturb the interstellar quiet.” Why? The answer, at once harrowing and poignant, might surprise you.

Karen Douglass, a writer and retired RN, has been published in many literary and mainstream magazines, including Sunken Lines, The Other Voices International Project, and Yankee. Her most recent collection is The Great Hunger (Plain View Press, 2009).  Douglass also blogs about writing and life at KD’s Bookblog.

And if you’re a poet or a visual artist, we hope you’ll consider submitting to Art of Nursing. Read this blog post for details. Guidelines can be found here. Still have questions? Write to the Art of Nursing coordinator (me) at sylvia.foley@wolterskluwer.com.

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2016-11-21T13:19:17-05:00February 17th, 2010|nursing perspective, patient engagement|2 Comments
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Will Texas Nurse Whistle-blower Case Have Dangerous Ripple Effect?

KERMIT, Tex. — It occurred to Anne Mitchell as she was writing the letter that she might lose her job, which is why she chose not to sign it. But it was beyond her conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine.

That’s from an article in today’s New York Times about a Texas nurse who’s being prosecuted for blowing the whistle on what she asserts were inappropriate medical practices by a doctor she worked with. We’ve posted on this as the case has developed and also written about it in the journal. Ultimately, the judgment is up to the court. But the concern we’ve expressed and which others have also voiced is that this will have the effect of silencing others who should be speaking out. In the process it may well reinforce old nurse–physician dynamics that profit no one. What do you think?

UPDATE: She was acquitted today (February 11)!Bookmark and Share

2010-02-11T17:35:19-05:00February 7th, 2010|nursing perspective|5 Comments
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The Checklist – Taking Finger-Pointing Out of the Equation

By Peggy McDaniel, BSN, RN

Ok, I will admit right off that I am a huge fan of Atul Gawande’s writing. I have read his books Better and Complications, and I think much of his work should be required reading for all health care students. I haven’t read his newest book, The Checklist Manifesto: How to Get Things Right. I plan to soon, but it’s the 3rd book down in the pile on my bedside stand.

That confession aside, there has been some recent news around the use of checklists that bears some attention. Dr. Gawande helped develop a two-minute checklist that is to be done prior to surgery. 

Dr. Peter Pronovost was involved in the development of a similar checklist related to the insertion of central lines. 

Airlines and airplane manufacturers, such as Boeing, use checklists constantly to ensure consistent, high quality outcomes. 

I did a quick Google search for “checklists and nursing” and found various references to skills and competency checklists. As a nurse, my skills have been observed and validated with checklists over the years. I have also been party to filling out checklists on myself and my peers. Come to think of it, much of our charting has been done by filling out checklists. 

I guess I am a bit surprised that the use of checklists to validate competencies and keep track […]

2016-11-21T13:19:34-05:00February 5th, 2010|nursing perspective|3 Comments
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Déjà Vu All Over Again: Internal Uterine Contraction Monitoring Another Case of Practice Without Evidence

By Shawn Kennedy, MA, RN, interim editor-in-chief

Last week, the New England Journal of Medicine (NEJM) reported (abstract available here) on a Dutch multi-center randomized trial comparing internal versus external monitoring of uterine contractions during induced labor on rate of cesarean or instrument delivery. Among secondary outcomes they examined were use of analgesia, oxytocin and antibiotics, adverse neonatal effects, and complications from the intrauterine catheter (hemorrhage, sepsis, among others).

What caught my eye was the first sentence of the paper, which read, “The monitoring of uterine contractions by means of internal tocodynamometry during induction or augmentation of labor is advocated by professional societies in obstetrics and gynecology.” Yet, as this study points out, there has been little data to support the societies’ recommendation for internal monitoring. And, lo and behold, the results of this trial “do not support the routine use of internal tocodynamometry for monitoring  contractions in women with induced or augmented labor.”

This reminds me very much of electronic fetal monitoring. […]

2016-11-21T13:19:36-05:00February 4th, 2010|nursing perspective|1 Comment
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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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