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

To Boldly Go . . . In Search of Nurses

By Beth Toner, MJ, RN, senior communications officer, Robert Wood Johnson Foundation

Nurse Christine Chapel, original Star Trek series/via Wikipedia Nurse Christine Chapel, original Star Trek series/via Wikipedia

Inaccurate Representations in Popular Culture

Many critics and fans delighted in the release of the “reboot” Star Trek in 2009; the film, after all, breathed new life into the franchise, and introduced a whole new generation to its beloved characters—including Kirk, Spock, and the inimitable Dr. McCoy, better known as ‘Bones.’ A lifelong Trekker (I was born just weeks after the series launched in 1966), I was delighted, too. Yet I was exasperated at the notable invisibility of a minor recurring character: Nurse Christine Chapel.

Many of you may be asking: “Really? What does a fictional science fiction nurse have to do with real, professional nurses?”

Symptom of Broader Invisibility

The lack of emphasis placed on Nurse Chapel’s character is symptomatic of what I believe is a larger problem: the absence of nurses’ voices in key positions—not just in pop culture, but more importantly in boardrooms, community and nonprofit organizations, and in policy making. Furthermore, where nurses are present, there is a general misunderstanding of what it is nurses do every day—and how our presence is vital to building a society in which all […]

2016-11-21T13:00:58-05:00September 8th, 2016|Nursing, nursing perspective, Public health|1 Comment

All Unhappy Patients Are Not Alike

illustration by the author illustration by the author

The first sentence from Leo Tolstoy’s novel Anna Karenina is one of the most famous in literature:

All happy families are alike; each unhappy family is unhappy in its own way.”

It can easily be applied to patients. Happy patients tend to love their doctors, feel they received the best possible care, and consider their nurses invaluable.

Unhappy patients are unhappy in their own way. The challenge for busy nurses is resisting the temptation to turn a deaf ear or feign listening, in effect reducing patients’ concerns to “waa, waa, waa.”

A common thread among unhappy patients is unmet expectations.

Sometimes the patient’s expectations are unrealistic because they’re based on incorrect assumptions—but they do not know this. Responding requires a willingness to listen and the patience to tease out why a patient is unhappy with their care. Let patients tell their stories. Most bedside nurses have limited time; it’s okay to enlist help from a case manager, social worker, or nurse navigator if necessary. However, investing time up front to improve communication with a patient may pay off in dividends by smoothing the rest of your shift.

Begin by listening. Sometimes, I’ll take a seat, and write what the patient says while they talk. This simple act conveys […]

AJN in September: Predicting Injurious Falls, Military Sexual Trauma, Recognizing MI, More

AJN0916.Cover.OnlineThe September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: Predicting Injurious Falls in the Hospital Setting: Implications for Practice

Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet most of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls. In an attempt to identify which patient factors are associated with injurious falls in hospitalized adults, the authors of this retrospective study analyzed 10 variables. Their findings may help hospital clinicians to identify at-risk patients and create better fall-related injury prevention interventions.

CE Feature: “Military Sexual Trauma in Male Service Members

The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members. This article discusses the unique ways in which men may experience MST and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man’s interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It also describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care […]

2016-11-21T13:00:58-05:00August 26th, 2016|Nursing, nursing perspective|0 Comments

Nurses Take Action on Moral Distress

Nurses gather at the Johns Hopkins School of Nursing to address this growing problem.

A nurse struggles to reconcile repeated surgeries and transfusions for a premature infant with the child’s slight chance of survival. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she is not giving needed care to patients because of inadequate staffing.

From left, Katherine Brown-Saltzman, Kathryn Trotochaud, Lisa Lehmann, Heidi Holtz From left, Katherine Brown-Saltzman,
Paula Goodman-Crews, Lisa Lehmann, Heidi Holtz

Situations like these are not rare for nurses and often give rise to moral distress—that is, when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

Moral distress in nursing has risen to unprecedented levels, contributing to burnout and staff shortages and imperiling safe, quality health care.

Seeking solutions.

Nursing researchers, clinicians, organization representatives, and other stakeholders convened in Baltimore on August 11-12 for an intense invitational workshop called State of the Science Symposium: Transforming Moral Distress to Moral Resiliency in Nursing. The meeting focused on how to best address moral distress.

The 46 participants heard from […]

Former Navy Nurse Raises Awareness About the Lingering Effects of Agent Orange

Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008. Susan Schnall and a group of children at Tu Du Hospital, Ho Chi Minh City, in 2008.

On August 10, 1961, the United States military first sprayed Agent Orange, a defoliant containing a particularly toxic dioxin compound, in Vietnam. Fifty-five years later, the effects of this and other chemicals linger on. And 48 years after former naval nurse Susan Schnall was court-martialed for protesting the Vietnam War, she visited Vietnam for the first time and witnessed these effects firsthand.

“In all my years in health care, I have never seen children with such severe birth defects,” Schnall said during an interview with AJN. After her court-martial, Schnall went on to have a successful 30-year career in hospital administration. After retiring and visiting Vietnam, she decided she needed to do something about what she witnessed there.

Schnall joined a group called the Vietnam Agent Orange Relief and Responsibility Campaign, made up of American Vietnam Veterans, Vietnamese Americans, social activists, and community leaders. The group aims to educate the public on the repercussions of the chemical warfare used in Southeast […]

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