nursing perspective Archives - Page 22 of 158

The Balancing Act: A Dying Patient and a Spouse Who Can’t Let Go

Illustration by McClain Moore

The Reflections essay in the March issue of AJN is called “The Balancing Act.” The author describes a situation she faced as an ICU nurse in which her efforts to keep a dying patient comfortable were complicated by a spouse’s reluctance to accept the inevitable. It’s often hard to advocate for a patient while honoring the emotional struggle of a close family member. Here’s the start of the essay.

I have just arrived to work in the ICU and am assigned a patient in respiratory distress. Her name is Darlene and her husband Tom is pacing the room. Within 10 minutes, he drinks three cups of coffee, ignoring the cot provided by the previous nurse so he could sleep next to Darlene. His wife has more than one cancer and both are growing. She left the hospital a week ago for hospice care, but has been readmitted after a decision by her husband to reattempt curative treatment.

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:24-05:00March 9th, 2016|Nursing, nursing perspective, Patients|2 Comments

‘Less Codes, Less Death’: A Study Explores Nurses’ Perceptions of the Benefits of Rapid Response Teams

By Sylvia Foley, AJN senior editor

For any given health care program, staff perceptions about how well it works will affect its use and maintenance. This is the case with regard to rapid response teams (RRTs). Nurse leaders’ perceptions of the benefits of RRT teams will influence their support for these teams; and the perceptions of RRT members and end users similarly will influence use. Yet little is known regarding such perceptions.

Nurse researcher Deonni Stolldorf recently conducted a study to learn more. She reports on her findings in one of this month’s Original Research features, “The Benefits of Rapid Response Teams: Exploring Perceptions of Nurse Leaders, Team Members, and End Users.” Here’s a brief summary:

Objective: This study sought to explore and compare the perceptions of nurse leaders, RRT members, and RRT users regarding the benefits of RRTs.
Methods: A qualitative, multiple-case study design was used. Semistructured interviews were conducted with nurse leaders, RRT members, and RRT users at four community hospitals, as part of a larger mixed-methods study examining RRT sustainability.
Results: All participants reported perceiving various ways that RRTs benefit the organization, staff members, and patients. Variations in the benefits perceived were observed between the three participant groups. Nurse leaders’ perceptions tended to focus on macro-level benefits. RRT members emphasized the teaching and learning opportunities that RRTs offer. […]

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Guest Author2016-11-21T13:01:24-05:00March 4th, 2016|Nursing, nursing perspective, nursing research|3 Comments

Just Breathe: A Nurse’s Tough Love Proves Crucial During One Mother’s Labor

Photo by chintermeyer, via Flickr.

By Amy Collins, AJN managing editor

The pain jolted me from my sleep. It was 1:30 in the morning. The sensation was stronger than anything I’d ever felt, and I grabbed my phone to start my contraction timer. I had read loads on labor and childbirth, and everything suggested I was in for the long haul. But my timer was showing the contractions were already only five minutes apart. I spoke with the hospital’s on-call physician, who told me to relax and spend as much time as possible at home so I could be more comfortable.

But within minutes, the pain had increased to a level where it was difficult to talk. The contractions were now three minutes apart and my water had broken. My husband and I decided to go to the hospital.

I’d like to say I was strong and handled the pain of labor well, but I was quickly losing control and succumbing to anxiety. By the time we got to the maternity unit, I was sobbing. The labor nurse assigned to me introduced herself as Jean. She was older and seemed seasoned, with a stern, no-nonsense attitude. She brought me to a delivery room and gave me a gown. Before labor started, my plan had been to see […]

Amy M. Collins, managing editor2016-11-21T13:01:25-05:00March 2nd, 2016|nursing perspective, patient engagement, patient experience|0 Comments

Nursing Reads: A Powerful New Novel Evokes Diverse Perspectives on an Organ Transplant

By Marcy Phipps, BSN, RN, CCRN, chief flight nurse at Global Jetcare

The Heart, a new novel by Maylis de Kerangal, caught my attention with a cover art image suggestive of the vascular and as beautiful as an angiogram. Taking place over a 24-hour period, the novel describes a 19-year-old accident victim who suffers brain death and the people who are connected to the heart transplant that follows: his parents, the doctors and nurses, the recipient of the heart. As a nurse who’s seen the organ transplant process from a number of angles, I wasn’t sure how De Kerangal could possibly navigate such material.

But the novel, which has been ably translated from French, is both subtle and powerful, casting light on the complexity of every character, from the pre-accident vitality of Simon, the donor, to the conflicted gratitude of the heart recipient; from the inexperienced ICU nurse to the surgeons.

Two important characters are nurses, though they are only a part of the larger picture:

Cordelia Owl, Simon’s ICU nurse, is an inexperienced practitioner. She carries out her nursing tasks in a distracted, perfunctory manner, speaking aloud to the unresponsive Simon as she cares for him. In doing so, she inadvertently intensifies the anguish of his parents, who are standing nearby and struggling with the concept of brain death.

Though her behavior shocks the attending physician, she’s […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:01:25-05:00February 29th, 2016|Nursing, nursing perspective, patient experience|0 Comments

AJN in March: Caring for Dying Prisoners, RRTs, Sexual Abuse and Survivorship, Anencephaly, More

AJN0316.Cover.2nd.indd

This month’s cover shows an elderly prisoner being handcuffed before transportation to a local hospital. Older inmates like this one represent the fastest growing age demographic in the U.S. prison population.

An important role in the care of prisoners is often filled by other inmates. The ambulance transporting the prisoner on our cover was staffed by inmates, for example, and inmates can be trained to care for sick prisoners, especially the terminally ill. For an in-depth look at the current state of care delivery for dying inmates, read “End-of-Life Care Behind Bars: A Systematic Review.”

Some other articles of note in the March issue:

Original Research: “The Benefits of Rapid Response Teams: Exploring Perceptions of Nurse Leaders, Team Members, and End Users.” It matters how a health care facility’s members regard its rapid response team (RRT). Subjective perceptions that the program has benefits—even in the absence of objective confirmation—tend to be associated with its continued use and long-term sustainability. This qualitative study investigates the perceptions of nurse leaders, RRT members, and RRT users concerning the benefits of RRTs. Its findings suggest several recommendations for practice, policy, and further research.

CE Feature: “Revisiting Child Sexual Abuse and Survivor Issues.” Child sexual abuse is a global issue that all nurses must be aware of as they care for children in various care settings. This article focuses on the prevalence, potential risk factors, […]

Diane Szulecki, editor2016-11-21T13:01:25-05:00February 26th, 2016|Nursing, nursing perspective|0 Comments