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

A Nursing Perspective on a Recent NEJM Palliative Care Article

Pam MolloyBy Pam Malloy, RN, MN, FPCN, director and co-investigator of the ELNEC Project, American Association of Colleges of Nursing (AACN), Washington, DC.

I just read a New England Journal of Medicine article by Drs. Craig D. Blinderman and the late J. Andrew Billings that came out on Christmas Eve, 2015. “Comfort Care for Patients Dying in the Hospital” was a thoughtful, informative article and I am grateful that it appeared in a journal that wasn’t focused solely on hospice/palliative care.

2016_ELNECLogoWhile the information in the article is essential for all health care professionals, I would like to take this opportunity to remind my nursing colleagues that we have a tremendous opportunity and privilege to plan, provide, and orchestrate the care that was described in this article—and we have been doing so for some time.

Nurses spend more time at the bedside and out in the community assessing and managing patients with serious, complex illness than any other health care professional. Our interdisciplinary colleagues depend on our assessments and we play a major role in developing plans of care with our diverse team. We are there having difficult conversations with patients—many times in the middle of the night when they cannot […]

2016-11-21T13:01:34-05:00January 8th, 2016|Nursing, nursing perspective, pain management, patient experience|2 Comments
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AJN in January: Year in Review, Fibromyalgia, Massage Redux, Fall Prevention, More

AJN0116 Cover Online

On this month’s cover, refugees clash with police as they attempt to cross the border into Macedonia from Greece. The photo, taken last August, depicts a chaotic scene that has become increasingly familiar as large numbers of migrants flee to Europe from the Middle East and Africa. At press time, the International Organization for Migration estimated that more than 832,000 refugees had crossed Europe’s borders by sea since January 2015. Many migrants, including those from Syria, are risking their lives to escape violence, destitution, and displacement caused by civil war.

Health concerns have arisen as Europe struggles to absorb the huge surge of arrivals. According to the World Health Organization (WHO), overcrowding in receiving facilities has led to unsanitary living conditions and instances of food- and waterborne diseases. But the journey itself also takes a toll: the WHO reports that injuries, burns, and psychological trauma are among the most frequent health problems refugees face. Those with chronic conditions like cardiovascular disease, diabetes, and hypertension find their diseases worsened by the interruption of treatment, and women suffer from pregnancy-related complications and sexual health issues.

As policy makers grapple with responding to the influx, the crisis is likely to remain a key global political and health issue in 2016. To read about this and other top health-related news stories of the past year related to nursing and health care […]

2017-03-24T03:43:24-04:00January 6th, 2016|Nursing, nursing perspective|1 Comment
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One Nursing Wish for the New Year

By Shawn Kennedy, AJN editor-in-chief

ShawnKennedyIf there’s one universal complaint by nurses, it’s that there aren’t enough of them on a shift to provide the care their patients need. We have a lot of data linking nurse staffing to patient outcomes and revealing the deleterious effects of missed care because of insufficient staffing. Yet, according to many hospital nurses I’ve spoken with, they still find themselves stretched to the breaking point by high patient acuity, rapid patient turnover, and increasing documentation requirements.

These nurses see no end in sight to this situation as hospitals argue that they have insufficient reimbursements and revenues to increase staffing. Ironically, as hospitals invest in pricey, cutting-edge new technologies that haven’t been shown to improve patient outcomes, the evidence about nurse staffing continues to be ignored.

In November, the ANA released a white paper, “Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes.” The paper summarizes and updates the research on staffing and outcomes, linking staffing to Medicare initiatives to reduce costs, adverse events, and readmissions. The report notes:

“Existing nurse staffing systems are often antiquated and inflexible. Greater benefit can be derived from staffing models that consider the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors. Factors that influence nurse staffing needs include: […]

2016-11-21T13:01:37-05:00January 4th, 2016|career, Nursing, nursing perspective|1 Comment
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Watching a Friend Fade Away: A Nurse’s Account of the Progress of Dementia

Illustration by Eric Collins, ecol-art.com. All rights reserved. Illustration by Eric Collins, ecol-art.com. All rights reserved.

By Jacob Molyneux, senior editor

Alzheimer’s disease and dementia have been in the news. There have been major movies about what’s it’s like to suffer the gradual loss of the ability to understand and to negotiate the world around us, with leading roles played by stars like Julianne Moore. The challenges of caregiving are receiving increasing attention, as are the growing pressures on our medical system. Every month there’s a report of a new potential cure, or a potential cause, or ways we might be able to fend off the illness through exercise, mental calisthenics, diet, and medications.

The January Reflections essay, written by Deborah Lane, a critical care nurse and community volunteer in St. Augustine, Florida, is called “Watching a Friend Fade Away.” Here’s the opening paragraph:

Frankie was a fast wit, a ginger-headed joker, impeccably dressed, and the first to laugh. She was a master’s-educated teacher who developed programs for at-risk teens, teaching pregnant high school students skills for employment and effective childcare. She loved to cook and her home was warm with beautiful arts and crafts she had made. She was a wonderful friend. Disease changed it all.

The author brings the perspective of both a loving friend and a nurse to this short, beautifully told account of the changes in her friend over the years, the efforts of two couples to keep spending […]

2016-11-21T13:01:38-05:00December 29th, 2015|narratives, nursing perspective, patient engagement|0 Comments
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Evening Shift, Christmas Eve: A Nursing Memory

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

One of my fondest memories of working Christmas Eve was after an evening shift at Bellevue Hospital in New York City. This was at the “old Bellevue Hospital,” when it still occupied a series of red brick buildings along the East River.

I had finished my evening shift in the ER, which was one of the busiest in the nation. It had been a crazy–busy night and I was too wired to just go home and sleep, so I decided to stop in the chapel for midnight mass. I was surprised to see my friend Helen there, since she was Jewish. I knew Helen always volunteered to work over the Christmas holiday so those who celebrated could be with their families, but I didn’t know that after work she’d go to the chapel to listen to the Christmas music, which apparently she loved.

We sat together, enjoying the quiet, calm pace of the service and the music. Helen knew all the words and sang along; she had a beautiful voice. Staff, visitors, and some patients (wearing the classic blue-and-white-striped Bellevue bathrobes—like draw sheets, these were hard to come by) shuffled in and out during the hour, clinicians sometimes leaving hurriedly after being summoned by a beeper.

Illustration for "A Change of Heart," AJN, December, 2014, by Lisa Dietrich for AJN. Illustration for “A Change of Heart,” AJN, December, 2014, by Lisa Dietrich

On the way out […]

2016-11-21T13:01:39-05:00December 23rd, 2015|career, narratives, Nursing, nursing perspective|7 Comments
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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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