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

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: patient […]

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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Protect Yourself, Protect Your Career: Get Informed About Nurse Licensure

Edie Brous, JD, MS, MPH, RN, is a nurse and attorney in New York City and the coordinator of AJN‘s Legal Clinic column.

By Daniel X. O'Neil/via Flickr By Daniel X. O’Neil/via Flickr

I just came back from speaking at a conference where I had the same experience I have every time I speak with nurses about licensure issues. Participants say I am telling them things they didn’t know before.

Nurses who have been in practice for decades didn’t know their state requires nursing board notification of name or address changes within a certain number of days. They didn’t know that criminal convictions, even unrelated to nursing practice, can lead to disciplinary action on their nursing licenses. They didn’t know that it is considered professional misconduct to default on child support payments. They didn’t know that discipline in one state can result in discipline in another state, even when the license in that second state is inactive or expired.

Misconceptions about state boards of nursing. Many nurses do not understand the mission of the nursing board and think that the board is supposed to be an advocate for individual nurses or for the nursing profession. In fact, the board’s mission is to protect the public. Members of the board of nursing are not there to advocate for you, but to protect the public from you when […]

2016-11-21T13:01:39-05:00December 18th, 2015|career, Nursing, nursing perspective|2 Comments
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Has the Future of Nursing Report Made a Difference?

Action Coalition logoBy Shawn Kennedy, AJN editor-in-chief

Last week, I went to Washington, DC, for a meeting convened to hear whether implementation of recommendations from the Institute of Medicine’s (now renamed the National Academy of Medicine, NAM) 2010 report, The Future of Nursing: Leading Change, Advancing Health, had indeed made a difference for nurses and the nursing profession.

The Robert Wood Johnson Foundation (RWJF), which sponsored the report, had also provided support to AARP’s Center to Champion Nursing in America to coordinate a “campaign for action” and manage the work of 51 state action coalitions. Five years later, RWJF asked the National Academy of Medicine to review and report on its progress.

In brief, the evaluation committee said that things were improving for nursing and that nursing needs to focus on three major themes:

  • communicating and collaborating with groups beyond nursing
  • improving diversity
  • getting better data

[…]

2016-11-21T13:01:39-05:00December 17th, 2015|career, Nursing, nursing perspective|5 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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