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

Catheter Ablation of Atrial Fibrillation: Essentials for Nurses

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

A postablation case was a rarity for me, even as an experienced ICU nurse. While floating to the cardiac ICU one day, I received a patient from the cath lab who had just undergone the procedure for recurrent atrial fibrillation.

My colleagues, experienced in electrophysiology care, gave me a heads up—“Just watch her rhythm. That’s the most important thing.” But no one could provide a standard protocol for me to follow in her care. While I had the usual critical care protocol for monitoring patients, and the orders given to me for this patient, before she arrived I did a little online searching to determine how to tailor my care for her needs.

The catheter ablation procedure involves electrical ablation of tissue around the circumference of the pulmonary veins, the most common site for atrial fibrillation triggers (A). Lesions are created through the use of an irrigated radiofrequency ablation catheter (B). Illustration by Anne Rains. The catheter ablation procedure involves electrical ablation of tissue around the […]

2016-11-21T13:01:50-05:00October 23rd, 2015|Nursing, nursing perspective|1 Comment
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Violence Against Women: Old Stories Repeat, But Some Progress

By Maureen Shawn Kennedy, AJN editor-in-chief

Emergency lights #5, by DrStarbuck via Flickr Emergency lights #5, by DrStarbuck via Flickr

It seemed ironic that, during this month of domestic violence awareness, a Florida judge showed little awareness of the fear that intimate partner violence can instill. Judge Jerri Collins came under attack from victim advocacy groups after she jailed a young mother who was a victim of domestic violence for failing to show up in court to press charges against her husband. According to various news reports, the distraught woman was afraid to face her husband in court for his sentencing to 16 days for choking and threatening her with a knife. Advocates say the judge’s action sends a message that may result in many women not bringing charges against abusers.

According to the CDC report Intimate Partner Violence Surveillance: Uniform Definitions And Recommended Data Elements (version 2.0; 2015), “over 1 in 5 women (22.3%) and nearly 1 in 7 men (14.0%) have experienced severe physical violence by an intimate partner at some point in their lifetime.” The real numbers are almost certainly higher, as many victims are afraid to report their partners for fear of retaliation once the abuser is released from jail. There are too […]

2016-11-21T13:01:51-05:00October 19th, 2015|Nursing, nursing perspective, Patients|0 Comments
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The First 50 Years of NPs: An Illustrated Timeline Shows Triumphs, Continuing Practice Barriers

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

This year marks the 50th anniversary of the nurse practitioner (NP) role. Themes of innovation and sustainability emerge as one examines an illustrated timeline of the history of NPs in AJN‘s October issue and reads the accompanying text. (The first section of the timeline is below. Click to enlarge.)

Screen Shot 2015-10-14 at 1.48.08 PM

How did this advanced practice nursing role come into being? As the timeline explains, ” [d]uring the 1960s, health care was becoming increasingly specialized. Physicians were moving out of general practice and into more complex and lucrative specialties, creating a void in primary care and prevention services, and in care of the chronically ill.”

To fill this void, public health nurse Loretta Ford, working with Dr. Henry Silver at the University of Colorado in 1965, launched the first NP certificate program, a seminal moment in the history of this prevention-driven, primary-care-focused nursing role.

Ford wrote about the compelling need for NPs. Calling health care a capital investment, Ford said:

“We have failed to realize the full potential of professional nurses to improve the quality of life. This group has great unused potential for bringing about health care reforms. Properly prepared and effectively utilized, nurses could advance the nation’s health […]

2016-11-21T13:01:52-05:00October 15th, 2015|career, Nursing, nursing perspective|0 Comments
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Case Studies in Effective Care Coordination by Nurses in Rural Kansas

“I did not have a clue how to proceed.”

Care coordinator Burlay Parks meets with a patient at Greeley County Health Services in Tribune, Kansas. Photo by Chrysanne Grund. Care coordinator Burlay Parks meets with a patient at Greeley County Health Services in Tribune, Kansas. Photo by Chrysanne Grund.

The opening sentence of “Pathfinding on the Frontier,” the In the Community column in the October issue of AJN, alludes to the confusion even the most organized and savvy person sometimes feels when navigating our health care system.

In rural settings, referrals to specialists from primary care providers can be difficult for patients and families to follow up on, sometimes requiring that patients travel great distances.

Patient care coordination has been shown to decrease the number of ED visits and hospitalizations. The authors of this article explore care coordination in two Kansas counties, presenting three case studies showing how a nurse care coordinator—as part of a program at a rural primary care practice funded by a two-year grant from the Robert Wood Johnson Foundation—resolved complex issues for seriously or chronically ill patients involving medications, specialists, and diagnoses. […]

2016-11-21T13:01:56-05:00October 12th, 2015|Nursing, nursing perspective, Patients|1 Comment
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One Nurse’s Ode to Fragility

Illustration by Lisa Dietrich for AJN. Illustration by Lisa Dietrich for AJN.

For nurses, the world outside work may from time to time seem as fragile and tenuous as the health of patients. Natural disasters threaten homes, illnesses afflict family members, the reminders of impermanence become too insistent. This month’s Reflections essay, “The Robin,” explores such emotional terrain with sensitivity and honesty.

Gentle warning: This is not an essay that neatly delivers a pearl of take-home wisdom at the end. But that’s what we liked about it. Sometimes the best we can do is hang in there and pay close attention. And, if we’re able and willing, write about it. Here are the opening few paragraphs of this short essay: […]

2016-11-21T13:01:56-05:00October 7th, 2015|narratives, Nursing, 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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