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

Nursing Ethics: Helping Out on the Unit vs. Teaching Nursing Students Crucial Skills

By Jacob Molyneux, AJN senior editor

scalesJust as no two hospital units are exactly alike, rarely are two ethical conflicts exactly alike. There are too many variables, too many human and situational differences. This month’s Ethical Issues column, “Teaching Crucial Knowledge vs. Helping Out on the Unit,” explores potential ethical and practical issues faced by a clinical instructor who must balance the duty to teach essential skills to nursing students against the staff’s need for help in meeting patient care needs.

Will there be an easy, cut-and-dried answer? Probably not. In the course of their analysis of a hypothetical scenario, the authors make the following point:

Because new situations arise all the time, and every situation varies in its ethically relevant aspects, rigid rules often cannot guide ethical action. Instead, analytic skills and transparent negotiation are crucial for resolving conflicts between values as they arise in day-to-day interaction—and for supporting the solutions we choose.

While people skills may be as important as abstract ethical analysis in dealing with real world situations, determining which ethical principles or priorities are coming into conflict may provide us with a certain measure of clarity in our approach. The authors frame the conflict described in the article in the following way:

[…]

2016-11-21T13:01:59-05:00September 23rd, 2015|Ethics, Nursing, nursing perspective, safe staffing, students|0 Comments
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Unexplained Deathbed Phenomena: Honoring Patient and Family Experience

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

by luke andrew scowen/flickr creative commons luke andrew scowen/flickr creative commons

When my dad died, a special little travel clock that he’d given me years before stopped working. It restarted a week after his death, and continued running for years. I have no explanation for this sudden lapse in timekeeping, but it made me feel closer to my dad.

I’ve heard many other stories of unusual events surrounding the death of a loved one. I was therefore delighted to read this month’s Viewpoint column, “Letting Patients and Families Interpret Deathbed Phenomena for Themselves.” In this short essay, Scott Janssen presents some intriguing research findings and a compassionate argument for speaking openly about these occurrences. He writes:

“It’s an open secret among those of us working with the dying – there’s a lot of strange stuff going on for patients, as well as for the clinicians and family members who care for them, that rarely if ever gets talked about: near-death experiences, synchronistic coincidences (stopped clocks at time of death, for example), out-of-body experiences, and visitations from deceased loved ones.”

Janssen, a former hospice social worker and now a psychotherapist, sees such phenomena as part of “the normal continuum of experiences at the end of life.” He calls upon clinicians to create safe contexts in which patients and families can share these experiences without fear that they will be judged, ridiculed, or dismissed by caregivers.

It’s food for […]

2016-11-21T13:01:59-05:00September 21st, 2015|Nursing, nursing perspective, patient experience, Patients|0 Comments
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Some Notes on Miss Colorado’s ‘I’m Just a Nurse’ Speech

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

I’m a sucker for beauty pageants. There’s something about the old-fashioned simplicity that fascinates me. While Miss America is, at its roots, a generous scholarship program, it’d be hard for me to say that I tune in for anything other than the sparkle and style.

With that said, I still love a Miss Congeniality angle, which this year’s Miss Colorado seemed to proffer in a much-praised speech. Similar to Sandra Bullock’s character, Gracie Lou Freebush, Kelley Johnson’s nurse-specific monologue was both engaging and educational. But her talent struck a little closer to home—she used the phrase “I’m just a nurse.”

Her two-minute speech won her a second-runner-up prize, as well as millions of hits online. But what did it get us nurses?

Sure, all PR for our profession is great, but the age-old, ubiquitous slur that served as the tagline for much of Ms. Johnson’s monologue makes a lot of us uneasy. Although Ms. Johnson very skillfully ended her monologue by refuting her initial proclamation, the public expression of it deserves a second look.

“Just a nurse” is not a new phrase to our profession; a brief scroll through Tumblr will do more than update the casual viewer. However, most of us steer away from association with the phrase; it discredits, it’s a conversation killer, and it has long been seen as a sarcastic way […]

2016-11-21T13:02:00-05:00September 15th, 2015|career, Nursing, nursing perspective|4 Comments
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Coming Home to Nursing: A Career Change Eases a Return to a Small Town

“Working as a nurse in the county where your family has lived for seven generations has a social complexity that can’t be prepared for.”

The Reflections essay in the September issue of AJN isn’t focused on a dire clinical situation, a wrenching ethical quandary, or a challenging coworker or boss. Called “Coming Home to Nursing,” the essay describes the many ways becoming a nurse helped the author begin to feel a sense of belonging when she returned to her small town. Here’s the opening:

Illustration by Gingermoth for AJN. All rights reserved. Illustration by Gingermoth for AJN. All rights reserved.

I had been taking care of people, in one way or another, for as long as I could remember, first growing up in Maine and then for 20 years in New York City. I had returned to my small town to help care for my mother, who had end-stage Parkinson’s disease. After she died, I felt a void. I looked around at this tiny place, where people are considered to be “from away” even if they’ve lived here for multiple generations. I wondered what I had to give back to the supportive community I’d grown up a part of—and I also wondered if I could fit in after 20 years away. Could I turn my love of […]

2016-11-21T13:02:02-05:00September 8th, 2015|career, narratives, Nursing, nursing perspective|1 Comment
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AJN in September: Pain Management in Opioid Use Disorder, STIs in the U.S., Teaching Vs. Unit Needs

AJN0915.Cover.OnlineOn this month’s cover, perianesthesia nurse Carolyn Benigno helps prepare a young patient for surgery at Children’s National Medical Center in Washington, DC. The photo, the first-place winner of AJN’s 2015 Faces of Caring: Nurses at Work photo contest, shows Benigno practicing “Caring through Play.” The art of working at a pediatric hospital, she says, is “learning how to play with children so that part of your nursing care is play.” Such play can both distract a child in the moment and help the child cope with the disorienting experience of hospitalization.

For another piece on how nurses try to make hospitalization less stressful for children, see this month’s Cultivating Quality article, “Improving Pediatric Temperature Measurement in the ED.”

Some other articles of note in the September issue:

CE Feature: “Acute Pain Management for Inpatients with Opioid Use Disorder.” Inpatients diagnosed with opioid use disorder (OUD) commonly experience acute pain during hospitalization and may require opioids for pain management. But misconceptions about opioids and negative attitudes toward patients with OUD may lead to undermedication, unrelieved pain, and unnecessary suffering. This article reviews the current relevant literature and dispels common myths about opioids and OUD. […]

2016-11-21T13:02:02-05:00September 2nd, 2015|career, Ethics, infectious diseases, 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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