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

‘An Immutably Personal Process’: A Hospice Nurse Contemplates Uncontrol

Megen Duffy, RN, BSN, CEN, currently works in hospice case management. She writes AJN’s iNurse column, which focuses on technology and nursing.

by mark ahsmann/ wikimedia commons by mark ahsmann/ wikimedia commons

I started my day the way I often do: watching sunlight begin to filter in and softly illuminate the sunken face of a person who would die, not later, but sooner. I sat curled in the chair I’d been in since 3:00 AM, wrapped in my sweater against the institutional chill, and waited.

This is, perhaps unbelievably, my favorite part of being a nurse. In hospice, there is no deadline. No one needs the room right now. The patient does not have to go to the floor in the next 30 minutes to avoid throughput delays. I do not have five other patients claiming my time. No, I have the gift of being able to sit quietly with only one objective: to do everything I can to make sure this person leaves this life without pain or fear.

I am not bored. It may appear as if I am doing nothing, but that is far from true. I am watching and listening for every breath, every movement, every toe that turns a deep bruised purple, every expression that may say “I am hurting.”

I am merely cooperating with death, and death’s agenda is never known to me. My […]

2016-11-21T13:02:06-05:00August 27th, 2015|Ethics, narratives, Nursing, nursing perspective|8 Comments
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As with Ebola Outbreak, Social Determinants of Health Crucial in Recent Rural U.S. HIV Outbreak

Rachel Parrill, PhD, RN, APHN-BC, is an associate professor of nursing at Cedarville University in Ohio

by banditob/flickr creative commons by banditob/flickr creative commons

This past fall, with the world watching, a crisis unfolded in West Africa that challenged our understanding of sociocultural environments, epidemiology, and health. The spread of Ebola and the intercontinental transmission of the disease exposed weaknesses in our epidemiological defense system. It also drew attention to the powerful role that cultural beliefs and practices can have on disease transmission during outbreaks.

In that same time frame, and with similar cultural etiologies, another infectious crisis played out much closer to home. The setting: the rural Midwest, in and around the small town of Austin, Indiana. The disease: HIV. The crisis: an unprecedented outbreak—one with incidence rates (up to 22 new cases a day at the height of the outbreak) estimated to be higher than those in many sub-Saharan African nations and transmission rates through injection drug use higher than in New York City. Contributing to this “perfect storm” were socioeconomic factors characteristic of many rural settings, including poverty, low education levels, limited access to health care, and few recreational or employment opportunities.

In my work as a faculty member in a rural Midwest setting, I introduce undergraduate and graduate nursing students to concepts of public health nursing and try to provide opportunities […]

2016-11-21T13:02:06-05:00August 25th, 2015|infectious diseases, Nursing, nursing perspective|0 Comments
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In a Changing Health Care Landscape, Narrowing Options for Older RNs?

Christine Contillo, RN, lives in New Jersey and has been a staff nurse at a university health service in New York City for eight years.

Fork_in_the_road_-_geograph.org.uk_-_1355424I’ve been a practicing nurse for 36 years, working continuously while raising three kids. After first trying a few other jobs, I entered nursing expecting a profession that would give me emotional fulfillment, some flexibility, and a good wage. Nursing has fit the bill for me on every level.

Throughout my career I’ve made every effort to keep advancing my skills. I’ve earned annual continuing education credits as well as attended national conferences and gained two certifications. The titles I’ve held have included supervisor, coordinator, and nurse educator. For the last eight years I’ve held a full-time position that I love in a primary care in a medical home setting. There I’ve had both an independent and a provider support role. I’m adept at use of the EHR, vaccines, triage, finding and booking specialists, travel health, patient education, removing sutures and dressing wounds, among other things.

However, I have a 3.5-hour commute each day. As I get older, my time has become much more precious. With college loans for my three kids finally paid off and my husband’s full encouragement, last year I began to look for a job closer to home.

I envisioned something similar to what I was already good at, as part of […]

2016-11-21T13:02:07-05:00August 21st, 2015|career, Nursing, nursing perspective|4 Comments
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Measuring a Nurse’s Career Through BLS

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

ParadisiBLSCertificationCardI was a child when I first heard the term CPR. My father, a volunteer fire captain in our community, had newly certified that day at drill. From the head of our dinner table he proclaimed, “It’s a terrible thing to have to do, but everyone should know how.”

He was right.

It feels as though I’ve known basic life support (BLS; sometimes still referred to as CPR) all my life, but I believe I was 16 years old when I first took a provider course, long before I knew I’d become a nurse.

Since then, as a former pediatric intensive care nurse, I have performed a lot of CPR, and a related professional compliment received during a pediatric resuscitation rests bittersweetly in my heart.

It was one of those codes that begins in the ED, and transfers into the PICU because survival is unlikely. The cause was cardiac. As I did compressions, and my colleague, a respiratory therapist, hand-ventilated the child, blood gases were drawn. The attending cardiologist looked over the results, and told us, “It’s too bad a perfect blood gas isn’t enough to save a life. The two of you are performing superb CPR.”

He was right. It wasn’t enough.

That was nearly 20 years ago. Basic life support recertification is required every two years. Now that […]

2016-11-21T13:02:08-05:00August 19th, 2015|career, Nursing, nursing perspective|1 Comment
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On Nursing Identity: What We Can Learn from African Nurses’ Oral Histories

 By Sylvia Foley, AJN senior editor

Port of Mauritius by Iqbal Osman, via Flickr Port of Mauritius by Iqbal Osman, via Flickr

“I have chosen this profession and nobody can take it away from me.”—Sophie Makwangwala, study participant

In the summer of 2009, at the International Council of Nurses (ICN) Quadren­nial Congress in Durban, South Africa, a small group met to discuss collaborating on joint history projects. At that meeting, several African leaders of pro­fessional nursing associations reported that their expertise had long gone unrecognized. Seeking to have the stories of African nursing history told, they pro­posed interviews with other retired nurse leaders. Barbara Mann Wall, an American nurse researcher who was in the room that day, found herself intrigued.

The study. In keeping with Braun’s tenet that “indigenous research should be led, de­signed, controlled, and reported by indigenous peo­ple,” Wall first trained three of the African nurse leaders in the oral history method, aided by a grant from the University of Pennsylvania School of Nursing. Then the team embarked on the study reported on in this month’s original research CE, “ ‘I Am A Nurse’: Oral Histories of African Nurses.” Here’s an overview: […]

2017-07-27T14:39:53-04:00August 17th, 2015|career, nursing perspective, nursing research|2 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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