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

AJN in January: Long-Term Complications of CHD Repair, Obesity Interventions, Nurses Planning for Retirement, More

AJN0115.Cover.OnlineAJN’s January issue is now available on our Web site. Here’s a selection of what not to miss.

Complications after cardiac repair. Nurses often encounter patients with complications that occurred years after congenital heart defect (CHD) repair. Yet many patients whose CHD was repaired in childhood have not had regular follow-up. Our CE feature, “Long-Term Outcomes After Repair of Congenital Heart Defects: Part 1,” the first in a two-part series, reviews six congenital heart defects, their repairs, and common long-term outcomes, as well as implications for nurses in both cardiac and noncardiac settings. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

To further explore the topic, listen to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes). A video of an atrial septal defect device placement is also available in the iPad edition of this article.

Obesity interventions. Patients with obesity often face stigma and bias, even from the nurses who care for them. “The Obesity Epidemic, Part 2: Nursing Assessment and Intervention,” the second article in a two-part series, presents a theoretical framework to guide nursing assessment of patients with obesity and their families and reviews the most common […]

2016-11-21T13:03:17-05:00December 29th, 2014|Nursing, nursing perspective|0 Comments
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A Lasting Gift for a Nurse’s Holiday Shifts and Lost Family Time

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

As we know, gifts come in many forms, and often are as valuable to the giver as to the receiver. The best ones come at times when we least expect them. Readers will find that the start of AJN‘s December Reflections essay, “A Change of Heart,” describes a frustration that may be familiar to many nurses. In this case, it’s Christmas Day, and a nurse is kept by the urgent demands of her job from spending time with family. She writes:

I’ve been a nurse for more than half of my life . . . I love my career and consider myself blessed to have found my calling. But we all experience times when our long hours and the rigorous demands of this job make us feel that we sacrifice too much of our personal and family time to care for strangers.

The author had planned to be home for Christmas dinner. But, she tells us, “we had four back-to-back emergency CABGs starting at 8 am and stretching long past my scheduled 3 pm end of shift.” The essay develops from there as the hours pass. And then we meet a patient with everything at stake. The author is not the only one in danger of missing Christmas with family, and not just this year but for all the years to come.

We are reminded again and again that nursing has […]

2016-11-21T13:03:19-05:00December 19th, 2014|career, Nursing, nursing perspective|3 Comments
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Nurses Reconsider Accepted Wisdom About Transfusion Catheter Size

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

Photo copyright Thinkstock. Photo copyright Thinkstock.

Most of us have had the unhappy experience of replacing a patient’s perfectly good IV with a 19- or 20-gauge catheter in preparation for transfusion. The Question of Practice column in our December issue, “Changing Blood Transfusion Policy and Practice,” explores the rationale behind the long-time practice of using only large-bore catheters for blood transfusions.

After one patient’s particularly harrowing series of sticks to place a “large enough” catheter, a small team of oncology nurses asked themselves, “What evidence supports the use of a 20-gauge-or-larger catheter for blood transfusions?”

Most of these nurses had little experience with formal literature searches. Under the guidance of their clinical nurse specialist, they formulated a “PICOT” question (Population, Intervention, Comparison intervention, Outcome, and Time):

In adults receiving blood transfusions (P), what is the effect of using a smaller-than-20-gauge catheter (I) versus using a 20-gauge-or-larger catheter (C) on hemolysis or potassium level or both (O) within 24 hours of transfusion (T)? (Many of us were taught that a larger-bore catheter is necessary in order to prevent hemolysis during transfusion. Potassium is released when red blood cells rupture.)

The nurses set out to explore the literature and the guidelines of authoritative sources such as the Infusion Nurses Society. But they weren’t left to work […]

2016-11-21T13:03:20-05:00December 17th, 2014|Nursing, nursing perspective, nursing research|9 Comments
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Nurses at Center Stage: AJN’s Top 10 Blog Posts of 2014

By Jacob Molyneux, AJN senior editor/blog editor

Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID Filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

It’s unsurprising that some of our top blog posts this past year were about Ebola virus disease. But it’s worth noting that our clinical editor Betsy Todd, who is also an epidemiologist, cut through the misinformation and noise about Ebola very early on—at a time when many thoughtful people still seemed ill informed about the illness and its likely spread in the U.S.

Ebola is scary in itself, but fear was also spread by media coverage, some politicians, and, for a while, a tone-deaf CDC too reliant on absolutes in its attempts to reassure the public.

While the most dire predictions have not come true here in the U.S., it’s also true that a lot of work has gone into keeping Ebola from getting a foothold. A lot of people in health care have put themselves at risk to make this happen, doing so at first in an atmosphere of radical uncertainty about possible modes of transmission (uncertainty stoked in part by successive explanations offered as to how the nurses treating […]

2016-11-21T13:03:21-05:00December 12th, 2014|career, healthcare social media, infectious diseases, Nursing, nursing perspective|1 Comment
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New CE for Nurses: Understanding the Origins of the Obesity Epidemic

By Gaulsstin/via Wikimedia Commons By Gaulsstin/via Wikimedia Commons

One of our two December feature CE articles, “The Obesity Epidemic, Part 1: Understanding the Origins,” is about a pervasive and complex issue that nurses see the health consequences of in every practice setting:

. . . more than 35% of adults and 16% of children ages two to 18 are obese. Obesity disproportionately affects racial and ethnic minorities as well as people at lower income and educational levels, though it is prevalent among men and women in every segment of society. Obese children and adults are at risk for type 2 diabetes, cardiovascular disease, musculoskeletal dysfunction, and certain types of cancer. The Centers for Medicare and Medicaid Services estimates the annual national health care expenditure on obesity to be about $147 billion, with per capita spending on obese people averaging $1,429 more than spending on individuals of normal weight.

Knowledge about this epidemic continues to evolve. This article is part 1 of a two-part series and provides readers a concise overview of current theories about the pathophysiologic, psychological, and social factors that influence weight control. As the overview points out, ” [t]o contribute to obesity’s treatment and prevention, nurses must be conversant in a wide range of theoretical and clinical perspectives on the problem.” […]

2016-11-21T13:03:22-05:00December 10th, 2014|nursing perspective, patient engagement, Patients|0 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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