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

Too Tired to Nurse

By Shawn Kennedy, AJN editor-in-chief

by patchy patch, via flickr by patchy patch, via flickr

Just about every nurse I know has been “asked” (or “guilted” or “mandated”) to work an additional shift on top of a grueling one. The worst such experience I ever had was having to work from midnight to 8 am after working a straight week of 4 pm to midnight shifts. I was exhausted, but someone had called in sick, leaving only two RNs and one aide for the 11-bed ED trauma unit.

I was so tired that at one point I found myself falling asleep while I was standing by a patient’s bed charting vital signs. I couldn’t remember the blood pressure reading I had obtained just moments before. It was good luck that I didn’t make an error—and had the good sense to have a colleague double-check medications I was readying (these were the old days, before unit dosing). […]

2018-03-28T10:19:26-04:00December 8th, 2014|Nursing, nursing perspective|7 Comments
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Patient Safety, Patient Advocacy: In Pediatric Nursing, A Tricky Balance

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

CT Scan ink and watercolor on paper 2014 by jparadisi CT Scan ink and watercolor on paper 2014 by jparadisi

I was precepting a new nurse. She’d earned a job in our PICU during her student clinical rotation. New grads weren’t routinely hired, but her competency led to her recruitment. Precepting her was a joy.

This particular shift, we were assigned one of those midafternoon admissions with the potential to keep us overtime: rule out meningitis. The preschool-aged patient had been brought to the ED after having a first-time seizure. When he reached the PICU, however, we were relieved that he presented more like a febrile seizure.

Besides a fever and runny nose, the only other remarkable characteristic about the child was his utterly charming personality. We drew his labs while starting an IV. An antibiotic infusion was started, and acetaminophen administered. Feeling better, and not the least postictal, he played with our stethoscopes.

This was many years ago. There were standards in place that accompanied certain diagnoses. ‘Rule out meningitis’ came with a CAT scan and lumbar puncture.

Both seemed excessive, given the child’s presentation, but there was the order for CAT scan. He sat upright in his crib singing, […]

2016-11-21T13:03:24-05:00December 3rd, 2014|career, Nursing, nursing perspective, Patients|3 Comments
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AJN in December: Surveillance Tech, Obesity Epidemic, Questioning Catheter Size, More

AJN1214.Cover.OnlineAJN’s December issue is now available on our Web site. Here’s a selection of what not to miss.

To watch or not to watch? Long-term care facilities are challenged with providing care for a growing number of patients with dementia or intellectual disabilities. This month’s original research feature, “The Use of Surveillance Technology in Residential Facilities for People with Dementia or Intellectual Disabilities: A Study Among Nurses and Support Staff,” describes an ethnographic field study on the ethics, benefits, and drawbacks of using this technology in residential care facilities.

The obesity epidemic. Obesity rates are rising at an alarming rate in the United States. “The Obesity Epidemic, Part 1: Understanding the Origins,” the first article in a two-part series, outlines pathophysiologic, psychological, and social factors that influence weight control.

Smaller catheter size for transfusions? “Changing Blood Transfusion Policy and Practice,” an article in our Question of Practice column, describes how a small team of oncology nurses designed and implemented an evidence-based project to challenge the practice that a 20-gauge-or-larger catheter is required for the safe transfusion of blood in adults. […]

2016-11-21T13:03:25-05:00December 1st, 2014|Nursing, nursing perspective|0 Comments
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Counting Your Blessings

By Maureen Shawn Kennedy, AJN editor-in-chief

A perhaps idealized past: 'Home for Thanksgiving,' Currier and Ives lithograph/Wikimedia Commons A perhaps idealized past: ‘Home for Thanksgiving,’ Currier and Ives lithograph/Wikimedia Commons

At the Thanksgiving holiday in the U.S., it’s customary to take some time to reflect on our good fortune—to give thanks for what we have. For many of us, it means being thankful for family and good health. But what about all the other people who may make a difference in how we live our lives, who make the world in which we live better or in some indirect way have had an impact on what we do, how we do it, how we feel about life or our work?

Here are some folks I’d like to thank:

2016-11-21T13:03:29-05:00November 26th, 2014|career, infectious diseases, Nursing, nursing perspective|0 Comments
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Widespread Support for Nurse’s Refusal to Force-Feed: Grounded in Ethical Principles

By Maureen Shawn Kennedy, AJN editor-in-chief

Nasal tubes, gravity feeding bags, and the liquid nutrient Ensure used in Guantanamo force-feeding/ image via Wikimedia Commons Nasal tubes, gravity feeding bags, liquid nutrient Ensure used in Guantanamo force-feeding/Wikimedia Commons

Last week, reports hit the news media of a nurse in the U.S. Navy facing possible discharge for refusing to participate in force-feeding a hunger-striking prisoner at Guantanamo Bay. An early discharge, two years shy of the 20-year mark, could cost him his pension and other benefits.

The nurse had initially volunteered for duty at the Guantanamo facility, but then, as we noted in a blog post examining the ethics of his decision back in July, decided he could not continue to participate in force-feeding detainees in violation of professional ethics.

In a letter to Chuck Hagel, U.S. secretary of defense, the American Nurses Association has supported the decision of the naval nurse. ANA president Pam Cipriano reaffirms that a nurse’s primary commitment is to the patient and “in addition, this commitment is present regardless of the setting in which nursing care is provided. The military setting does not change the nurse’s ethical commitments or standards.” […]

2016-11-21T13:03:29-05:00November 24th, 2014|career, Ethics, Nursing, nursing perspective, Patients|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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