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

Nurses, Brittany Maynard, Methods of Hastening Dying: No Easy Options

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

Last weekend, 29-year-old Brittany Maynard died, in her bed, in her bedroom, with her husband and immediate family beside her. I learned of her death on Twitter, along with millions of other readers. Several weeks earlier, Maynard had publicly announced, in a YouTube video, the way she planned to end her own life: using a lethal dose of medications prescribed to her for that purpose.

Maynard, while a compelling public advocate, is not the first to choose to die this way. Compassion and Choices, the organization that worked with Maynard to publicize her choice, lobbies for the drafting and passage of “death with dignity” laws, which currently exist in some form only in Oregon, Washington, Vermont, New Mexico, and Montana. Arizona.

In Oregon, where Maynard moved in order to be able to legally end her life before she was incapacitated by the effects of terminal brain cancer, approximately 71 other people made the same choice in 2013, the most recent year of reported data—the peak of a gradual increase from the law’s inaugural year of 1998, when 16 people did so.

Illustration by Denny Bond for AJN. All rights reserved.

2016-11-21T13:03:35-05:00November 5th, 2014|Nursing, nursing perspective, patient engagement|8 Comments
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Presence, Improvisation, Dark Humor: Crucial Skills of a Hospice Nurse

Illustration by Pat Kinsella for AJN. Illustration by Pat Kinsella for AJN.

Here’s the start of “Molly,” the Reflections essay in the November issue of AJN, written by hospice nurse Thom Schwarz.

Late evening, early spring, the peepers not yet trilling. I am in my car, rain streaking the windshield, reading a New Yorker essay about war writing, an ironic distraction from my visiting hospice nursing work.

This is a piece that doesn’t offer any easy answers for the facts of suffering and death. But it does posit a certain consolation in staying present, undaunted, engaged, and resourceful when faced with the power and mystery of each patient’s encounter with impending death.

All Reflections essays are free, so give it a look.—Jacob Molyneux, senior editor 

2016-11-21T13:03:36-05:00November 3rd, 2014|narratives, Nursing, nursing perspective, patient engagement|3 Comments
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AJN in November: Palliative Care, Mild TBI, the Ethics of Force-Feeding Prisoners, More

AJN1114.Cover.OnlineAJN’s November issue is now available on our Web site. Here’s a selection of what not to miss.

Palliative care versus hospice. For many seriously ill, hospitalized older adults, early implementation of palliative care is critical. These patients often require medically and ethically complex treatment decisions. This month’s original research article, “Staff Nurses’ Perceptions Regarding Palliative Care for Hospitalized Older Adults,” found that staff nurses often confuse palliative and hospice care, a fact that suggests a need for increased understanding and knowledge in this area. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

Mild traumatic brain injury (TBI) can have profoundly negative effects on quality of life and can negatively affect relationships with family and caretakers. This issue’s other CE feature, “Mild Traumatic Brain Injury,” reviews the most commonly reported signs and symp­toms of mild TBI, explores the condition’s effects on both patient and family, and provides direction for devel­oping nursing interventions that promote patient and family adjustment. Earn 2 CE credits by taking the test that follows the article. To further explore the topic, listen to a podcast interview with the author (this and other podcasts are accessible via the Behind the Article page on our Web site or, in our iPad app, by tapping the icon on the first […]

2016-11-21T13:03:37-05:00October 31st, 2014|career, Nursing, nursing perspective|0 Comments
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Ebola: A Role for Nurses in Sharing the Facts

By Shawn Kennedy, AJN editor-in-chief

Screen Shot 2014-10-29 at 12.27.27 PMThe current Ebola crisis has everyone concerned over transmission, and rightly so. The public has been in a quandary as to who and what to believe. I can’t say I blame them. We should have been better prepared and anticipated that, given the situation in West Africa, we would eventually see a patient with Ebola present to a U.S. hospital ED (or clinic or urgent care center). What’s surprising is that it didn’t happen sooner.

I’d thought fears about widespread transmission of Ebola had abated after no more new cases arose from that of Thomas Eric Duncan in Dallas: his family, who were in the apartment with him during the time he was sick, did not contract Ebola and have since been released from quarantine; the two nurses who became ill treating Duncan have now been declared Ebola free and none of their contacts have become ill; no other nurses who provided care for him have fallen ill.

But with the onset of confirmed Ebola in a New York physician who had recently returned from caring for Ebola victims in West Africa, fears of widespread contagion resurfaced. Craig Spencer had been self-monitoring his symptoms while he went about his life; when he began to feel ill and developed a low-grade fever, he initiated a controlled transport in […]

2016-11-21T13:03:37-05:00October 29th, 2014|career, infectious diseases, Nursing, nursing perspective|2 Comments
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Choosing Wisely: American Academy of Nursing Highlights Unnecessary Nursing Practices

The American Academy of Nursing (AAN) recently announced that it has joined the ABIM Choosing Wisely campaign with a list that focuses specifically on nursing interventions or practices that are not supported by evidence. The list is called Five Things Nurses and Patients Should Question. Here it is in short form—full explanations of the rationale for each item are available at the above link.

  1. Don’t automatically initiate continuous electronic fetal heart rate Screen Shot 2014-10-24 at 11.10.10 AMmonitoring during labor for women without risk factors; consider intermittent auscultation first.
  2. Don’t let older adults lay in bed or only get up to a chair during their hospital stay.
  3. Don’t use physical restraints with an older hospitalized patient.
  4. Don’t wake the patient for routine care unless the patient’s condition or care specifically requires it.
  5. Don’t place or maintain a urinary catheter in a patient unless there is a specific indication to do so.

The Choosing Wisely initiative encourages health care provider organizations to create their own lists of tests and procedures that may be overused, unsafe, or duplicated elsewhere. Using these lists, providers can initiate conversation with their patients to help them choose the most necessary and evidence-based care for their individual situations. The lists are not meant to be proscriptive, and also address situations where the procedures may be appropriate. […]

2016-11-21T13:03:40-05:00October 24th, 2014|health care policy, nursing perspective, nursing research, patient engagement, Patients|6 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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