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

10 Good Things About Being an Older Nurse

Alice Facente, MSN, RN, is a community health education nurse in Connecticut. Her Reflections essays, “At Her Mercy” and “The Dirtiest House in Town,” were published, respectively, in the August 2009 and January 2010 issues of AJN.

Puddle Reflection/by joiseyshowaa, via Flickr Puddle Reflection/by joiseyshowaa, via Flickr

I recently passed a professional career milestone: 40 years since I’d graduated from nursing school. When I began my career, nurses still wore white starched caps and white uniforms. I don’t know how we accomplished everything we did with those impractical caps perched on our heads. The shocking realization that four decades had so quickly passed forced me to think about all of the benefits of being a mature, experienced nurse. Right off the top of my head, I thought of 10 things (and yes, these are generalizations and exceptions exist).

1. Older nurses are often more empathetic. Chances are that in the last several decades every older nurse has been a patient, undergone surgery, become a parent and possibly a grandparent, encountered personal financial challenges, experienced the death of a close friend or family member, and much more.
2. Death is not so frightening. Nurses have cared for people at all stages of the life cycle and know that, […]

Unbalanced: The Art of Changing Nursing Roles

Bull and Monkey/ graphite, charcoal, acrylic on vellum/by julianna paradisi Bull and Monkey/graphite, charcoal, acrylic on vellum/by julianna paradisi

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

The culture shock experienced by new nurses making the transition from student to professional is well documented. Less well documented is the culture shock seasoned nurses face when changing jobs. Not all nurses are the same. Neither are all nursing jobs.

Working in an unfamiliar setting means being the new guy. You may have been in the top 10 of your nursing class for grades and clinical excellence. Or you may have held a position of leadership in your previous unit. In your new job, you are unknown and unproven.

For nurses changing jobs from high-acuity areas—ICU or bone marrow transplant, say—to an ambulatory clinic, the stress is twofold.

First, there’s a period of grieving the loss of hard-won skills and certifications that are not applicable in the new role.

Then there’s the shock that your skills and experiences did not prepare you for the outpatient setting. Often, the first realization is that high-acuity patients have central lines, so a nurse migrating from such a practice area may not have […]

AJN in October: Getting Inpatients Walking, Calciphylaxis, Nurses and Hurricane Sandy, More

AJN1014.Cover.OnlineAJN’s October issue is now available on our Web site. Here’s a selection of what not to miss.

Calciphylaxis is most often seen in patients with end-stage renal disease. “Calciphylaxis: An Unusual Case with an Unusual Outcome” describes the rare case of a patient diagnosed with calciphylaxis with normal renal function, and how the nursing staff helped develop and implement an intensive treatment plan that led to the patient’s full recovery. 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 podcasts are accessible via the Behind the Article page on our Web site or, if you’re in our iPad app, by tapping the icon on the first page of the article).

The adverse effects of bed rest. Prolonged periods of immobility can have adverse effects for patients, such as functional decline and increased risk of falls. “A Mobility Program for an Inpatient Acute Care Medical Unit” describes how an evidence-based quality improvement project devised for and put to use on a general medical unit helped mitigate the adverse effects of bed rest. This CE feature offers 2 CE credits to those who take the test that follows the article. […]

If You Want to Write, Do It (and Skip the ‘Weaseling Qualifiers’)

Photo by mezone, via Flickr. Photo by mezone, via Flickr.

Are you one of those people—nurse or otherwise—who daydreams about writing (a personal essay about a formative experience, an article about a quality improvement project you took part in, a blog post about some aspect of nursing) but can’t seem to find the proper way to get started?

Since the weekend is coming and the October issue of AJN is now live on our Web site, it seems a good time to draw attention to “On Writing: Just Do It,” the editorial by Shawn Kennedy, AJN‘s editor-in-chief. Kennedy points out the one idea common to most writing advice: you have to start somewhere. You have to do it, and learn from doing it, and then keep doing it. Or, as she puts it:

One key to becoming a good writer—or a good anything—is persistence.

But the editorial also gives a range of other excellent tips from Kennedy and several experts in the field, and quotes writing advice found in AJN issues through the decades. My favorite bit is from a 1977 editorial by former AJN editor Thelma Schorr:

“ [the writer] will use the active voice and not shirk his [or her] responsibility by introducing a statement with such weaseling qualifiers as ‘It is considered that…’ or ‘It is generally believed that…’”

What a great word: “weaseling.” It’s about as far as you can get from the jargon that afflicts so much academic […]

What Our Readers Had to Say About RN Staffing in Nursing Homes

By Maureen Shawn Kennedy, AJN editor-in-chief

nursing homeEarlier this month, AJN’s managing editor Amy Collins wrote a post about nursing homes, basing her discussion on a New York Times article by Paula Span at the paper’s New Old Age blog that examined efforts to address the inadequate number of registered nurses (RNs) in nursing homes. While federal regulations for agencies that receive Medicare or Medicaid require 24-hour nursing services, they only require an RN to be on site for eight hours daily. According to Span, 11.4% of nursing homes did not meet this requirement.

Collins found confirmation of this information in her own experiences visiting her grandmother in nursing homes:

“There always seems to be a lack of staff—and with so many residents these days suffering from varying levels of dementia and memory problems, staff are needed more than ever.”

We linked to the blog post on our Facebook page and received a tremendous number of comments on both sites. While both Span and Collins emphasized that increases in all levels of nursing personnel are needed, some LPNs responded to our post to assert that they too have valuable skills, as well as extensive experience, in this setting—and that a broader underlying problem is inadequate staffing tied to corporate cost-cutting.

Few people would argue with these assertions. Most LPNs do […]

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