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 Week: Time to Celebrate (Not Denigrate) Nursing’s Worth

shawnkennedyBy Maureen Shawn Kennedy, AJN editor-in-chief

So, on the cusp of Nurses Week, the week when Americans are encouraged to think about the value that nurses bring to health care, readers of the New York Times were treated to an op-ed written by physician Sandeep Jauhar. According to the byline, Jauhar is a cardiologist and the author of an upcoming memoir about his disillusionment as a physician. The title of the piece was “Nurses Are Not Doctors.” While the author makes sure to reassure us that he thinks nurse practitioners (NPs) have a valuable role to play in health care, he makes the usual charge that NPs are not qualified to practice primary care without physician supervision.

Jauhar conveniently ignores the many studies that have refuted this argument, while basing his case largely on weak anecdotes and one study from 1999 that showed NPs ordered more diagnostic tests. His conclusion: the NPs in the study ordered too many expensive tests because they lack the experience and knowledge of physicians (he concedes in passing that “there are many reasons the NPs may have ordered more tests”). I can’t help thinking that this piece’s publication was purposely timed to take some of the shine off Nurses Week.

I’m surprised that the Times published such a weak letter. First, along […]

2018-03-28T10:24:54-04:00May 5th, 2014|career, nursing perspective, nursing research|4 Comments
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Compelled by Professionalism

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

ParadisiThanksIllustration“Ah, Julianna.”

This greeting from a physician marked my arrival at work. I assumed he was about to give me information or an order about one of our patients. I prepared myself for the forthcoming shift—”Ready or not, here it comes.”

Instead, he did something completely unexpected. Quickly retreating to his office, he reappeared, extending towards me a bright blue envelope with my name neatly written on the back.

It contained a greeting card. Not the generic kind hospitals provide managers in bulk for staff recognition. Not the “You’ve Been Caught Doing Something Fabulous!” quarter page–sized certificates available in the staff lounge for coworkers to fill out in recognition of their peers. This was a genuine, bona fide greeting card, the kind you have to go to a store and select from a rack and purchase. Inside, he’d addressed it to me again, with a personal note in handwriting, shattering the long-held belief that physicians cannot write legibly in cursive.

Being thanked by a physician for an act of nursing I had provided for his patient isn’t what caught me off guard. During my years of practice, many physicians have verbally expressed appreciation for my nursing skills. A half-dozen have even apologized for disagreeing with an assessment of mine (only to find out later […]

2016-11-21T13:04:52-05:00April 30th, 2014|career, nursing perspective|1 Comment
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Codeine Overused in Children: Alternatives Exist for Hard-to-Manage Pain

By Jacob Molyneux, senior editor

According to a story at MedlinePlus, a study in Pediatrics has found that codeine is still prescribed too often to children during ER visits, though it’s known that a small but significant subset of children metabolize the painkiller far more rapidly than do other children, leading to potentially dangerous results. As AJN‘s February CE article on treating the often severe and stubborn posttonsillectomy pain in children noted, there are other effective and safer options for children in pain, such as hydrocodone in combination with acetaminophen, as well as some non-opioid analgesics. Here’s a brief overview of the article:

Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence.

There’s often no perfect answer in pain management, but it helps to know the full range of available strategies, their safety, and how well they work. As with all CE articles, this one is free.

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2016-11-21T13:04:56-05:00April 23rd, 2014|Ethics, nursing perspective, pain management|1 Comment
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A Tale of Two Dangerous Products

Holding On / D'Arcy Norman, via Flickr Holding On / D’Arcy Norman, via Flickr

Amanda Anderson, BSN, RN, CCRN, works in critical care in New York City and is enrolled in the Hunter-Bellevue School of Nursing/Baruch College of Public Affairs dual master’s degree program in nursing administration and public administration.

There are two news stories I’ve been chewing on lately. One made it to the front page of my New York Times almost every day for a while, and the other I saw just once in the paper’s international news section several weeks ago.

The blockbuster story involves a single company that covered up a problem with an important part in one of its products. Ten years passed and a number of people died before they finally informed the public about the problem. The products with the flawed part have now been recalled, and the company is embroiled in an investigation and likely to face lawsuits and massive fines.

The far less publicized story is about a growing body of research […]

2016-11-21T13:04:59-05:00April 21st, 2014|nursing perspective|5 Comments
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What Advice Would You Give a New Nursing Student? Our Readers Respond…

KarenRoushBy Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor

My daughter Kim is starting nursing school next month, so last week I asked AJN’s Facebook followers for the best piece of advice I could give her. The response was overwhelming: over 600 people offered wisdom, encouragement, and tips for success. I went through and read them all and the following is an attempt to synthesize the advice.

Of course, with so many responses, there were many valuable pieces of advice I had to leave out, from the practical to the profound, such as:

sit in the front of class, stick to your principles, invest in good shoes, choose clinicals that push you out of your comfort zone, be early for everything, celebrate the small victories, get a really good stethoscope up front, believe in yourself, pick the hardest patient you can at clinical, audiorecord the lectures, be truthful and committed to your work, eat healthy, get to know your instructors, coffee and chocolate!

And finally: look into the eyes of your patients and be sure they know you care. Every patient, every time.

(Oh, and not to leave out the lighthearted—Don’t hold your nose in clinicals. The teachers frown on that.)

Below are five areas of advice that stood out:

1) “Take a good […]

2016-11-21T13:05:03-05:00April 9th, 2014|career, healthcare social media, nursing perspective, students|8 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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