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

A Black Nursing Professor’s Personal Calculus in Choosing a Birth Center

“I knew getting pregnant meant that regardless of my socioeconomic status or education, as a black woman I was more than three times as likely to die during labor or in the weeks afterward compared to my white counterparts.”

Recent news stories have drawn attention the dismaying medical experiences of black women during and after childbirth, with even celebrities like Serena Williams and others finding their concerns about potentially life-threatening symptoms going dangerously unheeded by nurses and physicians. The statistics about maternal death from pregnancy or childbirth complications among black women tell us that such stories aren’t isolated examples but part of a larger pattern.

Illustration by Annelisa Ochoa.

A thoughtful professor weighs her options.

All of which makes the personal story told by Sheria Robinson-Lane, an assistant professor of nursing at the University of Michigan, in this month’s Reflections essay (“Birthing by the Numbers“) particularly timely. And yes, nuanced. She knows the numbers and she knows the stories about communication issues experienced by black women with their providers. However, she’s also affiliated with a respected major medical center.

So when she gets pregnant with her second child at age 39, what’s her best course of action in deciding where to have […]

2018-10-01T08:20:40-04:00October 1st, 2018|Nursing, nursing perspective, patient experience|0 Comments
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In Nursing, Some Things Never Change: Shift Report, 1985

Several days ago, we published “A Day in the Emergency Room for a Nurse Who Loves Her Job.” It gave an engaging, sometimes moving account of one nurse’s experience of a normal/stressful day in the ER. As it happens, colleague Theresa Stephany recently sent me the bare bones report we’re sharing today—an actual shift report from 1985. She received the copy many years ago from a friend who worked the night shift at a local hospital, and who had typed and sent it to her manager at the end of the shift. Stephany wrote to me that she “kept it all these years because it’s so horrible that it’s poignant.”

I’m sure that poor nurse was exhausted. Anyone have a shift story to tell, nightmare or otherwise?

SHIFT REPORT, 1985

TO: DIRECTOR OF NURSES
FROM: HEAD NURSE 2ND MAIN
SUBJECT: ACTIVITY RECORD, 11-7 SHIFT, 9/8/85                

Memorandum:

  1. 12 patients in restraints, 2 in leathers, acquired during the night.
  2. 3 Foley catheters pulled out
  3. 1 chest tube inserted with 1300 cc’s pus out
  4. 2 temperatures over 103°
  5. 3 Temperatures over 102°
  6. 7 Temperatures over 101°
  7. 3 patients having DT’s
  8. 3 Patients having chest pain
  9. 3 patients having respiratory distress
  10. Approximately 50 “now” or “stat” orders during the shift
  11. Several chest x-rays done (staff to deliver to x-ray and return)
  12. 2 beds had to be moved to make room for a sitter patient
  13. […]
2018-08-23T10:49:13-04:00August 23rd, 2018|Nursing, nursing perspective|2 Comments
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NPs ‘Move Mountains’

Rear Admiral Susan Orsega, chief nurse officer of U.S. Public Health Service

Last week I attended the annual conference of the American Association of Nurse Practitioners (AANP) in Denver. Yes, I was there for the record attendance (over 5,000) and the record heat wave (104 degrees). As with most large nursing conferences, there were numerous concurrent sessions—but here, many of them were like skills labs, including things not part of most RNs’ skill set, like performing a thoracentesis.

What was also different from other meetings was that the legislative and policy sessions, which were of high interest to me in order to find out how NPs are doing with scope of practice authority, were closed to media. No one could say exactly why.

Audio interview with U.S Public Health Service CNO Susan Orsega.

I did get a chance to speak with the keynote speaker, Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN, chief nurse officer and assistant surgeon general of the U.S. Public Health Service. She focused on the critical role of NPs in addressing health inequities. She urged NPs to become active advocates to improve health, and, mindful of our Colorado setting, she charged them to “Go, move […]

2018-07-06T08:27:26-04:00July 6th, 2018|Conference reports, Nursing, nursing perspective, Public health|0 Comments
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Nursing Homes: A ‘Place No One Wants to Be’

I’m on my way home from Atlanta, site of the 2018 NICHE (Nurses Improving Care for Healthsystem Elders) conference. This organization, housed at New York University-Rory Meyers College of Nursing for the last 26 years, provides education and consultation to organizations to improve the delivery of health care to older adults. It now counts over 700 member organizations in five countries and has been successful in helping facilities implement best practices for providing care to older adults.

Redesigning long-term care.

One of the speakers, Migette Kaup, PhD, from Kansas State University and an expert in designing care facilities, spoke about current efforts to redesign long-term care. She noted that traditional nursing homes, which were designed to mimic hospitals, are “a product no one wants” and a place many people would rather die than go to.

Kaup spoke about the success of the newer “household” model of long-term care, which mimics a home setting rather than a hospital. Key aspects of this model are that it centers around an open kitchen space and is made up of a dedicated staff and small group of residents who live together and implement best practices. Kaup cited successes in decreasing depression and pressure ulcers in low-risk patients, among other parameters. Of course the real goal, […]

2018-04-13T11:43:57-04:00April 13th, 2018|family caregiving, Nursing, nursing perspective|3 Comments
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Wabi-Sabi: Nursing and the Art of Brokenness

Wabi-Sabi (Kintsugi), watercolor and acrylic on paper, 2018 by Julianna Paradisi

Nursing is the art of healing, which ironically also makes it an art of brokenness. We pack and bind wounds. We administer medications to cure disease. We offer interventions for the side effects caused by the medication administered to cure.

We work in a health care system which, despite our best intentions, is broken: not enough resources, not enough staff or providers, not enough health care to go around for everyone.

Nurses have broken areas within ourselves too, but our work environments expect us to perform as perfectly as possible, amidst the brokenness of our patients, the brokenness of health care.

Patients, physicians, other departments, and hospital administrators expect nurses will fix problems, whatever they are, despite the brokenness.

A timely example this flu season is the paradoxical message: “Don’t come to work sick,” coupled with the implication, “Your sick call leaves us understaffed.”

The answer to brokenness is wholeheartedness.

The effort to fix the brokenness or imperfection of nursing and health care may be particularly exhausting for nurses because we are directly responsible for the safety of our patients.

The words of author David Whyte as he recounts a wise friend’s […]

2018-02-14T10:05:33-05:00February 14th, 2018|healthcare social media, Nursing, nursing perspective|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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