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

The Patient With No Name: When Nursing Illuminates Literature

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN. She doesn’t usually write about books in her posts, so we hope you enjoy this change of pace.

I didn’t know much about The English Patient when I picked it up recently at a library book sale—I only dimly recalled that the novel had been made into a movie I’d never seen. Since it was published by Michael Ondaatje in 1993, I can hardly blame a lack of time for my lapse. Yet I found myself glad I hadn’t read it until now, as my own nursing experiences suffused my reading of it, leaving me more deeply moved than I might have been otherwise.

The novel is set in the final days of World War II, in a bombed Italian villa that had served as a war hospital. As the story opens, the makeshift hospital has been recently evacuated, with patients and medical staff relocating to Pisa. One nurse remains, though—a young Canadian named Hana. Described as “shell-shocked” due to her experiences during the war, she refuses to leave the damaged hospital or a nameless English patient, who she insists is too fragile to be moved.

Other characters come into […]

2016-11-21T13:08:53-05:00November 16th, 2012|nursing perspective, patient experience, Patients|4 Comments
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White Uniforms for Nurses? The ‘Nays’ Have It…

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

Nurses and patients aboard U.S.S. Relief, 1921/via Wikipedia

Well, if sheer numbers rule, then the image of nurses in white uniforms has gone the way of the nurse’s cap.

Earlier this week, on AJN’s Facebook page, I asked whether RNs should go back to white uniforms as a professional standard. Within a few hours there were 20 comments; by the next day there were about 200 comments (we had to delete the post with the first 100 or so, since we were unsure about the copyright status of the image used—very sorry if that included your comment!).

Clearly, nurses care about what they wear. Comments ranged from one word (“No,” with multiple exclamation points), to thoughtful reasoning around stains and keeping the uniforms clean, to advocating for an individual’s right to choice (about colors, that is).

There were only a few comments that were pro-white, with arguments that they were more professional than colors and “wild prints” and helped patients identify RNs from other staff more easily.

Here’s a sampling of comments (a few minor typos corrected):

Yes—but no hats.

No—but I do think it makes a lot of sense to be able to clearly identify who is an RN when you are a patient in a hospital. Clear identification is definitely a problem.

I support white uniforms. This is the required color at the Cleveland Clinic. Patients tend to appreciate the crisp, clean look of […]

2016-11-21T13:09:03-05:00October 26th, 2012|healthcare social media, nursing perspective|4 Comments
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Individualized A1c Targets for Type 2 Diabetes

By Jane Seley, DNP, MPH, MSN, BC-ADM, CDE, diabetes nurse practitioner at New York Presbyterian/Weill Cornell Hospital, New York City

On April 19th, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) released a joint position statement online that represented a giant step forward in the care of people with type 2 diabetes. “Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach” is a comprehensive yet easy to read primer in the most up-to-date therapies, one that also emphasizes individualizing care as the key to success.

An example of the patient-centered approach of this position statement is a refinement of the customary across-the-board hemoglobin A1c test target recommendation of less than 7% for most people with type 2 diabetes, with pre-meal blood glucose (BG) targets of less than 130 mg/dL and post-meal targets of less than 180 mg/dL. The position statement suggests “more stringent” targets of 6%–6.5% for “selected” patients who are younger and in good health, but safer targets of 7.5%–8% for older patients who have comorbidities or are prone to hypoglycemia.

When discussing therapeutic options, each medication is ranked according to its potential for lowering A1c, risk of hypoglycemia, effect on weight, adverse effects, and cost. In addition, the clinician is encouraged to individualize the treatment regimen by considering age, weight goal, and comorbidities such as heart disease and kidney function. For example, if losing weight is an important consideration for the […]

2016-11-21T13:09:04-05:00October 23rd, 2012|nursing perspective|0 Comments
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What You May Not Know About Nurse Licensure

This month’s Legal Clinic installment in AJN is called “Common Misconceptions About Nurse Licensure.” Author Edie Brous, a nurse and attorney, lists these misconceptions:

  • 1. Nursing boards are nursing advocates. Not so, says Brous; they’re there to protect the public. “Because nurses care for vulnerable populations, the state that issues a nursing license has a social contract with the public to ensure that the licensee is qualified, competent, and ethical.”
  • 2. Private Conduct Isn’t Relevant to One’s Performance in a Professional Capacity. In fact, it can matter to a nursing board. The reasoning: “Conduct that reflects questionable judgment, impairment, or lapses in moral character may suggest to the board that a nurse poses a potential threat to the health, safety, and welfare of the public.” Ever neglect payment of student loans, child support, or taxes; have a substance abuse problem; commit a crime? It might be relevant.
  • 3. Disciplinary action taken by a state pertains only to that state. Not so: there’s a computerized system called Nursys (Nurse System) where nursing boards enter actions they take against a nurse and learn about actions taken elsewhere.
  • 4. Licensure is a right. “Rights are entitlements that are considered inherent and inalienable so they cannot be revoked, but privileges are granted by the state and are therefore conditional. As such, a nursing license may be restricted or revoked upon determination that the license holder poses a risk to the public.”

The article goes into more detail […]

2016-11-21T13:09:05-05:00October 19th, 2012|career, nursing perspective|9 Comments
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BRCA Gene Mutations: Knowing You’re At High Risk for Cancer

‘Autumn Washed Away,’ Diane Hammond/ via Flickr

By Shawn Kennedy, MA, RN, AJN editor-in-chief

October is Breast Cancer Awareness month. We thought we’d do our part with a feature article to help increase nurses’ awareness of some of the issues faced by women who find they are at high risk for breast cancer.

In the October issue, author Rebekah Hamilton describes her research with young women who learn they have a BRCA gene mutation that puts them at greater risk for cancer, especially breast and ovarian cancers. “Breast cancer risk ranges from 50% to 85% by age 50 in women with the mutation and is 12% in women without it.” Her study explores the consequences this knowledge has on decisions these women make about their future, especially those related to prophylactic surgery, relationships, and childbearing, and offers some recommendations for practice. The abstract is below, but I urge you to read the study, especially if your patients include young women.

Objective: Women who carry a BRCA1 or BRCA2 gene mutation face a risk of developing breast or ovarian cancer at an earlier age than women without such a mutation. Relatively little is known about the psychosocial consequences—especially regarding marriage and childbearing—in young women who test positive for one of these mutations.

Methods: In 2006, participants were recruited from Web sites for women with breast cancer or BRCA gene mutations. Forty-four women ages 18 to 39 from 22 states and Canada […]

2016-11-21T13:09:06-05:00October 15th, 2012|nursing perspective, nursing research|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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