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

What Do You Value?

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

“ ‘The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those in the shadows of life, the sick, the needy and the handicapped.’—Hubert Humphrey

These are the words that physician Donald Berwick saw as he went to work in the building that bears Humphrey’s name and houses the U.S. Department of Health and Human Services in Washington, DC. They reminded Berwick, the former administrator of the Centers for Medicare & Medicaid Services (CMS), of his most important mission: “to help the people who need our help the most.” And they are at the heart of an important topic of debate during this election season: what is the proper role of government in our lives?”

AJN Oct. cover, detail

So begins a blog post on the JAMA Forum by Diana Mason, PhD, RN, Rudin Professor of Nursing and codirector of the Center for Health, Media, and Policy at Hunter College, City University of New York, as well as president-elect of the American Academy of Nursing (and, for the sake of transparency, former editor-in-chief of AJN).

Her question is a critical one and one that has been a fundamental issue, tug-of-war even, for Americans. Our citizens take a great deal of pride in being independent, self-made, and self-reliant—yet it’s obvious that most of us also believe […]

2016-11-21T13:09:08-05:00October 8th, 2012|nursing perspective|4 Comments
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‘No One Ever Put the Puzzle Pieces Together’: A Nurse’s Guide to Celiac Disease

By Sylvia Foley, AJN senior editor

Wheat spikes by Dag Endresen, via Flickr

If you’ve thought that celiac disease is just another disease-of-the-moment that few people actually have, this month’s CE by McCabe and colleagues, “Celiac Disease: A Medical Puzzle,” might make you reconsider. The disease is an autoimmune genetic illness that typically targets the small intestine, and it’s caused by an intolerance to ingested gluten, a complex protein found in wheat and certain other grains. Until recently, celiac disease was considered rare; but widespread serologic testing has indicated otherwise. Experts estimate that up to 1% of the U.S. population—more than 3.1 million people—are affected.

Yet celiac disease remains widely underrecognized. For one thing, clinicians are still being taught that it’s a childhood illness, although onset can occur at any age; for another, disease presentation is highly variable (there are more than 200 associated signs and symptoms). All of the article’s six authors have themselves “either personally endured or witnessed the misery of misdiagnosis.” To help raise awareness, they offer several illustrative stories, including this one:

I am a registered nurse. I was treated for irritable bowel syndrome for more than 10 years. Although I was very careful with my diet, I never seemed to get better and felt sick most of the time. One day, I was admitting an elderly woman to home care and was reviewing her many diagnoses. She told me about her celiac disease and the symptoms she’d experienced. As […]

2017-07-27T14:53:00-04:00October 5th, 2012|nursing perspective|0 Comments
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Evidence Contradicts AAFP: NPs Ideal for Leading Patient-Centered Medical Homes

By Karen Roush MS, RN, FNP-C, AJN clinical managing editor

What will it take to end the turf war physicians are waging  against nurse practitioners? The latest foray is over who should lead patient-centered medical homes (PCMH). According to the American Academy of Family Physicians (AAFP), only physicians should. They insist that nurse practitioners do not have the knowledge or skills to do so and that expanding the NP’s role in primary care would create a “two-tiered health system,” with patients who are cared for by an NP receiving a lower level of care.

That’s not what the evidence says. Or patients for that matter. Studies consistently find that when care provided by NPs is compared to care provided by physicians, the care is similar as far as prescriptions ordered and referrals made—most important, outcomes are the same.

Well, there is one area where differences keep showing up: patient satisfaction. Patients consistently say that they are more satisfied with care provided by nurse practitioners. They say that nurse practitioners listen better, spend more time with them, and provide them with more information.

Not only are nurse practitioners capable of leading medical homes, their education and skills make them ideal for this role. Whereas physicians focus on pathology and have the depth of knowledge and skill to manage highly complex patients, NPs focus on the “human response to disease” and take a more holistic approach to patient care. Nurses coordinate care all the time, identifying […]

2016-11-21T13:09:11-05:00October 3rd, 2012|nursing perspective|4 Comments
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When a Fellow Nurse Abuses Drugs on the Job

. . . the nurse wasn’t anywhere on the floor. I started looking around, asking other nurses. My frustration grew when I realized that something about the entire floor felt wrong. The entire night shift had disappeared. My chest tightened and I started to worry about what had happened at the hospital last night.

That’s a short excerpt from the Reflections essay in the October issue of AJN, “A Good Nurse.” It’s by oncology nurse Theresa Brown, who happens to also have a new column out this week at the New York Times Opinionator blog. Never one to shy away from sensitive topics, in this essay she takes on the shock and betrayal in learning a fellow nurse has been abusing drugs on the job. Click the link above or the image on the right to read the whole short essay (click through to the PDF version for the best reading experience). We welcome your responses here, of course.—Jacob Molyneux, senior editor
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2016-11-21T13:09:12-05:00September 28th, 2012|career, nursing perspective|0 Comments
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Nursing Research: Alive and Well

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

Last week I spent two-and-a-half days in Washington, DC, where there are LOTS of campaign collectibles. My favorite: coffee mugs proclaiming “Friends Don’t Let Friends Vote (insert Democratic or Republican).” Also noteworthy: “Hot for Mitt” and “Hot for Barack” hot sauce (see photos). I was there attending the meeting of the Council for the Advancement of Nursing Science (CANS), where close to 1,000 nursing researchers met to share their work. It wasn’t too long ago that one would have been hard-pressed to find that many nurses doing research. The National Institute of Nursing Research (NINR) only celebrated its 25th anniversary in 2010 (see our 2010 article about their many accomplishments).

Creativity and innovation. Kathi Mooney, PhD, RN, FAAN, from the University of Utah College of Nursing, gave the keynote—and it was perfectly suited to this group, many of whose members are immersed in analytical thought and scientific methodology. Mooney talked about the importance of creativity and innovation in moving research forward—yes, applying scientific rigor to identifying knowledge […]

2017-05-27T10:35:26-04:00September 17th, 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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