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

Women’s Health: Paying Attention to an Invisible Group

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

My sister Ellen is getting married in two weeks, so last Sunday I threw a surprise bridal shower. We had all the traditional trappings—flowers and favors and (much to another sister’s chagrin) a shower game and prizes. The only thing not traditional: at this shower there were two brides, my sister and her fiancée, Pat.

After years of standing by invisible while sisters and brothers married, danced with their partners at each other’s weddings, celebrated births and graduations, now it’s their turn. No longer on the periphery, no longer the ‘other,’ at least for this day, these few weeks, they are finally able to celebrate their love and commitment to each other just like the rest of us.

Why am I writing about this in a nursing blog? Because this invisibility, this sidelining of lesbians like my sister and her fiancée, doesn’t only affect their family life—it extends into their health care as well. Neither Ellen nor Pat ever got routine women’s health care—no Pap smears, no clinical breast exams or mammograms, no routine assessment for osteoporosis risk. They were never hooked into the health care system by reproductive health needs, contraception, chlamydia testing or […]

2018-03-28T10:36:45-04:00July 5th, 2012|nursing perspective|1 Comment

Forward or Back? Some Personal Notes on Why the Affordable Care Act Matters

By Jacob Molyneux, senior editor/blog editor

So today the U.S. Supreme Court did something a little surprising in upholding the individual mandate provision in the Affordable Care Act (here’s the text of the full decision). It was the right thing to do, given judicial precedent, but it still comes as a surprise that Chief Justice Roberts was the swing vote rather than Kennedy, or that they actually did this. Justice Roberts must have looked to his conscience and seen how history would judge him. Or it’s nice to think so.

This is good for many reasons: those under 26 on their parents’ plans can now stay there. A bunch of money earmarked for nurse education will not suddenly disappear. Health care exchanges holding insurance companies to minimum standards will be implemented. Accountable care organizations can continue to experiment in an effort to replace the disastrously expensive fee-for-service model with one tied more closely to outcomes. And a great deal more.

But now we should ask ourselves: Do we go forward or back? This is the real question when it comes to the American health care system. Going back isn’t an option, though many are sure to go on pretending it is (the Republicans will make repealing the Affordable Care Act a centerpiece of […]

To the Nursing Class of ’12 (and ’84, and ’96, and ’01)

By Karen Roush, MS, RN, FNP-C, clinical managing editor. A version of this essay originally appeared in the 2008 AJN Career Guide, but we feel it’s still just as relevant to new nursing grads or even to seasoned nurses (and non-nurses, for that matter) who might need a sense of renewal.

via Wikimedia Commons

On a rainy cold Saturday last May my son graduated from Rensselaer Polytechnic Institute in Troy, New York. As I sat shivering in my complimentary plastic poncho, listening to the commencement speaker doing his best to inspire the faces peering up from under soaked tassels, the thought came to me that we all need a commencement address every five years or so. Someone to tell us we can make the world a better place, that the possibility for greatness exists within us, that we may yet achieve our dreams. Someone to remind us why we chose nursing, and why we work so hard.

So, whether you are a new graduate or graduated 50 years ago, this is my commencement address to you.

Stay alert. Be vital. Sharpen your mind and your skills. Read journals for nurses and on health care in general. But don’t limit your knowledge to health-related information. Read political discourse, economic theory, and great literature. At the time of this writing, a book of poems, Slope of the Child Everlasting by Laurie Kutchins, sits on my desk at home. Each evening it pulls me into a […]

When Your Child Has a Scary Chronic Illness

By Jacob Molyneux, senior editor

It may be easier to live with a chronic illness than to have a child who has one. The June Reflections essay, “Seized,” is by a mother who eloquently evokes her struggle to accept her daughter’s epilepsy. She honestly confronts her own resistance to letting her daughter be a normal child—despite the terrifying episodes, the sense of helplessness she feels as a parent, the wish that she could always protect her daughter.

Here’s how it begins, but I hope you’ll click the link and read the entire essay.

It begins with a gurgle from deep in Daney’s throat: low, primal, guttural. In the next few seconds, her back will arch and her palms will turn up. Her 10-year-old self will twitch, then tremble, like she’s being electrocuted—and in a way, she is.


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The Kiss: Hope in the ICU

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.

by limegreeen9, via flickr creative commons

I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.

My report, though, is politely cut short by the medical director.

“What’s changed?” he wants to know.

And I feel pressed to produce some crumb of improvement. 

“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”

A few people smile, and I hear a few chuckles.

“It’s a reflex!” I hear someone say as they move away.

I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant […]

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