Nursing Is Hazardous to Our Health

By Shawn Kennedy, AJN interim editor-in-chief

We all know that our nursing jobs expose us to various hazards—back and joint problems, needlesticks and other means of exposure to infectious diseases, traumatic injuries from encounters with violent patients or their family members, just to name some common ones. And as if that’s not enough, the psychological toll taken can result in burnout and even PTSD, which wreak havoc on retention. Heart disease and depression should probably also be on the list.

You may have seen news reports about a study with Danish nurses, published in the May issue of Occupational and Environmental Medicine. The researchers found that nurses younger than 51 years at baseline who perceived their workplaces as highly stressful were significantly more likely to have ischemic heart disease during the 15-year follow-up. Now, as the Journal of Clinical Psychiatry reports, a Finnish study has found that nurses and physicians who work in overcrowded acute care units have “twice the risk of sickness absence due to depressive disorders” compared with colleagues working in less crowded areas. And Health Policy reports on a study revealing that, among Canadian nurses, “Depression is a significant determinant of absenteeism for both RNs and LPNs.”

Is anyone surprised? Not nurses, for sure, and probably no one who’s worked at or been a patient in a hospital recently. With few exceptions, hospitals are generally terrible places to work. Yes, the

2016-11-21T13:17:24-05:00June 4th, 2010|nursing perspective, nursing research|6 Comments
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Rapid Response Teams Seen Through the Nurse’s Eyes: What A New Study Reveals

By Sylvia Foley, AJN senior editor

How do nurses who activate a call by their facility’s rapid response team feel about the experience? And why does it matter? These questions lie at the heart of a qualitative study by nurse researcher Susan E. Shapiro and colleagues, who report on their findings in this month’s CE feature (for optimum reading, open the PDF version). For the study, which was funded by the Robert Wood Johnson Foundation, Shapiro and colleagues interviewed 56 staff nurses from 18 hospitals in 13 states; all of the nurses had participated in at least one rapid response team activation. Based on the data, the researchers identified three categories, posed as questions, that best described the nurses’ experiences:

  • Why was the team activated?
  • What did the team bring to the bedside?
  • How did the activating nurses feel about the experience?

Nurses tended to activate the rapid response team when a patient had signs and symptoms “that were either unexplained or significantly different from baseline,” when the nurse had a “gut feeling” that something was amiss, or when the nurse felt a patient needed urgent attention and couldn’t get the treating physician to respond. Overall, the activating nurses appreciated the added expertise and resources that rapid response team members brought to the bedside. As one nurse said, “You don’t have to figure it out; there’s going to be other minds there to work through it.” […]

2010-06-03T10:13:37-04:00June 3rd, 2010|nursing perspective, nursing research|2 Comments
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‘Go Home, Stay, Good Nurse’: Hospital Staffing Practices Suck the Life Out of Nurses

By Shawn Kennedy, AJN interim editor-in-chief

After I last wrote to you from the NTI (the American Association of Critical-Care Nurses’ annual National Teaching Institute and Critical Care Exposition), I headed back to the exhibit hall to check out the helicopter and the Army’s mobile operating tent. But I didn’t get to either one, because I met a young critical care nurse from a regional hospital in Missouri. We chatted about her workplace, and it was obvious that she was very proud of the work she and her colleagues did. When I asked her, “What’s your biggest issue?”, she said that it was probably staffing. I expected her to cite the shortage and the difficulty of finding qualified critical care nurses. But that wasn’t what she meant—rather she was talking about  bare-bones staffing because of tight budgets. Her hospital routinely switches between two tactics: it sends nurses home when the patient census is low (when this happens, the nurses are paid only $2 an hour to be on call, but must still use a vacation day to retain full-time benefits, a tactic that rapidly depletes their vacation time); or, when the patient census is higher, the hospital imposes mandatory overtime, creating havoc in nurses’ schedules, finances, and personal lives. And people wonder why there’s a nursing shortage! […]

2017-03-28T13:15:48-04:00May 20th, 2010|career, Nursing, nursing perspective, nursing research, safe staffing|34 Comments
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Think Twice Before Inserting That Feeding Tube

By Shawn Kennedy, AJN interim editor-in-chief


One of the news stories in the May issue of AJN describes the “down the road” implications for a common practice—the use of feeding tubes in patients with end-stage dementia. Feeding tubes are often placed in these patients in the acute care setting and remain as the patient moves to a nursing home for continued care.

“Feeding Tubes Used Too Often in End-Stage Dementia” discusses a study recently published in JAMA that sought to examine this practice and identify what factors are associated with its continued use “despite a body of literature showing that they aren’t effective in improving clinical outcomes or survival.”

This is an important read as it reminds us to question why we do what we do, how it will improve or enhance outcomes, and what are the implications of intervening versus not intervening? Do we “follow the protocol” because it’s convenient, or do we look ahead at implications for patients and families?

So how does your hospital stack up?

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2016-11-21T13:17:48-05:00May 6th, 2010|nursing research|0 Comments
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Upper-Extremity Deep Vein Thrombosis: How Clinicians at One Hospital Achieved Lower Rates

By Sylvia Foley, AJN senior editor

At a suburban hospital in Indiana, clinicians noticed that the incidence of secondary upper-extremity deep vein thrombosis (DVT) at their facility seemed to be on the rise. As Lancaster and colleagues report in the May Emergency, this was alarming: upper-extremity DVT, once thought benign, is now known to be potentially dangerous, leading to complications such as symptomatic or asymptomatic pulmonary embolism, chronic venous insufficiency, and postthrombotic syndrome. Secondary upper-extremity DVT, which accounts for a majority of cases, can be linked to an identifiable risk factor. Patients may present with pain, swelling, and bruising in the area of the thrombosis—but many patients show no symptoms. So it’s essential that nurses know which patients are at risk and how to minimize that risk.

The Indiana clinicians reviewed the literature to deepen their understanding. They also tracked all patients who underwent ultrasonography at their facility and conducted retrospective chart reviews, gathering data for a full year. Several new risk factors were identified, including

  • the use of the large veins at the antecubital fossa for peripheral IV access;
  • the use of harsh medications administered via peripheral IV; and
  • certain peripherally-inserted central catheter (PICC) flushing and care practices.

What they learned prompted several changes to nursing care, and the incidence of secondary upper-extremity DVT at this facility has since declined. To learn more about this quality improvement project and the changes that were implemented, read […]

2016-11-21T13:17:55-05:00April 30th, 2010|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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