The Ethical Use of our Therapeutic Connections with Patients’ Families

“What would you do, doctor?” The family had been explicit in wanting straightforward communication about their child, whose neurological disease had progressed to the point where she was continually seizing, despite every medication the physicians had tried. The seizures were in turn damaging her brain, such that she was minimally responsive to stimuli and was not expected to regain significant awareness of her surroundings.

I held my breath as I anticipated the doctor’s reply. She had spent many hours with this patient and family, and had built trust with the parents.

“As a physician . . . I would transition my child to comfort care and ultimately let her go. But as a mother . . . I would struggle to do this.”

The patient’s mom nodded tearfully. The doctor had given an honest reply, and had still ultimately left the choice to the parents.

I took care of this patient in her final few days of life. The parents were heartbroken but also clear in their decision. We walked them through each step, and made sure they felt supported to the best of our ability, down to their very last goodbye with their child.

******

There is power in the medication and therapies we apply. […]

How to Get Started as a Nurse Advocate Around Key Issues Like Scope of Practice

Have you ever been frustrated by a professional issue and wondered if new legislation could fix it? This happened to me as a nurse practitioner after moving to a new state.

I was young and newly married, wanting to be closer to family. I didn’t realize how drastically different each states’ Nurse Practice Act could be in terms of advanced practice registered nurse (APRN) scope of practice. My work as a psychiatric NP had been focused on child and adolescent psychiatry, but moving to Florida in 2013 hindered my ability to continue this practice. State laws did not allow advanced practice nurses to prescribe controlled substances, and the majority of attention-deficit/hyperactivity disorder medications are considered Schedule II.

Getting started as an advocate.

Ultimately, this legal restriction led to two things: my transition to adult-only practice, and learning how to be a nurse advocate. This overview was developed as an introduction to the process of impacting legislative change as an advocate for your patients and your profession.

2024-08-23T15:25:02-04:00August 19th, 2024|career, Nursing, nursing roles|0 Comments

Implementation Science: Systematic, Sustainable, Evidence-Based Change

By Cagkan/Adobe Stock

Reading the article by Russell-Babin and colleagues in the December 2023 issue of AJN made me grateful for all the work that went into developing the nursing implementation science (IS) program at Inova. As a nurse working at this health care system, I’d like to share how I benefited from being in the first cohort of nurses trained and engaged in IS over the last three years.

For the past eight years, I’ve been a clinical coordinator of two different disease-specific programs—first stroke and now sepsis. In these roles, I’ve been engaged in many different quality improvement (QI) projects and have become familiar with the tools and processes used to improve patient care and outcomes.

Towards more comprehensive and systematic evidence-based change.

However, as I was invited to step into the world of IS, I began to realize that a strict QI approach cannot alone bring about all the changes we desire within the complex systems of health care. The fact is that […]

2024-01-11T10:06:42-05:00January 11th, 2024|Nursing, nursing roles, Quality improvement|1 Comment

Telehealth in Rural Nursing: Embracing Change for Better Patient Outcomes

rural road Photo by Bradyn Shock on Unsplash

When I first heard of telehealth services coming to our rural hospital, no one was a bigger skeptic than I was.

Perhaps the main reason was the way I was educated as a nurse and how I learned to practice as an APRN. Honestly, I am “old school” in every way possible. My first thought was, “This is not good practice; how could it be? Won’t there be shortcuts? How about the lack of a physical exam? How can you properly physically evaluate someone over telehealth? How can you take safe care of patients and avoid missing something that’s potentially life-threatening if you can’t touch them? How could someone a thousand miles away help me way up in the mountains of the Eastern Panhandle? What could they know about the community here and their needs?”

These were just a few of the questions and concerns I had regarding telehealth coming to our rural community access hospital. When we assess our patients, we not only to listen to their heart and lungs, look into their eyes, hear their voice, feel the temperature of their skin, but we connect. We are building trust and ensuring support with looking, listening, and feeling.

The […]

Comfort in the Midst of Grief: A Spiritual Care Journey

A mother’s grief.

Photo by Khamkéo Vilaysing on Unsplash

As a member of the spiritual care team, I received a request one morning to visit Ms. L, a patient who had just received devastating news: her son had unexpectedly died the previous night. Ms. L was recovering from a major surgery and in the process of being discharged from the hospital. The details surrounding her son’s death were unclear, but they only added to the profound sadness of the situation.

It was evident that the bond between Ms. L and her son was incredibly strong and loving. They had faced numerous physical challenges together, overcoming obstacles that strengthened their deep connection.

When I entered her room, there was a sense of familiarity about Ms. L, though I couldn’t quite place it. After I introduced myself, Ms. L turned to me, tears streaming down her face, and asked the agonizing questions that often arise in times of tragedy. “Why did this happen? Why were we subjected to so much pain? What had we done to deserve this punishment from God?” Ms. L, a devoted Catholic actively involved in her church, had always drawn strength from her religious beliefs for herself and her son.

In […]

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