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. […]

A COVID-Era Telehealth Appointment Drives Home the Fragility and Strength of the Therapeutic Relationship

The Reflections essay in this month’s AJN is by LaRae Huyck, a psychiatric mental health NP. In this one-page story with a dramatic COVID-era twist, she explores her years accompanying a young counseling patient from suicidal depression during adolescence to joyful engagement with life as she heads out into the world on her own. Writes Huyck:

The time I spent with her seems so short, but in actuality it made up nearly a fourth of her life. We had traveled though the awkward adolescent years, the landmine of her parents’ divorce, the loss of a beloved grandmother, and a failed relationship that ended her dreams of a prom date.”

The healing power of a therapeutic relationship.

The Importance of Time” adroitly summarizes this journey, revealing the author’s compassion for this young woman and her hopes for her as well. It’s a story of healing and growth that reveals the good that therapeutic relationships coupled with medication can do for some patients. […]

An Intimate Glimpse of Community Health Nursing During the Pandemic  

Photo courtesy of Monica M. Finifrock.

We hear a lot about frontline nurses and the trauma they’ve endured throughout the year fighting the world’s deadliest pandemic in 100 years. Their stories are harrowing and heroic and shine a much deserved spotlight on the importance of the profession. And yet COVID-19 has touched not only those working in ICUs and EDs—but in every area of health care. Our December In the Community article, “Keeping Calm in the Buffer Zone,” is just one example of a nurse touched by COVID-19 in her daily work.

Community health as a ‘buffer zone.’

When the article opens, author Monica M. Finifrock is on her way to work at a community health clinic in Seattle. It’s April and the pandemic is beginning to take a toll.

I don’t consider myself on the front lines of the pandemic . . . I’m not watching patients take their last gasps of air or making hard decisions about who gets a ventilator and who doesn’t. I’m a community health nurse, and my role during the COVID-19 pandemic is to do exactly what I always strive to do—serve the community.

Calling her clinic a “buffer zone,” Finifrock argues that community health clinics are […]

‘Didn’t You Used to Be a Nurse?’: Finding the Nurse Within

The author of the Reflections essay in AJN‘s September issue, Kathleen Resnick, confronts a question many nurses must confront at some point: what is it to be a nurse?

And a related question: what is the essence of nursing work? If you can no longer work as a nurse because of physical constraints or for another reason, are you still a nurse?

Writes Resnick in “A Different Kind of Nurse“:

My nursing career was spent in hospitals, working mostly in critical care as a bedside nurse, then in management. I worked hard and my work was a large part of my sense of self-worth. I loved patient care and the satisfaction of making a difference. As a manager, I felt my  primary mission was to enable those I served to do their best work. . . . I was somebody. Now what am I? An acquaintance asked me, “Didn’t you used to be a nurse?”

[…]

Documentary Filmmaker: The ED Reflects Everything Going on in Our Country

A new documentary profiles emergency nurses.

If you think the photo on the cover of the September issue is dramatic, it’s because it was taken during the emergency treatment of a young man with a gunshot wound. (See On the Cover for details.)

The photo is from the new film by filmmaking team Carolyn Jones and Lisa Frank, In Case of Emergency, which was made in concert with the Emergency Nurses Association to mark its 50th anniversary.

Michelle Lyon, RN, an ED nurse at the University of Kentucky Albert B. Chandler Hospital, Lexington.

The film’s release is scheduled for October 14th, the beginning of Emergency Nurses Week, and we highlight the film in a photo-essay in the September issue. (The article is free until the end of the month, and best viewed as a pdf.)

The film follows the work of ED nurses in several parts of the country. As a former ED nurse, I was struck by the ability of these filmmakers to accurately capture the work.

Scenes […]

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