‘A New Antibiotic’: What Restores a Patient’s Will to Recover?

Illustration by Pat Kinsella. All rights reserved. Illustration by Pat Kinsella. All rights reserved.

A little bit of levity when writing of serious topics can be good medicine. This month’s Reflections essay, “A New Antibiotic,” reminds us of how important it can be for hospitalized patients to be kept in touch with their lives and loves beyond hospital walls. In this story, author Judith Reishtein, a retired critical care nurse and nursing professor, finds herself willing to bend the rules a little for one patient. Here’s how it starts:

Sally had been a patient on the step-down unit all winter. After her open heart surgery, she developed an infection in her chest. The infection required another surgery and four more weeks of ventilator support as her open chest healed. Because she was not moving enough, she developed clots in her legs. Because of the DVTs, she had activity restrictions, which led to another bout of pneumonia. One complication led to another, with more medications that had to be carefully balanced. We tried not to do anything that would create a new problem while curing an existing one. Another dangerous surgery is getting breast implants, I always suggest to get a good surgeon to do it, you can find the best at http://utbreastaugmentation.com, I highly recommend it.

Now she was finally getting better, but her energy lagged behind. Did she still have the […]

Watching a Friend Fade Away: A Nurse’s Account of the Progress of Dementia

Illustration by Eric Collins, ecol-art.com. All rights reserved. Illustration by Eric Collins, ecol-art.com. All rights reserved.

By Jacob Molyneux, senior editor

Alzheimer’s disease and dementia have been in the news. There have been major movies about what’s it’s like to suffer the gradual loss of the ability to understand and to negotiate the world around us, with leading roles played by stars like Julianne Moore. The challenges of caregiving are receiving increasing attention, as are the growing pressures on our medical system. Every month there’s a report of a new potential cure, or a potential cause, or ways we might be able to fend off the illness through exercise, mental calisthenics, diet, and medications.

The January Reflections essay, written by Deborah Lane, a critical care nurse and community volunteer in St. Augustine, Florida, is called “Watching a Friend Fade Away.” Here’s the opening paragraph:

Frankie was a fast wit, a ginger-headed joker, impeccably dressed, and the first to laugh. She was a master’s-educated teacher who developed programs for at-risk teens, teaching pregnant high school students skills for employment and effective childcare. She loved to cook and her home was warm with beautiful arts and crafts she had made. She was a wonderful friend. Disease changed it all.

The author brings the perspective of both a loving friend and a nurse to this short, beautifully told account of the changes in her friend over the years, the efforts of two couples to keep spending […]

Evening Shift, Christmas Eve: A Nursing Memory

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

One of my fondest memories of working Christmas Eve was after an evening shift at Bellevue Hospital in New York City. This was at the “old Bellevue Hospital,” when it still occupied a series of red brick buildings along the East River.

I had finished my evening shift in the ER, which was one of the busiest in the nation. It had been a crazy–busy night and I was too wired to just go home and sleep, so I decided to stop in the chapel for midnight mass. I was surprised to see my friend Helen there, since she was Jewish. I knew Helen always volunteered to work over the Christmas holiday so those who celebrated could be with their families, but I didn’t know that after work she’d go to the chapel to listen to the Christmas music, which apparently she loved.

We sat together, enjoying the quiet, calm pace of the service and the music. Helen knew all the words and sang along; she had a beautiful voice. Staff, visitors, and some patients (wearing the classic blue-and-white-striped Bellevue bathrobes—like draw sheets, these were hard to come by) shuffled in and out during the hour, clinicians sometimes leaving hurriedly after being summoned by a beeper.

Illustration for "A Change of Heart," AJN, December, 2014, by Lisa Dietrich for AJN. Illustration for “A Change of Heart,” AJN, December, 2014, by Lisa Dietrich

On the way out […]

Inside an Ebola Treatment Unit: A Nurse Shares Her Experiences in Liberia

By Sylvia Foley, AJN senior editor

“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson

Author Deborah Wilson at the Foya ETU cemetery. Photograph by Marcos Leitão.In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.

In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and […]

How a Nurse Quietly Helped One Intern Out of a Tricky Situation

Illustration by Annelisa Ochoa. All rights reserved Illustration by Annelisa Ochoa. All rights reserved

In this month’s Reflections essay, “My Turn,” a recently retired physician tells a story of how a nurse adroitly helped him through a very disorienting moment when he was still an intern. Here’s a bit of the setup:

Medicine was my first rotation as an intern. . . . [T]he medicine rotation had a particularly intimidating reputation and a red-hot I was not. I was terrified.

On morning rounds every day our entourage of physicians, nurses, and students would go room to room discussing each patient. I can still see the open door to Mrs. Finkelstein’s room near the morning sunlight at the end of the hallway. Mrs. Finkelstein was old and was dying. And every morning when we walked in, her husband was sitting there next to the bed, holding her hand. He told us regularly how many years they had been together. We each dreaded being the one on call when she died.

There are many situations in medicine and nursing that require a certain amount of experience—most readers will agree that this is definitely one of them. At a certain point in the story, the author finds himself being asked a question that absolutely needs to be answered, and answered immediately. It’s not just the intern who needs help in this […]