The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… […]

Not a Nurse but Her Mother Was, and Now It Really Matters

June_Refl_Illustration Illustration by Lisa Dietrich for AJN

The loss of Emily Cappo’s mother, a competent and supportive parent and an accomplished nurse, leaves an enormous gap in her daughter’s life. Then her own son gets sick.

Cappo writes about these events in “I’m Not a Nurse, But My Mother Was,” the Reflections essay in the June issue of AJN.

Without her mother to turn to for help and guidance, Cappo has no idea how she’ll handle the situation. “There I was,” she writes,

the nonmedical person in my family, the person who hated blood and needles, being thrown into a situation demanding courage, stamina, and role modeling.

But we rise to the situation that presents itself, if the stakes are high enough. Cappo discovers what many nurses already know: the nurses who care for her son make all the difference in his care, and provide her with essential support as well. […]

Psychiatric Nursing: The Seemingly Unreachable Patient

By Jennifer Rodgers for AJN. Illustration by Jennifer Rodgers for AJN

In many fields, we must keep doing the same thing over and over without any apparent results. Nurses, for example, may find that their efforts to make a patient safe, to reach a patient, to ease a patient’s suffering have little visible effect. This is just part of the work, but some patients will inevitably pose a greater personal challenge than others.

Five Words,” the Reflections essay in the May issue of AJN, written by former psychiatric nurse Tania Renee Zayid, is about one of those patients and the feelings of hope and disappointment his nurse experiences in his presence. In it, she writes:  […]

‘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 […]

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