Coming Home to Nursing: A Career Change Eases a Return to a Small Town

“Working as a nurse in the county where your family has lived for seven generations has a social complexity that can’t be prepared for.”

The Reflections essay in the September issue of AJN isn’t focused on a dire clinical situation, a wrenching ethical quandary, or a challenging coworker or boss. Called “Coming Home to Nursing,” the essay describes the many ways becoming a nurse helped the author begin to feel a sense of belonging when she returned to her small town. Here’s the opening:

Illustration by Gingermoth for AJN. All rights reserved. Illustration by Gingermoth for AJN. All rights reserved.

I had been taking care of people, in one way or another, for as long as I could remember, first growing up in Maine and then for 20 years in New York City. I had returned to my small town to help care for my mother, who had end-stage Parkinson’s disease. After she died, I felt a void. I looked around at this tiny place, where people are considered to be “from away” even if they’ve lived here for multiple generations. I wondered what I had to give back to the supportive community I’d grown up a part of—and I also wondered if I could fit in after 20 years away. Could I turn my love of taking care […]

2016-11-21T13:02:02-05:00September 8th, 2015|career, narratives, Nursing, nursing perspective|1 Comment
Read More

‘An Immutably Personal Process’: A Hospice Nurse Contemplates Uncontrol

Megen Duffy, RN, BSN, CEN, currently works in hospice case management. She writes AJN’s iNurse column, which focuses on technology and nursing.

by mark ahsmann/ wikimedia commons by mark ahsmann/ wikimedia commons

I started my day the way I often do: watching sunlight begin to filter in and softly illuminate the sunken face of a person who would die, not later, but sooner. I sat curled in the chair I’d been in since 3:00 AM, wrapped in my sweater against the institutional chill, and waited.

This is, perhaps unbelievably, my favorite part of being a nurse. In hospice, there is no deadline. No one needs the room right now. The patient does not have to go to the floor in the next 30 minutes to avoid throughput delays. I do not have five other patients claiming my time. No, I have the gift of being able to sit quietly with only one objective: to do everything I can to make sure this person leaves this life without pain or fear.

I am not bored. It may appear as if I am doing nothing, but that is far from true. I am watching and listening for every breath, every movement, every toe that turns a deep bruised purple, every expression that may say “I am hurting.”

I am merely cooperating with death, and death’s agenda is never known to me. […]

2016-11-21T13:02:06-05:00August 27th, 2015|Ethics, narratives, Nursing, nursing perspective|8 Comments
Read More

The Present: What This Visiting Nurse Has to Give

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

It can be daunting for a visiting nurse to enter a patient’s home, especially if the patient seems less than receptive to the nurse’s efforts. In this month’s Reflections essay, “The Present,” Pia Wolcowitz describes one of her first assignments as a visiting nurse. She’s sent to assess a woman newly diagnosed with lung cancer. Here’s an excerpt:

I rang the bell and heard a voice, but couldn’t make out what she said. I rang again. This time I heard her loud and clear. “If you wanna come in, come in! Door’s open!” Entering, I found a woman in her mid-60s sitting hunched at her kitchen table, surrounded by bottles of medication and a bowl of cereal. It was way past noon.

She had cropped blue-black hair with accents of white. She studied me a moment, then her gray eyes examined my ID. “So, you’re the nurse?”

[…]

2016-11-21T13:02:10-05:00August 10th, 2015|narratives, Nursing, nursing perspective, patient engagement, Patients|1 Comment
Read More

Patient Satisfaction and Nursing: Listening Matters, Whatever the Situation

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN. Her last post on nursing and patient satisfaction surveys is here.

by runran/Flickr Creative Commons by runran/Flickr Creative Commons

During this hospital stay, how often did nurses listen carefully to you?
1. Never
2. Sometimes
3. Usually
4. Always

Listening Carefully About Patients
“Her crit is dropping with each bowel movement, and she just won’t stop bleeding,” said my night shift colleague during the early moments of my shift.

As soon as she finished telling me the rest of my new patient’s care, I got on the phone for the ordered blood. Waiting for the first of many products to be delivered, I went to see her. As I poked around the hanging drips and fluids, checking dosages and orders, setting alarm limits, I heard my patient’s voice:

“Hello, hello? I’m so anxious. I just fell asleep for a moment and now I’ve woken up and I’m terrified. I think I need to be changed again, and I just don’t know what to do, and who are you?”

My colleague, busy with the details of resuscitation, hadn’t said much about my new patient’s anxiety. Anxiety, too often coded as neediness, is clinically important, especially in a patient with questionable stability, and doubly in a patient whose […]

2016-11-21T13:02:10-05:00August 7th, 2015|narratives, Nursing, nursing perspective, Patients|3 Comments
Read More

The Borders of Loss: An Early First in One Nurse’s Career

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog. The illustration below is hers.

Peds Ward (2008), charcoal, graphite, flash, and acrylic. By Julianna Paradisi Peds Ward (2008)/charcoal, graphite, flash, and acrylic/by Julianna Paradisi

Working in oncology, the topic of whether it’s crossing a boundary for nurses to attend the funeral of their patients comes up. Sometimes, however, we’re carried across that boundary by our heartstrings. The first patient funeral I attended was that of my first patient.

During Jack’s short life, he was the first assignment of many a new nurse on the pediatric unit where I was hired as a newly graduated nurse. He had lived in the hospital his entire life.

Jack was nearly ten months old when we met. Born with a congenital illness requiring multiple surgeries, he failed to thrive. A nasogastric tube snaked through his nose into his stomach so he could conserve the calories burned eating from a bottle or spoon. As Jack’s nurse, I mastered the skill of nasogastric tube feedings.

Most parents bond with their chronically ill babies, but it takes a big commitment on their part. Babies like Jack do not look like the pictures of healthy babies in magazines. They are cloistered in an isolette and connected […]

2016-11-21T13:02:33-05:00May 8th, 2015|career, narratives, Nursing, nursing perspective, Patients|2 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top