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
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Bedpans and Learning: Nursing Basics Still Matter

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Photo by Morrissey, via Flickr. Photo by Morrissey, via Flickr.

There I was, orienting to a busy medical ICU, perplexed over a bedpan. You’d think, since I was just graduating from nursing school, that bedpans would be my area of expertise. Critical thinking and vent strategies came easy; how could I possible admit I had no idea how to give a bedpan to a patient?

Frightening, to graduate from nursing school and a competitive externship program without this competency. Somehow, though, every unit I’d experienced offered patient care assistants, or patients who didn’t need this age-old tool. I’d certainly helped patients to the bathroom and cleaned incontinent ones. Despite the barrage of clinical learning, the basics of offering the pink plastic tool hadn’t sunk in.

Paralyzed, I stood with it in my hand, looking at my intubated, awake patient. I’d had the wherewithal to ask the family to step out, but couldn’t figure out which end went first. The horror of my preceptor finding it backwards would end me. Did the pointed end go towards the patient’s back? The larger end toward the feet for better coverage? Why couldn’t I remember?

Somehow, I managed to decide, […]

2016-11-21T13:02:43-05:00April 8th, 2015|career, narratives, Nursing, nursing perspective, patient engagement|7 Comments
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Telling the Truth, Keeping a Patient’s Trust

“Am I going to be okay?” Ami gasps. Her breath hitches, her chest rising and falling in spasms. One of my hands holds a mask to her face; the other hand holds hers. Pain has made her strong—my fingers are almost as white as her pale face, radiant with fear.

Illustration by McClain Moore for AJN. Illustration by McClain Moore for AJN.

That’s the start of the Reflections essay in AJN‘s February issue, “Am I Going to Be Okay?” Nurses tell patients ‘it’s going to be okay’ because the words can keep them calm, because no one can tell the future, because it’s comforting to hear ritualized phrases from a caregiver—even when they’re not, strictly speaking, true.

But are there times when more honesty is desirable? The author of this short Reflections essay delves into one such situation where the patient needs, above all, to feel trust for her nurse. […]

2016-11-21T13:02:53-05:00March 9th, 2015|narratives, Nursing, nursing perspective, patient engagement, Patients|1 Comment
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So You’re a Nurse With a Story to Tell…

Madeleine Mysko, MA, RN, coordinator of AJN’s monthly Reflections column, is a poet, novelist, and graduate of the Johns Hopkins Writing Seminars who has taught creative writing in Baltimore for many years.

karindalziel/ via Flickr Creative Commons karindalziel/ via Flickr Creative Commons

Whenever I meet someone new who happens to be a nurse—in both clinical and social settings—I wait for the right moment to mention my work at AJN on the Reflections column. It’s not only that I’m proud of the column. It’s also that I’m forever on the lookout for that next submission—for a fresh, compelling story I just know is destined to shine (accompanied by a fabulous professional illustration) on the inside back page of AJN.

“I imagine you have a story or two to tell,” I’ll say to a nurse I’ve just met—which is the same thing I say, whenever I have the chance, to nurses I’ve known for years. I mean it sincerely; given the vantage point on humanity that our profession affords, I actually do believe that every nurse is carrying around material for a terrific story.

The response I usually get (along with a wry smile, the raising of eyebrows, or a short laugh) is, “Oh yes. I have stories.”

But then—even as I’m mentioning the Reflections author guidelines, even […]

2018-04-17T13:41:27-04:00January 30th, 2015|narratives, Nursing, nursing perspective, nursing stories|5 Comments
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‘Tables Turned’: When the Patient’s Family Member Is a Nurse

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Illustration by Eric Collins. All rights reserved. Illustration by Eric Collins. All rights reserved.

Nurses are not always comfortable when a patient’s family member is also a nurse. In AJN’s January Reflections essay, “The Tables Turned,” a critical care nurse describes her attempt to navigate the role change from nurse to family member when her sister is hospitalized with multiple injuries after a bike accident.

Her sister is in obvious pain, but pain management is complicated by a low blood pressure. The author asks her sister’s nurse about alternative analgesics. She writes:

“The nurse, perhaps caught off guard by my question, answered abruptly: ‘I don’t think so. We don’t do that here.’ There was a pause. ‘Don’t do what?’ I asked. ‘We don’t do IV Tylenol,’ she repeated. She did not offer an explanation, an alternative, or say she’d ask another provider… I felt helpless, both as a critical care nurse and as a sister.”

As if to reinforce that the patient’s sister is not welcome to participate in care discussions, the charge nurse soon comes by and suggests that the author “step out to get some rest.”

Of course we don’t know the nurse’s […]

2016-11-21T13:03:16-05:00January 7th, 2015|career, narratives, Nursing, nursing perspective, pain management, Patients|5 Comments
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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.
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