The Complex and Illuminating History of Nurse Participation in Bedside Rounds

This week’s offering in homage to Women’s History Month.

We know from research that interdisciplinary bedside rounds improve communication and create a safer care environment. As noted by the author of a new CE article in the April issue, nurse–physician bedside rounding “has been shown to reduce mortality, medication errors, hospital length of stay, and hospital costs; improve staff and patient satisfaction; expand the health care team’s understanding of the patient’s plan of care; and increase both efficiency and perceptions of patient safety.”

Not your grandmother’s rounds.

In her article, “An Historical Review of Nurse–Physician Bedside Rounding,” Genevieve Beaird notes that while nurses rounding with physicians is not new, the nurse’s role today is vastly different from the early days. At that time, the nurse’s main concern was often preparing the stage, so to speak, for the physician’s appearance at the bedside. Here’s a quote from Dorothea Gothson, RN, in a 1913 issue of AJN:

“There is nothing more distressing to either patient or the earnest hardworking nurse than to be surprised by the attending doctors…. Equally annoying is the experience of patients and nurses being ready, waiting for the doctors, and their not appearing for one or two hours after the appointed time—perhaps not at all—thus […]

Updating Your Knowledge of the Many Medications for Type 2 Diabetes

According to the latest figures from the CDC, 30.3 million people in the U.S. have diabetes, and another 84.3 million adults have ‘prediabetes.’ Type 2 diabetes accounts for 90% to 95% of all cases. Are you up-to-date on the new drugs? This month in AJN, Patricia Keresztes and Annette Peacock-Johnson help us find our way through the latest information on the many drugs (other than insulin) used in type 2 diabetes.

Lifestyle, of course, is critically important in the management and prevention of type 2 diabetes. Diet, physical activity, weight control, and whether or not we smoke are all factors in managing the disease.

Keeping track of the many newer antidiabetes drugs.

But drug therapy is central to diabetes control for most people, and there has been an explosion of new drugs for diabetes over the last several years. Do you know which currently available antidiabetic drug (or drug class) . . .

  • is the least expensive?
  • is more likely to cause weight gain?
  • is associated with the greatest risk of hypoglycemia among non-insulin agents?
  • should not be used by people who have (or have had) bladder cancer?
  • is associated with an elevated risk of bone fractures in women?
  • can decrease the effectiveness of hormonal contraception agents?
  • may lead to urinary tract infections or genital mycotic infections?

A CE article to update your pharmacologic expertise.

Update your knowledge of medications for type 2 diabetes by reading this month’s […]

2019-03-18T11:02:58-04:00March 18th, 2019|Nursing|0 Comments

The Lasting Influence of the Progressive Visiting Nurses of the Late 19th Century

Nursing has a long history of advocacy and activism on behalf of vulnerable populations. For Women’s History Month, we have been drawing attention to the theme of the intimate connection between nursing history and women’s history. In this post, we share an image of nurses at the Henry Street Settlement in New York’s Lower East Side in the late 19th century, where nurse and social worker Lillian Wald organized nurses to bring essential health services and much more to the poor immigrant populations of the area.

A new model of possibility.

These early visiting nurses established a new model of possibility that has echoed through efforts since to improve the health and living conditions of millions. The following text, from the editorial comment in the January 1902 issue of the American Journal of Nursing, suggests that the efforts of these progressive nurses in the Lower East Side threw into relief some of the forces of corruption in New York City’s famed and powerful political machine that were keeping the poor in such abysmal and unhealthy living and working conditions.

Henry Street Settlement Nurse, Lower East Side, New York City

“After the downfall of Tammany, the public […]

Is the Current Nurse Manager Role Attractive to Millennials and Gen Xers?

Image by TeroVesalainen from Pixabay

A perennially challenging role.

I’ve always found the role of nurse manager to be the most difficult one in health care. Crushed between staff nurses begging for enough resources to do the job and administrators pressing for cost containment, nurse managers often find it hard to make any progress at all.

This job comes with 24-hour responsibility, often (incredibly) for more than one unit. This can mean taking responsibility for, say, 50 patients, and 80 or more staff. Just managing payroll for so many people (as many managers still have to do) can take half the pay period! And all this for the princely salary of . . . less than what many of their senior staff nurses are making.

Redesigning the nurse manager role includes greater role flexibility.

Those of us who’ve been in nursing for decades simply accepted that, if you wanted to move up the nursing career ladder, you would have to accept all of the above. Younger generations of nurses, though, see things differently. […]

2019-03-15T10:09:41-04:00March 13th, 2019|Nursing, nursing career|0 Comments

Women’s History is Nursing’s History

We would be remiss not to highlight Women’s History Month—after all, nursing’s history is intrinsically tied to women’s history. As women became more independent, so too did nursing. And it’s important to acknowledge our history of contributions to shaping this country’s health care system. As I note in a March 2015 editorial:

“The story of nursing continues to be one of social commitment, innovation, and problem solving. It legitimizes and supports our inclusion on governing boards and our presence at policymaking tables. It can infuse each of us with pride and energy for the work we do.”

One hundred and nineteen years of archives.

Linda Richards, first American trained nurse

AJN has 119 years of archives documenting nursing’s legacy (all free to read for subscribers). To mark Women’s History Month, each Friday this month we are highlighting an archive article and making it free until April 1. Today we’re sharing “Recollections of a Pioneer Nurse,” which was published in January 1903 (click through to the PDF version for the best version).

First trained nurse in the United States.

The article was written by Linda Richards (1841-1940), considered the first trained nurse in the United States. It’s a vivid first-person account of her experiences in nursing at the turn of the century, and also […]

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