Mental Health Nursing: Transcending the Limitations of Words

When I met Dorothy, she was always counting. Her chapped lips moved nonstop as she chanted random numbers. She’d increase the speed, as if that would help her to reach the end quickly—but since the numbers didn’t appear to be in any sensible order, this loomed before her like an impossible task…

The challenge of mental health nursing.

Illustration by Pat Kinsella. All rights reserved.

This month’s Reflections column, “Dimensions of Dorothy,” begins with this harrowing look at a woman in the grip of a mental health crisis. Author Maureen Bonatch goes on to poignantly describe how this illness can “steal someone’s identity and overwhelm their self-control.”

As a new nurse at the state psychiatric hospital, Bonatch definitely had a “new normal” to adjust to at work. As she observed the manifestations of severe mental illness, she also developed insight into why some had so few visitors: “It had to be difficult,” she writes, “to helplessly observe as an illness crept in to hold the person you knew and loved hostage.”

An inadequately valued area of […]

2018-11-20T10:07:55-05:00November 20th, 2018|mental illness, narratives, Nursing|0 Comments
Read More

As Patient Handling Injury Rates Remain High, Schools Teach Outdated Methods

The old-fashioned way to reposition patients.

I haven’t seen draw sheets in hospitals for years now. “Back in my day,” those narrow sheets we placed across the middle of the bed were considered essential to patient care. Draw sheets were easier to change than the full sheet and they kept the bed neat. They always seemed to be hard to come by—probably because most nurses had stashed their own supply of them in patients’ rooms.

But more importantly, they were what we used to reposition patients. We used to work in pairs on turning rounds—one of us on each side of the bed, rolling the draw sheet tightly to get a grip, then sliding the patient up in bed or turning them on their sides. It was hard work, and no form of “good body mechanics” saved your back or shoulders and neck from strain when you needed to stretch across a bed—or, many times, climb on top of it—to move an unconscious patient. It’s no wonder that nurses and nursing assistants had such high rates of serious musculoskeletal injuries.

The institution of ‘No-Lift’ policies.

Then came electric beds, overhead lifts and transfer stretchers, and “No Lift” policies, which were based on data from the Occupational Safety and Health Administration (OSHA) on the frequency of injuries and supported by nursing organizations. Many hospitals and nursing homes implemented safe patient handling and mobility (SPHM) […]

2018-11-16T07:25:15-05:00November 16th, 2018|Nursing, nursing career, wellness|5 Comments
Read More

To Recruit More Men, Rebrand Nursing as ‘Masculine’? Or Just Stop Oversimplifying the Profession

As a registered nurse for more than 40 years—with experience in pediatrics, public health, and philanthropy—I read a recent article by NPR’s Shankar Vedantam (“Why More Men Don’t Get Into The Field Of Nursing”) with interest. Vedantam essentially argued that more men don’t enter nursing because it’s seen as a “feminine” profession and proposed that we start emphasizing the more “masculine” attributes of the profession.

From youthful contrarianism to a deeper vision of the profession.

When I became a nurse in 1975, my choice was shaped first by my youthful desire to be contrarian: to bend gender norms by being a man in a “woman’s” profession.

When I began practicing nursing, however, I grew in my understanding that a commitment to nursing, particularly in my specialty field of public health, provided me with the means to act every day in concrete ways to further healing and build community. And so I applaud calls like Vedantam’s drawing attention to the need for more men in nursing. The need for diversity (of all kinds) in nursing was highlighted in the 2010 Institute of Medicine’s Future of Nursing report.

The deep-rooted public view of nursing as ‘women’s work.’

Share this:

2018-11-14T10:57:09-05:00November 14th, 2018|men in nursing, Nursing|6 Comments
Read More

What Can Nurses Do to Influence Health in Their Communities?

What can I do as just one nurse?

As a nurse, I have often heard my colleagues question their ability to influence health in their communities. At times I have felt this same sentiment. What can I do as just one nurse?

Nurses have a unique perspective of how a community’s physical, social, and economic environment can affect patients’ health. And as we expand our understanding of what creates health, nurses have the opportunity to be a powerful voice when it comes to influencing the health of their communities.

Nightingale as precedent.

Nightingale in Scutari ward during Crimean War/Library of Congress

Nurses working to improve health through environmental modification is not new. The story of Florence Nightingale is well-known. As a nurse, Nightingale recognized changes needed to improve the health of soldiers in a hospital during the Crimean War, when more of the hospitalized soldiers were dying from the spread of infectious disease than from war-related injuries. Through her work with a group of nurses, she was able to significantly […]

2018-11-09T08:50:06-05:00November 9th, 2018|Nursing, nursing roles, Public health|3 Comments
Read More

In Pediatrics, What’s the Best Way to Assess for Pressure Injury Risk?

The evolution of a scale.

In children, most hospital-acquired pressure injuries are related to medical devices rather than immobility. A device that can’t be repositioned, such as this cast, presents additional risk. Photo by Rafael Ben-Ari/Alamy Stock Photo.

Pressure injury prevention has always been a top nursing priority. Do you know about the latest tool for early identification of pediatric patients at risk for pressure injury?

The well-known Braden Scale, developed in 1987, was followed in 1996 by the Braden Q Scale for use in kids. Both were developed by nurses and are widely used around the world. However, the Braden Q Scale focused on immobility as a risk factor and wasn’t designed to address device-related pressure injuries, risks to children younger than three weeks of age or older than eight years, or children with congenital heart disease.

An update to include device-related risk in children.

So Sandy Quigley and Martha Curley, the nurses who modified Braden and Bergstrom’s original Braden Scale, set out to validate an updated version of their pediatric tool in order to address medical device use, a broader age range, and children born with heart disease. In “How to Predict Pediatric Pressure Injury Risk with the Braden QD Scale” in this month’s AJN, they explore the use of their Braden QD Scale (the D is for device related).

Quigley, Curley, and colleagues emphasize that while immobility-related pressure injuries in children have decreased significantly, “[in pediatrics] most hospital-acquired pressure injuries are associated […]

2018-11-07T10:32:44-05:00November 7th, 2018|Nursing|0 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