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The 2018 ANA Membership Assembly: Making True Dialogue a Reality

By Katheren Koehn, MA, RN, FAAN, executive director of the Minnesota Organization of Registered Nurses (MNORN) and a member of AJN‘s editorial board.

I have been a member of the American Nurses Association (ANA) for over 40 years, an active member for about 35 years. I “grew up” in the association as a delegate to the House of Delegates. I learned to “edit on the fly” by debating perhaps hundreds of resolutions introduced by state nurses associations at the annual, then biannual meetings of the highest level of governance of ANA.

Debating resolutions.

Resolutions had a formal structure of “whereas” and “be it resolved.” Whereases contained the facts; the be-it-resolved contained the actions delegates wanted the ANA to enact. Whereases could not be edited or debated; be-it-resolveds could be edited and debated for hours, or until someone remembered to use the Robert’s Rule “Call the Question.” Debate over resolutions had more to do with proving your point than listening to another’s point of view. It was great theater, but I don’t know how often those resolutions moved our profession forward. I’m sure some of them did, but I remember the debate more than the resolution.

Making the ANA governing body a membership assembly.

When the 2012 ANA House of Delegates voted to change the governing body of the […]

Guest Author2018-07-30T08:49:53-04:00July 30th, 2018|Nursing|0 Comments

August Issue: Pain in Nonverbal Children, Sepsis Update, Particulate Matter Exposure, More

“I didn’t really know what to do . . . . This happened to other people’s families, not mine. I was supposed to be reading the monitors and titrating the drips. I was supposed to be taking care of the patient. I was supposed to be comforting the family. I was the nurse.” —Tonja Padgett, author of this month’s Reflections essay, “The Crazy Aunt or the Nurse“

The August issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Pain in Nonverbal Children with Medical Complexity: A Two-Year Retrospective Study

Children with medically complex conditions often experience pain, but in the absence of self-report, assessing pain can be challenging. The authors of this article sought to describe the signs and symptoms parents of such children find worrisome, the sources of pain in these children, and how to best assess their pain.

CE: A Review of the Revised Sepsis Care Bundles

An update on recent revisions to the sepsis care guidelines, including development of the new one-hour bundle, plus screening and assessment tools to identify sepsis in the ICU, in the ED, on the medical–surgical unit, and outside the hospital.

Environments and Health: Nursing Practice and Particulate Matter Exposure

Both indoor and outdoor particulate matter […]

Diane Szulecki, editor2018-07-27T09:18:49-04:00July 27th, 2018|Nursing|0 Comments

Instructor Incivility Toward Nursing Students

“An anxious student is practicing Foley catheter insertion on a manikin in the nursing skills laboratory. The instructor rolls her eyes as the student nervously fumbles and breaks sterility.”

A less well known type of incivility.

Incivility and bullying in health care have been much discussed in recent years, as they should be. In this month’s issue, Linda Koharchik focuses on a less well known manifestation of this problem: instructor incivility toward nursing students. This kind of vertical violence can be particularly distressing, given the fact that nursing instructors function as de facto gatekeepers for entry into practice. Student nurses can’t simply refuse to deal with them.

Eye rolling, reprimands within earshot of classmates, criticism of the student in front of the patient, and even frank bullying and intimidation are examples of instructor behaviors that some students have to cope with. It’s not hard to imagine what this kind of anxiety-provoking “guidance” can do to a student’s performance, leading to yet more abuse from the instructor.

Merely a rite of passage?

Koharchik notes that some authors have suggested that dealing with incivility is a “rite of passage” for students, one that will help them better cope with the challenges of their chosen work. But nursing students are already exposed to plenty of stress during their training, especially when many […]

Betsy Todd, MPH, RN2018-07-23T09:15:34-04:00July 23rd, 2018|Nursing|0 Comments

Decreasing the Trauma of IV Sticks – for Patients and Nurses

In my clinical days, I was adept at IV sticks. I had a lot of experience from my days in the ER, but especially from working as a chemotherapy nurse, where I had patients with fragile and damaged veins. I learned every trick to coax a vein to appear and which gauge needle would work the best to avoid puncturing through the vein. I was so “into” IVs at one point, I’d note the veins on people’s arms, judging whether they’d be an easy or hard stick.

Little instruction in starting an IV.

But it wasn’t always so. I recall approaching the first time I had to draw blood with much trepidation. There was virtually no training—a more experienced colleague had me watch her and then walked me through it in a few minutes:

“It’s not that hard: see which hand or arm has the better veins; tie the tourniquet around the arm; swab the skin with alcohol; insert the needle, bevel down; pull back and see if […]

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Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-07-19T12:02:08-04:00July 19th, 2018|Nursing|0 Comments

A Nurse’s Open Letter to Parents Who Have Lost a Child

“You are never alone as you miss these children, as you laugh recalling moments with them. Don’t worry that the memory of them is fading—their presence is strong and lives even beyond you and your love for them. We remember them, too.”

In this month’s Reflections column, author Jessica L. Spruit has written an open letter to parents who have lost a child. Spruit, a pediatric NP in a hematology/oncology department, makes it clear that the children in her care are not forgotten and that their deaths are never routine, even on a hem/onc unit. Here, she shares memories of her patients from over the years, recalling the things that made them unique—as children, and not just as “patients.”

In her letter, Spruit describes something that is often hard to convey about our work. In spite of all of the stress and frustrations of nursing today, we still are able to engage deeply with other people. The courage and grace (and fun and joy, too) that we have the privilege to witness become part of who we are. When our patients are children, their gifts to us are particularly memorable.

“Please don’t ever think that we ‘do this all the time’ or that it is ‘just part of our job.’ Please don’t fear that you are the only ones who remember and miss your children.”

Read “We Remember Them, Too” in […]

Betsy Todd, MPH, RN2018-07-17T14:28:09-04:00July 17th, 2018|Nursing, pediatrics|0 Comments