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 […]

2018-07-27T09:18:49-04:00July 27th, 2018|Nursing|0 Comments
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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 […]

2018-07-23T09:15:34-04:00July 23rd, 2018|Nursing|0 Comments
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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.

Venous access may be difficult to achieve in older adults. Photo © Alto / Alamy Stock Photo.

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 […]

2018-07-19T12:02:08-04:00July 19th, 2018|Nursing|0 Comments
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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.”

Illustration by Barbara Hranilovich for AJN. All rights reserved.

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 […]

2018-07-17T14:28:09-04:00July 17th, 2018|Nursing, pediatrics|0 Comments
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AJN Wants You! A Call for Peer Reviewers and Authors

nurse typing on keyboardTake your career to the next step—become a peer reviewer or author.

For over 118 years, AJN has presented its readers with timely and informative content to support best nursing practice and to examine issues of the day that are relevant to nurses and the profession. While that’s still our aim today, content development is more complex—it now includes peer review; fact-checking to ensure accuracy; citing evidence from the literature; ethical guidelines that govern editor, reviewer, and author behavior; careful editing to meet standards for quality writing; transparency to avoid bias and conflicts of interest. We’re proud of our commitment to high standards, and our success is borne out by the many awards we’ve received—more than any other nursing journal.

All of this wouldn’t be possible without the help of peer reviewers and authors, who commit to making the content we publish the best that it can be: timely, accurate, readable, and useful.

Peer reviewers are essential to any scholarly journal.

Peer-reviewing is also an excellent way for fledgling writers to better understand what editors look for in manuscripts. We welcome new reviewers who have expertise in nursing, are current with the literature and practice in their area of expertise, have a master’s degree or higher (or a BSN and certification in a specialty area), and are willing to review three to six manuscripts a […]

2018-07-12T11:15:23-04:00July 12th, 2018|Nursing, nursing career, writing|0 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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