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Critical Mass at the Critical Care Nursing Conference

Boston + 9,000 nurses = NTI2018

The American Association of Critical-Care Nurses (AACN) is well-known for its annual National Teaching Institute (NTI), but this year, in terms of sheer scope, it surpassed all other meetings I know of. With over 9,000 attendees, registration had to be closed for the first time ever. Imagine—there were almost too many people at the Boston Convention Center, one of the largest venues in the country.

The exhibits, as always, were never-ending, with sections for industry, education, organizations, recruiters, and publishers. And as always, the “newbies” could be identified by the bags of giveaways they carted off . . . as opposed to the NTI veterans, who merely scan badges and have info sent to them.

Obstacles as opportunities for change.

Monday’s opening address by AACN president Christine Schulman was heartfelt. Reflecting on her soon-to-end year as the president and its chosen theme, “Guided by Why,” she encouraged us to explore the possibilities of making real changes when we face obstacles. And she announced that AACN was planning to take on the fundamental issue of nurse staffing:

“Inappropriate staffing has gone on for far too long. It involves many factors . . . and needs a major shift in how we think about delivering patient care.”

Body language creates and projects confidence.

The next day’s keynote address by social psychologist Amy Cuddy (see her popular TED Talk, “Your Body Language May Shape Who You Are“) gave attendees some insight […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-06-06T12:38:27-04:00June 6th, 2018|career, Conference reports, Nursing|0 Comments

As a Long-Predicted Nursing Shortage Gets Real, Staffing and Retention Issues Get Urgent

Is the nursing shortage finally here?

In her June issue editorial, AJN editor-in-chief Shawn Kennedy notes that in her recent visit to the annual National Student Nurses’ Association (NSNA) conference, many of the senior students she spoke with already had jobs lined up.

She surveys some recent indicators pointing to the possible arrival at last of a long-predicted nursing shortage, and some of the possible implications this is having or may have in the coming years for patient care and the health of organizations. For example:

“A survey of 233 chief nursing officers conducted last July conducted last July by national staffing company AMN Healthcare found that 72% said their shortages were moderate to severe, and most expected shortages to worsen over the next five years. They also acknowledged that the shortage was having a negative effect on patient care, patient satisfaction, and staff morale.”

Bonuses for new hires.

She notes that, with hospitals in some regions paying signing bonuses to new nurses, the question of staff retention and development remains the elephant in the room.

The class of 2018, it seems, is entering a job seeker’s market. . . . Organizations that can invest in new nurses with programs that provide support and training will have a leg up in recruitment. But […]

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Jacob Molyneux, senior editor/blog editor2018-06-04T12:21:33-04:00June 4th, 2018|Nursing|2 Comments

The Risks and Benefits of Transfusion Therapy

Potential complications of transfusions.

Photo © GARO / PHANIE / agefotostock

If your patient develops mild jaundice or thrombocytopenia two weeks after a blood transfusion, would you consider their transfusion history an important part of your assessment?

When I think of monitoring a patient who is receiving a blood transfusion, I think primarily about watching for a hemolytic transfusion reaction or circulatory overload. To me, that means keeping a close watch during the transfusion and for about 24 hours afterwards. Yet “classic” hemolytic reactions and volume overload are not the only potential complications of blood therapy. Delayed reactions can occur days or even weeks after you’ve run through your saline flush and disposed of the blood bag.

Update of current transfusion practices.

In this month’s AJN, Margaret Carman and colleagues provide readers with an update of current practices in transfusion therapy. In “A Review of Current Practice in Transfusion Therapy,” the authors survey the benefits and risks of fresh whole blood (used today primarily in military or disaster settings) and blood components—red blood cells, plasma, cryoprecipitate, and platelets. […]

Betsy Todd, MPH, RN2018-05-29T11:19:05-04:00May 29th, 2018|Nursing, patient safety, Patients|0 Comments

June Issue: Hearing-Impairment and Hospitalization, Gaucher Disease, an Early Mobility Protocol, Giving and Getting Report, More

“The problem is the insidious way personal smartphones divert and fracture our attention. If you don’t take work home with you, why is it okay to bring home to work?” —Kathleen Bartholomew, MN, RN, author of this month’s Viewpoint

The June 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: Understanding the Hospital Experience of Older Adults with Hearing Impairment

Older hospitalized adults with hearing impairment may be labeled confused, experience heightened fear and anxiety, or misunderstand the plan of care. This qualitative study assessed the hospital experience of hearing-impaired patients in order to formulate suggestions for improving nursing care.

CE: Understanding the Nurse’s Role in Managing Gaucher Disease

The author discusses the epidemiology and pathophysiology of Gaucher disease—a lysosomal storage disorder that can affect the spleen, liver, bones, bone marrow, and central nervous system—as well as recent advances in screening, diagnosis, and management.

Cultivating Quality: The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients

The authors present their quality improvement initiative to establish an NP-led early mobility protocol aimed at reducing uncomplicated postsurgical spine patients’ length of hospital stay and eliminating the […]

Diane Szulecki, editor2018-05-25T08:48:44-04:00May 25th, 2018|Nursing|0 Comments

What the Patient Knew: Communication and Patient Safety

Anticipating emergencies.

by rosmary/via Flickr

At the start of every shift after receiving report, I take a moment to consider what emergencies I might anticipate for my particular patient in our PICU. Monitor for excessive bleeding in a liver failure patient. Monitor for an altered neurological status in a patient with a head bleed. I try to envision how I would start CPR in the room if required. I try to be thorough in checking that all my emergency equipment is present and working. I try to keep patient safety at the forefront of my mind and priorities.

I came to work one day and received report about my 9-year-old patient who was post-operative day one from a planned craniofacial surgery. He would remain nasally intubated with eyes sutured shut for a few days until the swelling had reduced, and then would return to the OR to be extubated and to have the eye sutures removed. I’d had patients like him before and felt he would be very easy to keep safe, especially given that per handoff report, he was comfortably sedated and not overly agitated when he did briefly waken with nursing care.