May Issue: Transfusion Therapy, Sustaining Fall Prevention Programs, Nurses’ Role in Assisted Suicide, More

“Nursing students are the future of nursing. Treating them with anything less than respect, support, and nurturing is unacceptable and unprofessional.” —John Burkley, MSN, RN, author of this month’s Viewpoint

The May 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: Exploring Clinicians’ Perceptions About Sustaining an Evidence-Based Fall Prevention Program

Although hospitals have made extensive efforts to reduce patient falls through evidence-based fall prevention programs, sustaining such programs has proven challenging. This qualitative study addresses the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients.

CE: A Review of Current Practice in Transfusion Therapy

The authors review the blood products that are commonly transfused, discuss the potential complications of transfusion—including TACO, TRALI, and TRIM—and outline current recommendations for transfusion therapy.

Special Feature: Assisted Suicide/Aid in Dying: What Is the Nurse’s Role?

This article presents the panel discussion that occurred during a policy dialogue on aid in dying (AID) at the American Academy of Nursing’s annual conference in 2016. The discussion explored the arguments for and against the growing state expansion of AID legislation, and the role of nurses in assisting patients who request […]

2018-04-27T09:18:27-04:00April 27th, 2018|Nursing|0 Comments

Recognizing Delirium in Hospitalized Children

A hospital can be a scary place for any of us, but the experience is likely to be especially upsetting for children. An unfamiliar environment, possibly painful procedures, immobility, food that’s not from home (or no food), and disturbed sleep are hard on most people. A child’s particularly vivid imagination may exacerbate an already-frightening experience. It’s not surprising that delirium can occur in hospitalized children.

Characteristics of pediatric delirium.

Delirium in children has not been explored to the extent that it has been in adults, but research suggests its manifestations in either group can include five characteristics: agitation, disorientation, hallucinations, inattention, and sleep–wake cycle disturbances. Some evidence also suggests that children with delirium may have a more labile affect than adults, and more severe perceptual disturbances. […]

2018-04-25T10:05:56-04:00April 25th, 2018|Nursing, pediatrics|0 Comments

The Nurse’s Temptation to Fill in the Patient Handoff Narrative

The limitations of handoff report

In bedside nursing, the nurse enters the story of the patient’s life at the point where the handoff report ends.

“Pt is an 8 mo old female, history of hypoxic ischemic encephalopathy (HIE), baseline 2L oxygen at home. Admitted to the unit for respiratory distress.”

Handoff report then goes through a systemic description of the patient’s current state: neurological, cardiovascular, respiratory, GI/GU, skin, and finally, psychosocial. The report is thorough but brief, never truly complete.

The oncoming nurse takes report and seeks to develop an accurate picture of her patient’s physiological state in order to anticipate emergencies and prioritize nursing interventions. But as any experienced nurse knows, no report can replace thorough and ongoing assessments—patients can change, and even the most expert nurses who have previously cared for this patient can miss details.

This holds true both in terms of a physiological assessment and a psychosocial assessment. What the nurse receives during handoff in terms of the patient and family’s psychosocial status is typically brief. “The patient’s parents are involved. Dad is a little more anxious and doesn’t stay at the bedside for long. Mom has a lot of questions, and she likes to help a lot with the hands-on care.”

Assumptions rush in to fill empty spaces

At […]

2018-04-23T10:26:19-04:00April 23rd, 2018|Nursing|2 Comments

Earth Day 2018: Making the Connection Between Environmental and Human Health

Trafalgar Square during the Great London Smog of 1952. Photo © TopFoto / The Image Works.

This Sunday is Earth Day, an annual event started by a bipartisan group of citizens and congressional representatives in 1970 to highlight the need for a healthier environment and the importance of legislative protections.

Along the mighty Hudson—beautiful, but still contaminated

Growing up just north of New York City, along one of the most beautiful but contaminated sections of the Hudson River, I’ve seen up close the effects of industrial pollution before environmental protections were put in place. In addition to producing electrical wire, cables, munitions, and other products, the factories that lined my town’s waterfront for much of the 20th century were also responsible for extensively contaminating the surrounding area with polychlorinated biphenyls (PCBs) and petroleum hydrocarbons.

For many decades, the environmental damage caused by such industry was accepted as the price of progress. Raw sewage and oil slicks in the waters of the Hudson were not unusual sights, and relatives tell stories of a popular spot along the river, from which swimmers in the 1960s would emerge covered in the dye produced—and dumped—by a nearby riverfront factory. Most […]

Seeking Good Nurses With a Story to Tell

karindalziel/ via Flickr Creative Commons karindalziel/ Flickr Creative Commons

Whenever I meet someone new who happens to be a nurse—in both clinical and social settings—I wait for the right moment to mention my work on AJN‘s Reflections column.

It’s not only that I’m proud of the column. It’s also that I’m forever on the lookout for that next submission—for a fresh, compelling story I just know is destined to shine (accompanied by a fabulous professional illustration) on the inside back page of AJN.

‘But I’m not exactly a writer…’

“I imagine you have a story or two to tell,” I’ll say to a nurse I’ve just met—which is the same thing I say, whenever I have the chance, to nurses I’ve known for years. I mean it sincerely; given the vantage point on humanity that our profession affords, I actually do believe that every nurse is carrying around material for a terrific story.

The response I usually get (along with a wry smile, the raising of eyebrows, or a short laugh) is, “Oh yes. I have stories.”

But then—even as I’m mentioning the Reflections author guidelines, even as I say warmly that we’re eager to read—I can sense the backing away.

“Sure,” the nurse will say. “I’ll check it out . . . but the thing is, I’m not exactly […]

2021-11-29T17:32:55-05:00April 18th, 2018|Nursing, nursing stories|1 Comment
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