Nurses Know Safety Can’t Depend on Assumptions

In health care, we are trained not to rely on assumptions. We build systems that anticipate risk, standardize response, and make the next step clear before it is needed. When something goes wrong, we do not improvise. We follow a plan that already exists.

This is why it is so striking to encounter environments where safety depends almost entirely on assumption.

The tragic example of AED accessibility.

I began thinking about this outside of health care. I came to this through someone I know, John Ellsessar, whose life has been shaped by loss. His son, Michael, died at 16 after suffering sudden cardiac arrest on a high school football field where an AED was not immediately accessible.

That experience changed what he did next. It also changed how I think about a question that often goes unasked: What is the plan when something goes wrong?

Consider sudden cardiac arrest. It is one of the few situations in medicine where the response is both straightforward and time-dependent.

When John explained it to me, he put it simply: A heart attack is a plumbing problem, a blocked artery.
Sudden cardiac arrest is an electrical problem. The heart’s rhythm […]

2026-05-15T13:18:43-04:00April 27th, 2026|Nursing, Public health|0 Comments
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TAVR Review, Skin Tone Representation in Nursing Texts, and Other May Issue Highlights

The May issue of AJN is now live.

Here are some highlights. Some articles are open access or temporarily free; others will require log-in for access.

AJN senior clinical editor Christine Moffa’s guest editorial (free to read) addresses the 2026 Nurses Week theme—The Power of Nurses. “If there is a message to carry into this Nurses Week, it may be that the vigilance we practice at the bedside can guide us as a profession,” she writes. “Noticing what is subtle, identifying what is shifting, and acting before harm takes hold, these are skills we already possess.”

Over the past decade, transcatheter aortic valve replacement (TAVR) has become a transformative intervention for patients with aortic stenosis (AS). This month’s CE article, “The Evolution of Transcatheter Aortic Valve Replacement: From Novel to Normal,” (also free to access) reviews current approaches to evaluation, diagnosis, and management of AS before and after TAVR, as well as the evolving role of TAVR in the treatment of AS.

In their original research article, “Dark Skin Tone Representation in Foundational Nursing Textbooks: A Quantitative Image Analysis,” Eleonor Pusey-Reid and John Wong evaluate how prelicensure nursing texts visually represent clinical conditions across diverse skin tones, with a focus on the extent to which dark […]

2026-05-04T09:47:31-04:00April 23rd, 2026|Nursing|0 Comments
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What’s in the Air? Rethinking Airflow and Infection Risk in Health Care

Image generated using Google’s Nano Banana 2, 4/20/26.

For nurses, environmental infection prevention is often framed around visible conditions such as high-touch surfaces, shared equipment, and visible dirt. In my experience, airflow and ventilation are not topics that receive significant emphasis in nursing education or orientation. While this may vary by setting, many nurses are left to learn these concepts in practice rather than through formal training.

With the recent COVID-19 and measles outbreaks, there has been more focused attention placed on contaminated air as a risk to patient safety. In my work with health care teams across settings, I’ve found that while nurses are highly attuned to cleaning and disinfection practices, airflow and ventilation are often assumed to be “handled” by the facility operations staff. In reality, these systems depend heavily on how the environment is used at the bedside. Small, routine actions—like leaving a door open or introducing a fan—can unintentionally disrupt carefully designed controls.

This gap in awareness among clinical staff matters. While the Centers for Disease Control and Prevention continues to report progress in reducing health care-associated infections (HAIs), these infections remain at a persistent risk for patients. Expanding the nurse’s focus on the environment […]

2026-04-22T12:32:28-04:00April 21st, 2026|infection control, infectious diseases, Nursing, Public health|0 Comments
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Beyond ‘This Is How We Do It’: Teaching Nurses to Think Critically About Practice

A nurse I was orienting asked a question that stopped me.

“Why do we have to wait for a current type and screen before ordering red blood cells, but not platelets?”

It was the kind of question that should have a clear answer. She wasn’t new to nursing, just new to our unit, which made it land differently. This wasn’t inexperience. It was a fresh perspective on a practice I had stopped questioning.

I had a general understanding. I knew that red blood cells carry the antigens most likely to trigger clinically significant antibody formation, and that ensuring compatibility before transfusion is critical. Platelets, by comparison, are less likely to require the same level of matching in routine situations. But when I tried to explain it clearly and completely, I hesitated.

My first instinct was to simplify the answer: “That’s just how we do it.” I paused before saying it out loud. Although the practice made sense to me, I had never examined it in a way that I could confidently teach, explain, or connect back to policy.

The question exposed a gap between practice, policy, and understanding. It also raised something larger: how often do we follow practices we can’t fully explain, document, or defend?

This experience highlighted a broader issue […]

2026-04-15T09:24:30-04:00April 13th, 2026|Nursing, questions of practice|0 Comments
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What’s Lurking in the Sink? Rethinking Water as an Infection Risk in Health Care

Image: Shutterstock

Nurses play a primary role in patient safety through direct care and through the environments in which care is delivered. While clinical responsibilities are well defined, the nurses’ role in promoting a health care environment that prevents health care–associated infections (HAIs) is not always clear.

A recent report from the Centers for Disease Control and Prevention (CDC) revealed that U.S. hospitals saw meaningful declines in several major HAIs in 2024, including Clostridioides difficile (C. diff) infections, catheter-associated urinary tract infections (CAUTIs), central line–associated bloodstream infections (CLABSIs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Despite the obvious progress, each day, approximately one in 31 hospitalized patients and one in 43 nursing home residents contract at least one HAI in association with their health care. This alarming statistic underscores the need for frontline vigilance by nurses in every clinical setting.

When the Environment Works Against Us

Infection prevention is often framed around what we can see—dirty floors and high-touch surfaces, visibly soiled equipment, and stained linens. Some of the most consequential risks in health care are not visible. One emerging area of concern is the role of health care water systems as reservoirs for pathogens. Surprisingly, it’s not dirty water that’s being scrutinized, but clean […]

2026-04-08T10:03:07-04:00April 8th, 2026|infection control, Nursing|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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