AJN in April: Deep Breathing for Dialysis Patients, Isolation Care, Sleep Loss in Nurses, More

AJN0415.Cover.OnlineOn our cover this month is Pablo Picasso’s Le Rêve (The Dream). We chose this portrait of a woman in a restful pose to highlight the importance of proper sleep to a person’s overall health and well-being. Unfortunately, not many Americans are able to get the proper amount of rest. The Institute of Medicine (IOM) estimates that 50 to 70 million U.S. adults have chronic sleep and wakefulness disorders—and nurses are not immune.

Between long shifts and the stressful nature of their jobs, nurses are especially vulnerable to not getting an adequate amount of quality sleep. Fatigue from lack of sleep may diminish the quality of nursing care. Sleep loss has been linked to impaired learning, memory, and judgment and is also associated with a slew of chronic diseases. This month’s CE feature, “The Potential Effects of Sleep Loss on a Nurse’s Health,” describes the acute and chronic effects of sleep loss on nurses, strategies nurses can use to improve the quality of their sleep, and institutional policies that can promote good rest and recuperation.

This feature offers 2 CE credits to those who take the test that follows the article. You can further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad […]

2016-11-21T13:02:46-05:00March 27th, 2015|career, nursing perspective, nursing research|0 Comments
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Interprofessional Collaboration and Education: Making an Ideal a Reality

Photo courtesty of Penn Medicine. Photo courtesty of Penn Medicine.

We hear a lot about interprofessional collaboration, the potentially dynamic and enlightening process of sharing knowledge across disciplines to improve patient care, but what’s being done to make this a reality?

The promotion of interprofessional collaboration is one focus of an ongoing national initiative by the Future of Nursing: Campaign for Action, as described in “Interprofessional Collaboration and Education,” an article in the March issue of AJN.

To close the gap between policy bullet points and the reality of daily work for nurses is neither impossible nor inevitable; it depends on smaller coalitions and the engagement of multiple organizations—but also, one imagines, a willingness to engage in inquiry and to try new and imperfect processes at the local level that may need refinement over time. The article is free, but here are a couple of paragraphs that give an a good overview of why it matters and where we are:

Interprofessional collaboration is based on the premise that when providers and patients communicate and consider each other’s unique perspective, they can better address the multiple factors that influence the health of individuals, families, and communities. No one provider can do all of this alone.

However, shifting the culture of health care away from the “silo” system, in which […]

2016-11-21T13:02:49-05:00March 25th, 2015|career, Nursing, nursing perspective, Patients|0 Comments
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Missed Empathy, Missed Care: Is It Time to ‘Reconceptualize Efficiency’?

A physician’s lament is nursing’s, too.

By Maureen Shawn Kennedy, AJN editor-in-chief

By Alan Cleaver/via Flickr By Alan Cleaver/via Flickr

Last week, the New York Times Well blog published “The Importance of Sitting With Patients” by Dhruv Khullar, a Harvard medical resident. Khullar expressed regret over not spending more time with a patient who was near death, and then discussed how little time residents actually spend with patients—eight minutes, according to a Journal of General Internal Medicine study (2013) that analyzed the time of 29 interns over a month. (The study found that only 12% of the residents’ time was spent on direct patient care; 40% of their time was spent on computers.)

Khullar detailed the various activities that take him away from direct patient contact and noted as well that the shorter working hours mandated for residents had the unintended consequence of reducing time with patients. He wondered:

By squeezing the same clinical and administrative work into fewer hours, do we inadvertently encourage completion of activities essential in the operational sense at the expense of activities essential in the human sense?

The second part of the question seemed especially pertinent for nurses. Hospital nurses have long lamented that paperwork, insufficient staffing, and nonnursing tasks keep them from the bedside. The promise of computers to […]

2016-11-21T13:02:50-05:00March 23rd, 2015|career, Nursing, nursing perspective, Patients|5 Comments
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Workplace Conflict Engagement for Nurses: Consider the System

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

by Sachin Sandhu/Flickr by Sachin Sandhu/Flickr

This month, Debra Gerardi writes about initial steps to managing workplace conflict as nurses. The quotes below are from her article in the March issue of AJN, “Conflict Engagement: A New Model for Nurses” (free until April 30, the article is one in an ongoing series on conflict).

Just as with most medical errors, there is usually not a single cause of workplace conflict—instead, a number of interrelated variables lead up to an event.

Sure, I was new to nursing, but I wasn’t new to work. My life as the child of small business owners had ingrained in me a certain sense of duty that I felt my colleague lacked. When you grow up with parents who make you pick up cigarette butts in their business parking lots, no work is below you, and there’s no time to complain. Maya wasn’t new to nursing, but she seemed, to me, new to the idea that work was to be done without a fight.

In my first months on the unit, I saw her complain much more than I saw her put her head down and plod through the tasks before her. Our unit was full of really sick patients, to be […]

2016-11-21T13:02:50-05:00March 20th, 2015|career, Nursing, nursing perspective|2 Comments
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Early Localized Prostate Cancer: Nurses Can Help Men Weigh Diagnostic, Treatment Options

By Jacob Molyneux, AJN senior editor

A new diagnosis of prostate cancer can be daunting. Nurses play an increasingly important role in helping men and their partners find their way through the maze of available information and choices. One of the two March CE feature articles in AJN, “Early Localized Prostate Cancer,” gives a thorough overview of tests and treatments.

The author, Anne Katz, is a certified sexuality counselor at CancerCare Manitoba, a clinical nurse specialist at the Manitoba Prostate Centre, and a faculty member in the College of Nursing at the University of Manitoba, Winnipeg, Canada, and Athabasca University, Alberta, Canada. She is also the editor of Oncology Nursing Forum. Writes Katz:

. . . as many as 233,000 men in the United States are diagnosed with prostate cancer each year, 60% of whom are ages 65 or older. Most diagnoses are low grade and localized . . . . Since low-grade, localized prostate cancer is slow growing and rarely lethal, even in the absence of intervention, it can be difficult for men to make treatment decisions after diagnosis—particularly if they do not understand the nuanced pathology results they receive and the potential for treatment to result in long-term adverse effects that can profoundly affect quality of life.

Pros_Cons_PSA_ScreeningThe article discusses options for intervention, potential adverse effects associated with each option, and, crucially, the nurse’s “role in helping men and their […]

2016-11-21T13:02:51-05:00March 18th, 2015|Nursing, nursing perspective, patient engagement, Patients|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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