February Issue: Patient-to-Nurse Violence, The Future of Hospital at Home, More

“Workplace violence has become a familiar threat for those employed in a health care environment.”—Miranda Squire and Karen Hessler in this month’s Original Research article, “Patient-to-Nurse Violence During One-to-One Assignments: A Silent Epidemic”

The February issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

AJN Reports: What’s the Future of Hospital at Home in the United States?

Programs offering this promising acute care model have proliferated since 2020, but payment and regulatory structures to address equity, oversight, and sustainability are needed.

CE: Caring for Patients After Ileostomy Surgery

A review of postoperative care following ileostomy, including hydration, medication, and nutritional management.

Original Research: Patient-to-Nurse Violence During One-to-One Assignments: A Silent Epidemic

This qualitative cross-sectional study investigated workplace violence from the perspective of nurses and nursing assistants working one-to-one assignments who experienced violent encounters with patients or visitors.

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2023-01-30T09:10:36-05:00January 30th, 2023|Nursing|0 Comments
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Cross-Sector Collaboration and the New York City Involuntary Hospitalization Policy

Although currently living upstate, I’ve closely followed news of Mayor Eric Adams’ policy for removing residents who appear mentally ill on city streets. As a nurse with a background in health care administration, I find this policy ethically problematic. As a PhD candidate studying how organizations collaborate to transition patients lacking homes at discharge, I know the complexities of implementing this policy.

Mayor Adams is proposing a close read of section 9.58 of Article 9 of the New York State Mental Hygiene law, which is the state’s legislation pertaining to involuntary hospitalization of people experiencing acute mental illness. To “939” someone, as it is often informally termed, means to place them under involuntary psychiatric hospitalization because they pose an imminent threat to themselves or others; ‘imminent threat’ is usually interpreted to mean active suicidal ideations or homicidal threats or actions. What Mayor Adams proposes is to allow peace officers and mobile outreach units to apply a wider interpretation of this clause such that it includes any behavior that might threaten an individual’s ability to take care of their daily living needs.

I believe that housing first policies are the bare minimum for giving a person with serious mental illness or any significant […]

2023-01-30T10:31:58-05:00January 25th, 2023|mental illness, Nursing, nursing roles, Public health|0 Comments
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A Tip Sheet for Care of Textured Hair in Hospitalized Patients

“Black patients’ hair is often neglected due to lack of appropriate products and a predominantly non-Black health care staff unfamiliar with caring for hair different than their own.”

Click to expand; see link in text for a pdf of the full tip sheet.

Irene Friedman, MS, RN, and Michelle Sison, MSN, RN, noticed that hair care for Black patients needed improvement at their hospital. In response, they developed a Tip Sheet for Care of Textured Hair as an initiative in line with the goals of their hospital’s nursing diversity, equity, and inclusion (DEI) Magnet core council.

They have generously made this downloadable pdf available to AJN to share with readers who would like to make use of it in their own hospitals.

This two-page document also includes recommended hair care products and QR code links to videos to instruct staff on how to care for textured hair.

To learn more about why and how Friedman and Sison developed this tool, read their December 2022 Viewpoint in AJN, “Equitable Patient Care Includes Equitable Hair Care.“

2023-01-19T09:54:02-05:00January 19th, 2023|Nursing|0 Comments
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Death by PTSD: When Patients Are Afraid of Health Care

“I pleaded with her to go to the hospital.” Don’s voice is suffused with sadness as he sits at the bedside of his dying 39-year-old partner, Clarisse. “She was terrified of medical tests and procedures. By the time she saw a doctor the cancer had spread. She was so overwhelmed she refused any treatments.”

Over the years, I’ve had several patients like Clarisse; younger people who refused to seek medical care or declined treatments that might have cured them. Some were depressed, others worried about the financial burden. But there was a common thread: all were intensely distrustful, avoidant, and afraid.

Depressive thoughts, distrust, avoidance, and fear are all common features of post-traumatic stress disorder (PTSD) and every one of these patients had either been diagnosed with PTSD or would have if they’d sought psychological care.

Effects of PTSD in patient response to health care.

Clarisse had survived childhood sexual abuse at the hands of one of her mother’s boyfriends. This had left her intensely sensitive to intrusions into her personal space, terrified of being touched or probed by medical staff, and distrustful of men and authority figures. There were a number other common effects of PTSD evident in my work with Clarisse.

2023-01-18T09:55:42-05:00January 17th, 2023|Nursing|0 Comments
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Every Patient Needs an IV, or Do They?

(This post is by an author of AJN‘s January CE feature, “Evidence-Based Practice for Peripheral Intravenous Catheter Management.”)

Questioning the status quo.

As a former critical care nurse and now a vascular access nurse researcher, I’ve had the good fortune to travel widely and work with nurses from around the globe on multiple projects. As a researcher, part of my role is to question clinical practices we often take for granted and to ask, “Is this the best way? Could there be a better way?” Identifying practice that may not always be evidence-based is how research often begins.

Prior to the Covid-19 pandemic, I undertook a two-month fellowship in the US and visited several hospitals where, time and again, I noticed the majority of hospital patients had a peripheral intravenous catheter (PIVC) in place, but many were not in use. When I asked the nursing and medical staff why patients had a PIVC that was not in use, I was repeatedly told, “Every patient needs an IV, just in case.” When I pointed out that some patients had two or three PIVCs not in use, or a central venous access device as well, it became obvious that this is a common problem.

An ‘idle’ catheter is a PIVC that has not […]

2023-01-11T11:41:34-05:00January 11th, 2023|Nursing, patient safety|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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