It Bears Repeating: ‘A Smart Doctor Listens to the Nurses’

AprilReflectionsIllustraionBy Jacob Molyneux, AJN senior editor

The April Reflections essay in AJN—Reflections is a monthly one-page column we’ve run for many years inside the back cover—has an unambiguous title: “A Smart Doctor Listens to the Nurses.”

Written by a pediatrician whose mother was a nurse, it gives a vision of continuity in the health care profession rather than opposition, of mothers and daughters, and seems particularly relevant as debates continue about whether or not nurses should be allowed to practice to the full scope of their abilities and knowledge. Here’s the opening paragraph, but it’s free, and we hope you’ll read the entire short essay:

I was in the hall outside a patient’s room with a new crop of interns and residents. As usual, they had all made rounds first thing in the morning, checked on new lab results, examined their patients, and were now ready to report everything to me, the attending. And, as usual, these bright, eager residents, though anxious to do a good job, hadn’t thought to talk with the nurses taking care of their patients.

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2016-11-21T13:07:58-05:00April 1st, 2013|career, nursing perspective|0 Comments
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Downsizing with Dementia

fence 2 Photo by Shawn Henning, via flickr.

By Amy M. Collins, editor

I’ve blogged before about my grandmother and her dementia, which has long since been staking a claim on her memory. A few years ago I wrote a post called “No Country for Old Women.” In it I tried to describe the feeling of helplessness that my family felt when a series of providers had failed to diagnose the cause of sudden delirium superimposed on dementia . . . a frustrating game of hot potato had ensued, with each physician passing her around to the next. It ended when a nurse finally diagnosed her with an impaction.

A similar sinking feeling strikes me as her dementia advances, and again, there seems to be no place for her to go. At her independent living center, we know she’s just barely scraping by. If it weren’t for the nurse we hired to keep an eye on her each day, her difficulty living there would be much more obvious.

Our nurse faithfully calls to let us know when my grandmother has forgotten to shower; when she’s been seen in the same clothes a few days running; when she won’t stop cleaning the break room, the distant memory of her long-standing career as a housewife stubbornly clinging to her; when she’s been found wandering the corridors at night. I think we’ve kept her there so long because everyone there loves her, she’s allowed to have […]

2016-11-21T13:07:59-05:00March 29th, 2013|Nursing|5 Comments
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Making It Safe: Skills to Promote Healthy Conversation at Work

Photo from otisarchives4, via Flickr. Photo from otisarchives4, via Flickr.

Medora McGinnis, RN, has written several previous posts for this blog. She is now a pediatric RN at St. Mary’s Hospital in the Bon Secours Health System, Richmond, Virginia, as well as a freelance writer.

What makes communication at work feel safe? We can all identify situations that “go south”—we feel instantly uncomfortable in the work environment (or anywhere, really) if we are accused, blamed, insulted, or overlooked. It’s easy to recognize when our communication is not safe, not going well, and not professional. So what makes it safe?

Effective communication can only take place when all parties feel safe; we must feel comfortable sharing our clinical insights without fear of the reaction we might get from the other party. While we can’t always know what their reaction will be, by learning to make it safe we can learn to talk with anyone about anything. New nurses in my hospital go through a six-month “RN residency” program in which we meet once a month for education, journaling exercises, and sharing. The book Crucial Conversations: Tips for Talking When Stakes Are High was used in our training to help us further develop our communication skills in the workplace. As a first-year nurse myself, I’ve found that some of the book’s ideas have played a big role in my learning curve.

Mistake #1: Watering down the content so the message doesn’t get across.

When […]

2016-11-21T13:08:00-05:00March 27th, 2013|career, nursing perspective|0 Comments
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The Real Reason Why Older Nurses Don’t Retire

By Julianna Paradisi. All rights reserved. Snow Tops/ by Julianna Paradisi

Julianna Paradisi, who blogs at JParadisi RN and elsewhere, works as an infusion nurse in outpatient oncology. Her artwork has appeared several times in AJN, and her essay, “The Wisdom of Nursery Rhymes,” was published in the February 2011 issue.

I hate to break this news to new graduate nurses struggling to find jobs, but the real reason that older nurses don’t retire isn’t—as you may have been led to believe—the struggling economy. The reason is that a large percentage of retirement-aged nurses enjoy working. As a middle-generation nurse, I’m coming to grips with this reality myself.

Many of my longtime colleagues are old enough to retire. When they do, they often retain on-call status. They never really go away. It’s weird to attend a retirement party for a coworker and then see her or him again the next day at work, helping out with a special project for their manager.

This trend among older nurses was also in evidence at a meeting I recently attended. Most of those present were nurse managers. Although a few were younger than me, most were older, sporting hipster eyeglass frames and sophisticated bob haircuts that left their natural silver.

These men and women are a testament […]

2017-01-26T12:35:09-05:00March 25th, 2013|career, Nursing|26 Comments
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At Denver Nurse Exec Mtg: Sully on Sources of Errors, Chow on Crucial Role of Patients and Families

Some quick take-homes from AJN’s editor-in-chief, Shawn Kennedy:

690px-Plane_crash_into_Hudson_Rivercroped via Wikipedia

I’m in Denver at the annual meeting of the American Association of Nurse Executives (AONE), the organization comprised mostly of hospital nurse executives, administrators, and managers. As you can imagine, the focus is on leadership.

Captain “Sully” Sullenberger, the former US Airways pilot who safely landed a disabled passenger plane on the Hudson River in New York City in 2009, was the featured keynote speaker. He of course talked about the event that launched his second career as a speaker, author, and safety expert, but his message was really about leading in challenging times. Some key messages:

  • His success in landing the plane was the result of teamwork, with everyone executing what they had learned and practiced.
  • Core values must be made real on a daily basis in organizations.
  • Errors and bad outcomes are almost never the result of a single person or event, but a result of a cascading chain of events or failures.

AORN meeting cover image AORN meeting cover image

Marilyn Chow, who spoke only briefly after accepting the AONE 2013 Lifetime Achievement Award, could as easily have been the keynote speaker at the meeting. Chow, who is vice-president, national patient care services, Kaiser Permanente, spoke with humor and passion about her values and where she thinks nursing’s values should be. She told of her 87-year-old mother’s great joy […]

2018-03-13T10:49:45-04:00March 22nd, 2013|nursing perspective|1 Comment
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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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