A Nurse and Mother on Dialing Back the Risk in Football

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

One Monday afternoon when my son Bryan was a senior in high school I got a call from him. He had hurt his back during football practice and was in so much pain he couldn’t move to get into his car. I rushed over to the field and found him standing, tense and still. When I lifted his shirt to look at his back, I gasped. The entire lumbar area was rounded and swollen out to the size of a grapefruit. At the hospital tests revealed he had a large hematoma, no critical damage done. The first question Bryan had for the doctor—“Can I play on Saturday?”

All week he insisted he could play and I insisted he couldn’t. His arguments never let up—he was quarterback and Saturday’s game was with an archrival. There wasn’t time for the backup quarterback to learn the plays, his team depended on him. Finally I made a bargain. We would go see his physician, whose judgment I trusted, and we would both respect his opinion, whichever way it went.

He played. One of the coaches wrapped his back in layers of padding with an ACE bandage and out he went. It was a brutal game. As determined as he was, the pain still slowed […]

2016-11-21T13:09:20-05:00September 14th, 2012|nursing perspective, Public health|1 Comment
Read More

Passion and Fear: Signs of a Kindred Nursing Spirit

Florence Nightingale in Crimean War, from Wikipedia Commons

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

“It’s not that we want something bad to happen; we just want to be there when it does.”

One of my colleagues recently saw that phrase on a T-shirt, and it perfectly echoes the sentiment of the ICU nurses I work with. We’re prepared for crises, primed for instability—and the lower acuity patients who have been populating the ICU lately leave many of us restless and discontented. We start to miss the dramatic cases, the incredible saves and miracles; we miss using our skills. We do see the irony of being in the awkward position of wishing for trauma patients, yet not actually wishing ill on anyone.

I haven’t always embraced unstable patients. When I was a new nurse I simultaneously dreaded yet was drawn to the instability of the ICU. I remember the early morning drives into work, a time of quiet anticipation filled with a gnawing fear that I’d make a mistake or be inexcusably inadequate at a crucial time.  I’d pray to gods above to be good enough, to be up to the tasks of the day; I clearly recall, more than once, taking report on an unstable patient and getting physically sick. Dramatic, I know, but born […]

2016-11-21T13:09:21-05:00September 12th, 2012|career, nursing perspective|1 Comment
Read More

Best Care at Lower Cost: New IOM Report Spotlights Crucial Role of Nurses

By Mary D. Naylor, PhD, FAAN, RN. Dr. Naylor is the Marian S. Ware Professor in Gerontology and director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care. She was appointed to the Medicare Payment Advisory Commission in 2010. 

Building on the Future of Nursing report’s call for nurses to fully engage with fellow health care professionals, a new report from the Institute of Medicine, Best Care at Lower Cost, calls on nurses and others in the health care system to apply emerging tools, technologies, and approaches to yield lower costs and better health outcomes. I had the great fortune to serve as a member of the study committee.

The complexity problem. The report couldn’t be more timely or relevant, particularly for nurses and the patients they serve, given the complexity of the current health care system. Administrative and workflow inefficiencies limit hospital nurses from spending more than about 30% of their time on direct patient care. With increasing specialization, modern medicine now includes nurses in more than 50 specialties. To successfully coordinate a patient’s care, nurses need to communicate and collaborate with patients, family caregivers, physicians, pharmacists, social workers, and many other team members.

The complexity […]

2016-11-21T13:09:23-05:00September 6th, 2012|career, nursing perspective|1 Comment
Read More

AJN’s September Issue: Bariatric Surgery, Biomarkers, Mobile Technology for Nurses, More

AJN’s September issue is now available on our Web site. Here’s a selection of what not to miss, including two continuing education (CE) articles, which you can access for free.

It’s no surprise that obesity and overweight are on the rise in this country, and nurses will likely find themselves caring for patients who have undergone bariatric surgery at some point in their career. “Outcomes and Complications after Bariatric Surgery” reviews the five most common procedures, outcomes and complications of surgery, and pre- and postoperative patient care. This CE article is open access and can earn you 2.5 CE credits.

Nearly 40% of all surgeries in the United States are performed on adults ages 65 and older. A common complication of surgery in this population is postoperative delirium, which is associated with extended lengths of stay, higher patient care costs, increased morbidity, and greater risk of death. “Postoperative Delirium in Elderly Patients” evaluates risk factors for postoperative delirium in elderly patients and examines potential intervention strategies. This CE article is open access and can earn you 2.5 CE credits.

Smartphones, e-readers, and tablets are everywhere, including at the bedside. In “Tablet Technology for Nurses,” Megen Duffy provides a guided tour of the potential uses and pitfalls of mobile technology for nurses—plus a comparison of the iPad and Kindle Fire.

Whether to predict, diagnose, or monitor disease, biomarkers are useful in every step of patient care. “Biomarkers: […]

2016-11-21T13:09:24-05:00August 31st, 2012|Nursing|0 Comments
Read More

Caring for Patients Who Have Bariatric Surgery

Roux-en-Y gastric bypass. Image courtesy of Ethicon Endo-Surgery, Inc.

By Sylvia Foley, AJN senior editor

People who are obese (BMI of 30 kg/m2 or greater) are prone to a laundry list of ills. They’re not only at greater risk for diseases such as type 2 diabetes, coronary heart disease, stroke, and osteoarthritis—they’re also more apt to experience discrimination and psychological abuse, and to suffer from anxiety and depression. Many have repeatedly tried to lose weight through diet, exercise, psychotherapy, and pharmacotherapy, to no avail. Until recently, there was little else providers could offer them.

But bariatric surgery, known to be an effective treatment for obesity and obesity-related comorbidities, is becoming an increasingly common option. In 1998, only about 13,000 bariatric procedures were performed in the United States; by 2007 that figure had jumped to 200,000, and it continues to rise. With prevalence rates for overweight and obesity also at record highs in this country, more nurses will likely find themselves caring for patients who have undergone such procedures.

In this month’s CE, “Outcomes and Complications after Bariatric Surgery,” authors Lauren Gagnon and Emily Karwacki Sheff explain the two main types of bariatric surgery and outline five of the most common procedures in the United States: 

2017-07-27T14:52:43-04:00August 30th, 2012|Nursing|1 Comment
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top