Success Being Relative

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.

blood bags/ by montuno, via flickr

We trouped in from the parking garage through the fading starlight of early dawn to find most of night shift gathered in one room. Portable surgical lights added to the overhead fluorescence, casting a striking glare on the scene. The patient was ominously flat: his positioning and pallor an instant indicator of his perfusion status, which was confirmed by a quick glance at the monitor. His blood pressure, we said among ourselves, was “in the toilet.”

He’d been in a motor vehicle accident and had suffered a prolonged extrication. There’d been a fatality at the scene. He wasn’t my patient (although he was everyone’s patient, really), so I’m not the one who got the long report. I didn’t know each and every one of his injuries, but I knew the only one that was relevant at the time—his liver was badly fractured and he was bleeding out. His abdomen was hugely distended and firm. He was cold to the touch, and his skin bore the expected pallor of a man in shock.

We […]

2016-11-21T13:09:30-05:00August 8th, 2012|nursing perspective, nursing stories|2 Comments
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Like ‘Being in Jail in a Way’: A Study Investigates How Anorexic Adolescents and Their Nurses View Inpatient Treatment

By Sylvia Foley, AJN senior editor

Bar the View by HereStanding, via Flickr

For adolescents with severe anorexia, experts have long relied on treatment in specialized pediatric acute care settings, using programs that are based on behavior modification principles and that promote stability through refeeding.

But what is it like to be a young inpatient in such a program? And how does the behavior modification approach affect the nurse–patient relationship? To learn more, nurse researcher Lucie Michelle Ramjan and colleague Betty I. Gill conducted a study in an Australian acute care facility. Their findings are reported in this month’s CE: Original Research feature, “An Inpatient Program for Adolescents with Anorexia Experienced as a Metaphoric Prison.”

The research. Ramjan, the study’s principal investigator, conducted in-depth, face-to-face interviews with 10 adolescent patients being treated for anorexia and 10 pediatric nurses. The interviews were audiotaped; the tapes were then transcribed verbatim, read and reread, and subjected to thematic analysis. As another writer has noted elsewhere, in qualitative research, metaphors often “illuminate the meanings of experiences.” In this study, the researchers found that both nurses and patients “consistently used the metaphor of prison life to articulate their experiences.”

That striking metaphor offered Ramjan and Gill a framework for interpreting […]

2016-11-21T13:09:31-05:00August 6th, 2012|nursing research, patient engagement|3 Comments
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An NP’s Plea: Hold That Specialist

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

Recently someone I know woke up in the middle of the night with severe foot pain. In the morning he headed to the ED, where he was diagnosed with a fracture of one of the sesamoid bones in his foot and sent to an orthopedist. Over the three days between the ED visit and the orthopedist appointment, the pain began to ease. At the orthopedist it was determined that the problem wasn’t that little sesamoid bone, but gout.

And then they sent him to a rheumatologist.

Why? The condition was already improving and he had no comorbidities. So, why the need for a specialist visit at a cost of $500 just to walk through the door as a first-time patient? A primary care provider should be competent to manage a straightforward case of gout—order and review bloodwork, prescribe medications, educate the patient about their diet, and follow up on their progress. Then if the patient doesn’t respond to treatment or anything unusual develops, call in the specialist.

This happens all the time. When I was first diagnosed with hypothyroid I was sent off to an endocrinologist (under protest). There was nothing unusual in my presentation and I had no comorbidities or history […]

2018-03-28T10:35:59-04:00August 2nd, 2012|nursing perspective|5 Comments
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One Instructor’s Updated Nightingale Pledge

Editor’s note: This post by Lorita Renfro, BSN, RN, proposes an updated version of the Nightingale Pledge. The author is a clinical nursing instructor in the ADN/VN programs at Kaplan College in San Diego and is currently working toward an MSN with an educational focus. Let Lorita know what you think. Would your version differ in any way?

Florence Nightingale in Crimean War, from Wikipedia Commons

As the science of nursing evolves, one aspect of nursing remains the same: the art. We see it when we are inspired to do the best for our patients, develop higher standards, and provide care from our hearts. This inspiration is the basis of all good nursing practice.

The science of nursing is seen in the interventions that provide comfort and protect our patients from harm. In the past, this protection often meant cleaning floors and carrying bed pans. My father believed until the day he died that what I did was to “help the doctors” heal the patients.

This may still be true at times, but the science of nursing is now also represented by innovation, intuition, strength, and the responsibility of being a team member who collaborates in the delivery of care. […]

2016-11-21T13:09:36-05:00July 31st, 2012|career, nursing perspective|20 Comments
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AJN’s August Issue: A Metaphorical Prison, a Found Manuscript, a Nurse Carries the Torch, More

AJN’s August 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.

Nurses play a crucial role in inpatient programs for anorexia in adolescents, but how do the patients view them? Our Original Research article, “An Inpatient Program for Adolescents with Anorexia Experienced as a Metaphorical Prison,” describes the experience of adolescents in an Australian inpatient behavioral program and how both nurses’ and patients’ perception of the program as a metaphoric prison negatively affected the development of therapeutic relationships between them. This CE article is open access and can earn you 2.5 CE credits.

Health information technology (HIT) is a central aspect of current U.S. government efforts to reduce costs and improve the efficiency and safety of the health care system. But what does this really mean for nurses? “Health Information Technology and Nursing,”  the first article in a series of three on HIT and nursing, will examine the federal policies behind efforts to expand the use of this technology. This CE article is open access and can earn you 2.1 CE credits.

Accord­ing to the U.S. Department of Labor’s Bureau of Labor Statistics, more than 348,000 unlicensed as­sistive personnel were employed in the hospital set­ting in 2011. Our Cultivating Quality article, “Continuing Education for Patient Care Technicians: A Unit-Based, RN-Led Initiative,” explores how one teaching […]

2016-11-21T13:09:36-05:00July 27th, 2012|Nursing|2 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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