The Kiss: Hope in the ICU

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.

by limegreeen9, via flickr creative commons

I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.

My report, though, is politely cut short by the medical director.

“What’s changed?” he wants to know.

And I feel pressed to produce some crumb of improvement. 

“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”

A few people smile, and I hear a few chuckles.

“It’s a reflex!” I hear someone say as they move away.

I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant […]

What to Do If the Nursing Board Takes Action Against You: A Lawyer and Former RN Advises

At 7 AM, when RN Michelle Flacco took over the care of 66-year-old Lester Scanlon, who had dementia and type 1 diabetes, she was notified that his blood glucose level was significantly elevated, at greater than 550 mg/dL. Ms. Flacco performed blood glucose tests three times during her shift, each time after Mr. Scanlon had eaten a meal, and each time his blood glucose level was elevated. However, Ms. Flacco didn’t notify Mr. Scanlon’s physician, nor did she administer insulin to the patient. The next shift, Mr. Scanlon was found unresponsive, with a very elevated blood glucose level. He was diagnosed with diabetic coma. The incident was reported to Ms. Flacco’s state board of nursing, and she was accused of professional incompetence. The board is seeking revocation of her RN license.

That’s the opening of “You’re Being Investigated by Your State Nursing Board” in the June issue of AJN. The case described is a composite, but it illustrates a situation that a nurse can find herself or himself in. The article, currently open access, is by Margaret E. Mangin, who practiced nursing for 12 years before becoming an attorney. For the past 26 years, she has practiced law in San Diego, primarily defending hospitals, nurses, and other health care providers. This is the latest installment of our Legal Clinic column. You might want to check it out. The table below gives the most frequent licensing violations, 1996 to 2006.

Staffing: Hot Topic as Usual for Nurses

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

Our recent Facebook post on an article on nurse staffing at the NPR Shots blog (“Need a Nurse? You May Have to Wait”) got a lot of responses. Staffing is a hot topic for nurses—from both a personal  and a patient care perspective. And I say “hot” because it never fails to raise emotions.

Everyone agrees that adequate nurse staffing is essential for safe, high quality patient care and nursing job satisfaction. Research has shown that it significantly improves patient outcomes.

Yet we—nurses, as well as the larger health care community—continue to debate how to determine what “adequate staffing” is and how to best achieve it. Acuity-of-care measures? Unit-by-unit mandated staffing plans? State-mandated staffing ratios? What do you think?

We’ve published numerous articles and news pieces on this topic in recent years; here are a few examples:

News, reports, and analysis (open access articles)

“Nurse Staffing Matters—Again”

“California Mandated Nurse–Patient Ratios Deemed Successful”

“Nursing Shortage—or Not”

Feature. Requires subsciption or purchase; abstract only

“Nurse Staffing and Patient, Nurse, and Financial Outcomes”

And here are some blog posts that deal either directly or indirectly with issues related to nurse staffing.

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2016-11-21T13:10:00-05:00May 31st, 2012|nursing perspective|1 Comment

Critical Care 2012: An Educational Extravaganza

By Maureen Shawn Kennedy, AJN editor-in-chief

So, for the 12th or 13th time (I’ve lost count), I attended the National Teaching Institute of the American Association of Critical-Care Nurses (the “other” AACN organization, not to be confused with the American Association of Colleges of Nursing) in Orlando last week. And as usual it was impressive—approximately 6,000 attendees, and rows and rows of exhibitors. There were two helicopters, a bus, and an ambulance in the exhibit hall, as well as two-story booths and classrooms. While there were some recruiters looking for staff, they were overshadowed by monitoring companies, bed and equipment manufacturers, and pharmaceutical companies.

Some highlights:

Left to right: Outgoing AACN president Mary Stahl and incoming president for 2013, Kathryn Roberts.

Kudos to the AACN for its creativity in making general sessions lively and interesting. This year, the organization held open auditions for a member to assist as “MC” for the general sessions (or “super sessions”). It was a tie, and attendees were treated to two of their own in action, hamming it up and enjoying the spotlight.

The TED-talk presentation style used by both AACN president  Mary Stahl and president-elect Kathryn Roberts was refreshing—and unique for nursing meetings.

I interviewed both presidents—click the link to listen to the podcast (it may take a minute to load). The 2013 president, Kathryn Roberts, MSN, RN, CNS, CCRN, […]

Memorial Day, 2012

This Memorial Day, we here at AJN would like to pay tribute to those nurses who gave their lives in defense of their country. And to all the nurses who care for the casualties of war with dedication, skill, and compassion, often at great risk to their own safety – we honor and thank them.

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