Monitoring for Intolerance to Gastric Tube Feedings

Monitoring GRV is one way to assess gastric emptying in patients with tube feeding intolerance. Here aspirate is drawn from the stomach through the port via a small-bore feeding tube.

At some point in their education, nurses might have read a book or article by Norma Metheny, PhD, RN, FAAN, long considered an expert on fluid and electrolytes and tube feedings. She’s been researching tube feeding placement and assessment throughout her career—her current article in our August issue, “Monitoring Adult Patients for Intolerance to Gastric Tube Feedings,” marks her 12th publication in AJN.

Monitoring GRV.

Nurses have long been taught to check, before administering tube feedings, whether there are any residual contents remaining from the prior feeding. Monitoring gastric residual volume (GRV) was a key indicator to determine gastric emptying and thereby reduce the chance of regurgitation or vomiting and aspiration pneumonia.

Intolerance to feeding, as Metheny notes in her article, can be as high as 36% in critical care patients and approximately 27% among […]

2021-08-13T14:20:21-04:00August 13th, 2021|Nursing|0 Comments
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Understanding Imposter Syndrome Among Nurses

Photo by Elina Krima/Pexels

The self-doubt began when I applied for nursing school. I’d think, “What makes you think you should have this sort of responsibility?” or “I can’t possibly do this— everyone says nursing school is so hard.” I’d been accepted into two different programs, but this only heightened my suspicion that there had been some mistake. I worried that once I was in school people would realize that I didn’t belong there.

These beliefs were hard to shake. I thought I was the only one with such doubts, but it turns out that I’m not alone and this phenomenon has a name. Imposter syndrome (IS) is the feeling of being a fraud. It often affects women and minorities, and it tends to occur at times of career transitions and in high-achieving individuals. Nurses can be particularly affected.

What is it?

In 1978, Pauline Rose Clance and Suzanne Imes published their study on what they called the imposter phenomenon. Now commonly called imposter syndrome, it is described as having deep feelings of unworthiness and doubt of one’s capabilities, coupled with the fear of being “found out” or exposed as a fraud. It’s accompanied by an inability to acknowledge one’s accomplishments.

People with IS are often […]

2021-08-14T12:24:25-04:00August 11th, 2021|Nursing|1 Comment
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A New Nurse Learns Focus and Grace Under Pressure

“I entered this new chapter in my life running at full speed. But at nearly the same time, the world seemed to be coming to a full stop.”

That’s from the August Reflections essay in AJN: “2020: What a Time to Become a Nurse.” Alicia Sgroi finished nursing school and started as an RN in a Florida ICU in February 2020, just as the pandemic was starting to get a foothold in the United States. By June, her unit had been converted to a COVID-positive step-down unit.

Much has been written about the pressures and trauma of being a nurse during the pandemic. We know that it’s been tough for all nurses, sometimes overwhelmingly so. In fact, the original research article in the August issue of AJN is a study that looks at personal and institutional factors affecting levels of well-being and resilience among nurses during the pandemic, from staffing to support networks to personal resilience.

Rising to the occasion.

As a new nurse, Sgroi was understandably worried about catching the virus and also about having the skills to care for such patients. But as she tells it, far from discouraging her from continuing as a nurse, the experience taught her confidence […]

2021-08-06T10:41:37-04:00August 6th, 2021|COVID-19, Nursing, nursing stories|0 Comments
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AJN – More Than ‘Just’ a Print Journal

An overview from our editor-in-chief of what you can find on AJN’s home page.

As many of you might know, the American Journal of Nursing (AJN) has been providing nurses with information since 1900, when AJN first appeared in nurses’ mailboxes. Now, when people want information, they’re more likely to head online and search for information.

Print subscriptions at many publications have declined, supplanted by the demand for online content, and most journals, AJN included, have been part of this trend. Many journals now have interactive sites hosting not only the monthly or weekly journal issue content, but supplemental digital content that includes videos (for practical, “how to” information, you can’t beat videos to show step-by-step procedures), webinars, and podcasts (and of course, links to blogs and other social media channels).

So for those of you who may not have visited us in a while (or, who knows, maybe never!), here’s a summary of what you can access on AJN’s website, AJN Online.

On the home page, you’ll find the journal’s featured articles for the month. Most of these, including the CE article or articles of the month, are usually free to read.

Under the Articles & Issues tab at the top left of the home page, you can find the archives, including every issue published since the first issue in October 1900. […]

2021-08-04T08:24:48-04:00August 4th, 2021|Nursing|0 Comments
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A Plea for Help in Making Nursing Sustainable

by Casey Horner/via Unsplash

My hairdresser made a comment that I hear from a lot of people who are not in health care.

“I don’t know how you do a full 12-hour shift when it’s life-and-death work. I mean, I have long days working too, but cutting and styling hair isn’t life and death. I just can’t understand how you do it.”

I smiled and shrugged, as I usually do.

“Thanks for recognizing that. I don’t know. We get used to it, and we have a certain flow at work, even when it gets crazy. Plus it cuts down on the number of days I have to commute to work since I get so many hours in in one day.”

I had so much more to say, but that wasn’t the place for it. This is.

It’s true that at our core, we nurses are just wired to do this kind of work and we can push through it beyond a standard eight-hour work day. It also works well for consistency in ICU patient care to only have one changeover of the patient’s nurse from one 12-hour day shift to the incoming 12-hour night shift. We have generally found ways to ride the waves of an especially high census mixed with especially sick patients, typically followed by […]

2021-08-19T16:46:41-04:00July 29th, 2021|health care policy, Nursing, nursing career, Public health, safe staffing|5 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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