Intensive Care of a Different Ilk

MayReflectionsIllustrationThis month’s Reflections essay (“Intensive Care”) is by John Fiddler, an NP who describes his work as an inpatient hospice nurse in New York City as being “as close to the ideal of nursing as I have ever been.”

This is a big claim—but if you read Fiddler’s brief, artful summary of the evolution of his nursing career, which started in an actual ICU, and then his description of what he found when he went to work in a hospice, you might find that he makes a pretty good case.

Here’s a small excerpt:

Inpatient hospice to me was the room at the end of the palliative care corridor that I had never bothered to visit. I had pictured it as a quiet haven for the dying, where birds chirp outside and music is heard playing through open windows as patients calmly drift off and up into dusty shafts of sunlight.

Not quite.

Instead, picture a unit where patients arrive on stretchers in extreme pain and distress, afraid, breathless—usually with families trailing behind, holding on to as much emotional and personal baggage as they can carry. Often these patients bear the physical and psychic bruises of a prolonged ICU stay.

And this is what happens here…

Maybe the author will someday find another ideal of nursing care, or maybe he won’t, but it’s worth reading his account of the current one. Reflections essays are open access. (Click through to the PDF […]

2016-11-21T13:04:48-05:00May 9th, 2014|career, nursing perspective|1 Comment
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Nurses Week: Time to Celebrate (Not Denigrate) Nursing’s Worth

shawnkennedyBy Maureen Shawn Kennedy, AJN editor-in-chief

So, on the cusp of Nurses Week, the week when Americans are encouraged to think about the value that nurses bring to health care, readers of the New York Times were treated to an op-ed written by physician Sandeep Jauhar. According to the byline, Jauhar is a cardiologist and the author of an upcoming memoir about his disillusionment as a physician. The title of the piece was “Nurses Are Not Doctors.” While the author makes sure to reassure us that he thinks nurse practitioners (NPs) have a valuable role to play in health care, he makes the usual charge that NPs are not qualified to practice primary care without physician supervision.

Jauhar conveniently ignores the many studies that have refuted this argument, while basing his case largely on weak anecdotes and one study from 1999 that showed NPs ordered more diagnostic tests. His conclusion: the NPs in the study ordered too many expensive tests because they lack the experience and knowledge of physicians (he concedes in passing that “there are many reasons the NPs may have ordered more tests”). I can’t help thinking that this piece’s publication was purposely timed to take some of the shine off Nurses Week.

I’m surprised that the Times published such a weak letter. First, along […]

2018-03-28T10:24:54-04:00May 5th, 2014|career, nursing perspective, nursing research|4 Comments
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Compelled by Professionalism

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

ParadisiThanksIllustration“Ah, Julianna.”

This greeting from a physician marked my arrival at work. I assumed he was about to give me information or an order about one of our patients. I prepared myself for the forthcoming shift—”Ready or not, here it comes.”

Instead, he did something completely unexpected. Quickly retreating to his office, he reappeared, extending towards me a bright blue envelope with my name neatly written on the back.

It contained a greeting card. Not the generic kind hospitals provide managers in bulk for staff recognition. Not the “You’ve Been Caught Doing Something Fabulous!” quarter page–sized certificates available in the staff lounge for coworkers to fill out in recognition of their peers. This was a genuine, bona fide greeting card, the kind you have to go to a store and select from a rack and purchase. Inside, he’d addressed it to me again, with a personal note in handwriting, shattering the long-held belief that physicians cannot write legibly in cursive.

Being thanked by a physician for an act of nursing I had provided for his patient isn’t what caught me off guard. During my years of practice, many physicians have verbally expressed appreciation for my nursing skills. A half-dozen have even apologized for disagreeing with an assessment of mine (only to find out later […]

2016-11-21T13:04:52-05:00April 30th, 2014|career, nursing perspective|1 Comment
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If You Really Want to Get That Letter Published

By Karen Roush, PhD, RN, FNP, AJN clinical managing editor

via Wikimedia Commons via Wikimedia Commons

We love getting letters to the editor . . . really . . . whether it’s to agree or disagree, applaud or admonish. With some articles we actually feel a sense of excited anticipation—this should get some letters!—not because we like to create controversy (though we don’t shy away from it either when there’s something important at stake), but because we want to create dialogue among our readers.

That’s what the Letters to the Editor column is for: to add to the conversation by pointing out nuances, adding support from personal experience, expressing a dissenting view of a topic, or offering corrections or clarifications.

A good letter to the editor contains:

• a point of view
• a sense of the writer and why they were moved to write a letter
• additional information that clarifies, corrects, or enhances the original text (and the evidence backing it up)
OR:
• a reasoned, respectful argument (and the evidence to back it up) against some aspect of the original text
OR:
• a narrative that gives a clearer sense of the human implications of the original text

These are the main criteria we look for in the letters we receive.

We are glad when you enjoy an article or are pleased to see the topic […]

2016-11-21T13:04:53-05:00April 28th, 2014|career, nursing research|0 Comments
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What Advice Would You Give a New Nursing Student? Our Readers Respond…

KarenRoushBy Karen Roush, MSN, RN, FNP-C, AJN clinical managing editor

My daughter Kim is starting nursing school next month, so last week I asked AJN’s Facebook followers for the best piece of advice I could give her. The response was overwhelming: over 600 people offered wisdom, encouragement, and tips for success. I went through and read them all and the following is an attempt to synthesize the advice.

Of course, with so many responses, there were many valuable pieces of advice I had to leave out, from the practical to the profound, such as:

sit in the front of class, stick to your principles, invest in good shoes, choose clinicals that push you out of your comfort zone, be early for everything, celebrate the small victories, get a really good stethoscope up front, believe in yourself, pick the hardest patient you can at clinical, audiorecord the lectures, be truthful and committed to your work, eat healthy, get to know your instructors, coffee and chocolate!

And finally: look into the eyes of your patients and be sure they know you care. Every patient, every time.

(Oh, and not to leave out the lighthearted—Don’t hold your nose in clinicals. The teachers frown on that.)

Below are five areas of advice that stood out:

1) “Take a good […]

2016-11-21T13:05:03-05:00April 9th, 2014|career, healthcare social media, nursing perspective, students|8 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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