When There’s a Disconnect Between Good Nursing Practice and Reality

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

shawnkennedyThis is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

Giving Thanks for Meaning in a Nonclinical Setting

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.

NiceNurseSome Thanksgiving seasons, it feels like the only specific nursing thing to be thankful for is the overstocked larder of the staff lounge, marking the advent of The Season of Eating.

I’m being facetious. Actually, there’s lots to be thankful for in nursing, including a regular paycheck, which is not taken for granted. However, most nursing units remain understaffed, despite hoards of nursing school graduates desperately seeking jobs—creating a no-net gain on the gratitude side of the ledger.

Ethical issues and long hours also make finding gratitude a challenge. It’s not the gifts from patients of flavored popcorn and boxes of chocolates in the staff lounge that warm a nurse’s heart so much as the handwritten cards accompanying them, thanking us for their care. For nurses, finding meaning in what we do goes hand in hand with gratitude.

This season, however, I was surprised by an opportunity to find meaning as a nurse outside of a clinical setting, and I want to share the experience.

One afternoon, a neighbor came to my door asking for help. She is the mother of two small children, and her toddler had accidentally burnt his hand in the kitchen. She’d taken him to the emergency department and […]

2018-03-28T10:27:41-04:00November 25th, 2013|career, nursing perspective|6 Comments

Are Hospitals Doing Enough to Help Newly Licensed RNs?

CalloutNewNursesVoices

Staff retention is a big issue in hospitals. There can be advantages in hiring newly licensed RNs, but some hospitals and workplaces may pay insufficient attention to helping new nurses with the challenging transition from classroom to clinical practice. In our November issue, some of these issues are brought more clearly to light by an original research article called “Hearing the Voices of Newly Licensed RNs: The Transition to Practice.”

“The first few months of employment is a crucial time in a nurse’s career,” write the authors of this small study. According to interviews with newly licensed RNs conducted by the authors, the following factors can make a big difference:

  • The quality of the preceptor—is the preceptor knowledgeable, adequately experienced, and nonjudgmental?
  • Professional growth and the development of confidence over time in terms of time-management, communication skills, and learning from experience.
  • A sense of being nurtured by the program, the preceptor, and peers.
  • The thoroughness and effectiveness of orientation.

Read the article, or listen to an author podcast on our Web site. What worked in your own transition to practice? What didn’t work? Or how do you help others with this transition? We’d love to know. —Jacob Molyneux, senior editor


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A Focus on Meaning and Attitude: This Week’s Nursing Blog Post Suggestions

By Jacob Molyneux, AJN senior editor

'Autumn Washed Away,' Diane Hammond/ via Flickr ‘Autumn Washed Away,’ Diane Hammond/ via Flickr

Here are a few recent posts by nurses that you might find of interest. As I put this together, a theme emerged, so it seemed fair to just go with it. Maybe the approach of these bloggers has to do with the time of year, the shorter days and colder weather as we approach the winter holidays . . .

At the intriguingly titled Nursing Notes of Discord blog, there’s a short reminder post with a fairly straightforward descriptive title: “Anyone Can Make a Positive Difference.” And, the author points out, you “don’t even have to be a nurse” to do so.

At Digital Doorway, Nurse Keith has a recent post that also focuses on positivity, this time about one’s profession: “For Nurses, ‘Just’ Is a Four-Letter Word.”

At HospiceDiary.org, in the lovely post “Leaves, Geese and Other Ramblings”—as the below quote may suggest—we find another angle on this theme of being present and focusing on the good in the midst of sometimes constant, poignant awareness of change, loss, dying, and rebirth:

A Report from the ANA Safe Staffing Conference

Katheren Koehn, MA, RN, AJN editorial board member and executive director of MNORN (Minnesota Organization of Registered Nurses), reports from last week’s ANA conference on staffing held in Washington, DC.

staffiing Click image for source page at ANA staffing site.

The ANA Safe Staffing Conference ended on Saturday. There were almost 700 registered nurses from all over the country in attendance—nurses in management, direct care, and leadership—all gathered to try to discover new strategies for how to solve the most challenging issue in nursing: safe staffing.

Not a new issue. This has long been the most challenging issue for nursing. Teresa Stone, editor of Poems from the Heart of Nursing: Selected Poems from the American Journal of Nursing, told me that, as she was searching the archives of 113 years of AJN issues for her book, she found that staffing issues were a frequent theme. Today, as the work of nurses has become more complex, the need to create sustainable solutions to ensuring appropriate staffing is our most critical issue—hence the ANA Staffing Conference.

The body of evidence supporting the idea that appropriate nurse staffing makes a difference in saving patients’ lives has grown exponentially in the past 20 years. This evidence—paired with the new federal financial incentives for hospitals to improve patient outcomes and experiences—makes it seem inevitable that increasing nurse staffing would be the […]

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