Best Care at Lower Cost: New IOM Report Spotlights Crucial Role of Nurses

By Mary D. Naylor, PhD, FAAN, RN. Dr. Naylor is the Marian S. Ware Professor in Gerontology and director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing. She is also the National Program Director for the Robert Wood Johnson Foundation program, Interdisciplinary Nursing Quality Research Initiative, aimed at generating, disseminating, and translating research to understand how nurses contribute to quality patient care. She was appointed to the Medicare Payment Advisory Commission in 2010. 

Building on the Future of Nursing report’s call for nurses to fully engage with fellow health care professionals, a new report from the Institute of Medicine, Best Care at Lower Cost, calls on nurses and others in the health care system to apply emerging tools, technologies, and approaches to yield lower costs and better health outcomes. I had the great fortune to serve as a member of the study committee.

The complexity problem. The report couldn’t be more timely or relevant, particularly for nurses and the patients they serve, given the complexity of the current health care system. Administrative and workflow inefficiencies limit hospital nurses from spending more than about 30% of their time on direct patient care. With increasing specialization, modern medicine now includes nurses in more than 50 specialties. To successfully coordinate a patient’s care, nurses need to communicate and collaborate with patients, family caregivers, physicians, pharmacists, social workers, and many other team members.

The complexity […]

2016-11-21T13:09:23-05:00September 6th, 2012|career, nursing perspective|1 Comment
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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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To the Nursing Class of ’12 (and ’84, and ’96, and ’01)

By Karen Roush, MS, RN, FNP-C, clinical managing editor. A version of this essay originally appeared in the 2008 AJN Career Guide, but we feel it’s still just as relevant to new nursing grads or even to seasoned nurses (and non-nurses, for that matter) who might need a sense of renewal.

via Wikimedia Commons

On a rainy cold Saturday last May my son graduated from Rensselaer Polytechnic Institute in Troy, New York. As I sat shivering in my complimentary plastic poncho, listening to the commencement speaker doing his best to inspire the faces peering up from under soaked tassels, the thought came to me that we all need a commencement address every five years or so. Someone to tell us we can make the world a better place, that the possibility for greatness exists within us, that we may yet achieve our dreams. Someone to remind us why we chose nursing, and why we work so hard.

So, whether you are a new graduate or graduated 50 years ago, this is my commencement address to you.

Stay alert. Be vital. Sharpen your mind and your skills. Read journals for nurses and on health care in general. But don’t limit your knowledge to health-related information. Read political discourse, economic theory, and great literature. At the time of this writing, a book of poems, Slope of the Child Everlasting by Laurie Kutchins, sits on my desk at home. Each evening it pulls me into a […]

2016-11-21T13:09:53-05:00June 15th, 2012|career, nursing perspective, students|2 Comments
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Big Changes for New York Nurses

By Shawn Kennedy, AJN editor-in-chief

On Thursday, May 17, the New York State Nurses Association (NYSNA) held a special members-only meeting at New York City’s Jacob Javits Center to vote on bylaw changes that will drastically alter the future of the organization, morphing it from a professional association into a union. One of the key changes had to do with who could hold office in the organization: going forward, only bedside nurses, retirees, and “non-statutory” supervisors (i.e., those not able to hire or fire employees) would be eligible for office.

Other changes include eliminating the position of CEO and changing it to that of executive director, in order “to better reflect the union’s democratic roots and greater accountability to working nurses,” and a decision to push for nurse–patient staffing ratio legislation in the next session.

The NYSNA, which with 37,000 members, was founded in 1901 and is the oldest state nursing association in the country. Until January, when it was suspended for one year, it was the largest constituent member association of the ANA.

According to ANA documents, the NYSNA violated ANA bylaws by engaging in “dual unionism” when its newly elected board of directors replaced the CEO with Julie Pinkham, who is also the executive director of the Massachusetts Nurses Association (MNA). The MNA had disaffiliated from ANA in the past, along with the California Nurses Association, and were founding members of National Nurses United. The ANA […]

2016-11-21T13:10:04-05:00May 21st, 2012|career|0 Comments
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The Evolution of Nursing: Always a Mirror for Cultural Attitudes, But With Some Constants

Of hygiene practices at one public institution, Hobson wrote, “The visitor found a woman with a broken leg twelve days after she had been brought to the hospital in the same miserable garments in which she fell.” In describing an almshouse (poorhouse) hospital, she said, “The condition of the patients was unspeakable; the one [untrained] nurse slept in the bathroom, and the tub was filled with filthy rubbish.”

. . . On the subject of nutrition, Hobson recounted a Friday meal in the same hospital, wherein “the dinner of salt fish was brought in a bag to the ward and emptied on to the table; the convalescents helped themselves, and carried to the others their portions on a tin plate with a spoon.”

Pediatric NP, circa 1965. Courtesy of Barbara Bates Center for the Study of the History of Nursing, Univ. of Penn. School of Nursing

These are quotes from “Key Ideas in Nursing’s First Century,” an article in the May issue of AJN by historian Ellen Davidson Baer. Baer draws on vivid primary sources  from the 19th century, such as the one quoted above, to depict stages in the evolution of nursing into a respected and regulated profession with standards and essential skills and knowledge.

Though nursing has changed a great deal since its early days, Baer sees theory and compassion as intertwined constants throughout the history of nursing, both of them very much present from the start.

She’s also attuned to ways in which the […]

2016-11-21T13:10:09-05:00May 14th, 2012|career, nursing perspective|1 Comment
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