A Place for Faith: Despite Chronic Illness, a Return to Bedside Nursing

flickr creative commons/by krassy can do it

Relearning the Details of Clinical Nursing

After being away from bedside nursing for over 11 years, I recently returned to this role on the same medical-surgical floor I’d worked on 11 years earlier. The impetus behind such a drastic transition was, in part, my return to nursing education as a clinical nursing instructor. As an educator, I felt the need to update my own clinical skills as I instructed young nurses eager to enter my profession.

The other reason for returning to clinical nursing had to do with a spiritual pull I felt in my heart, a hope that I’d be able to to show patients the compassion, empathy, and patience they all deserved. I’d come to realize that I’d sometimes lacked these qualities when I was a younger bedside nurse. Now I felt that God was giving me a kind of ‘do-over’—and I had to at least try to live up to this expectation.

Within the first week of orientation, I quickly realized how different things had become in the nursing world. The last time I’d worked as a clinical nurse on this very unit in 2005, the hospital was still using paper documentation, private community physicians still rounded on their patients, and there were no ‘computers on wheels’ or in patients’ rooms to access patient information […]

2017-03-08T11:17:02+00:00 March 6th, 2017|career, Nursing, patient experience|2 Comments

Nurses and Patient Safety: Parallel Histories

Photo from AJN archives.

I’m especially pleased that one of the CE articles in the February issue focuses on nursing’s role in creating a safe environment for patients: “Nursing’s Evolving Role in Patient Safety.” And in full disclosure, I was excited to see that the authors used the AJN archives to chronicle how nursing addressed (or didn’t address) safety issues around patient care.

From the earliest days of nursing through to the current complex systems in which we practice, nurses have been the health professionals responsible for ensuring safe passage of patients through the health care system. From Nightingale’s criteria for creating a healing environment to the “5 rights of medication administration,” patients rely on nurses to act as sentinels.

The authors reviewed 1,086 AJN articles from 1900 to 2015 and conducted a content analysis to identify patient safety themes. Aside from uncovering many fascinating (and sometimes alarming!) details of former health care practices, the authors drew this general conclusion:

“Emphasis on patient safety increased as patient care became more complex. As nurses developed a professional identity, they often put a spotlight on safety concerns and solutions.”

Here’s a quote from a nurse who wrote in 1908 about nurses’ duties: […]

Nursing Stories: Celebrating a Family Matriarch’s Life as Death Approaches

Illustration by Gingermoth for AJN. All rights reserved.

In this month’s Reflections essay, “Helen’s Family,” a home health nurse remembers a family that was not ashamed to celebrate life around a beloved matriarch even as her death approached.

The author, Cyndy Irvine, understands the crucial and difficult role played by family caregivers, who were “often partners in caring for” her patients:

. . . Some situations were not so difficult for them, perhaps a course of IV antibiotic therapy for osteomyelitis, or a posthospital assessment of medication compliance and mobility issues; others were more daunting, such as the last stages of an incurable disease.

The timing of Helen’s illness was not convenient—the march of family responsibilities carried on in the lives of her children, yet they recognized her final weeks and days as a sacred part of her life, and of their own.

Every family has a style, an energy, a way of relating or not relating. The author finds something special in this family’s efforts to fill “Helen’s” home with laughter, beauty, and a kind of celebration. The essay is rich in sensory details, and pervaded with a poignant awareness of the gift of life, even when it’s most fragile and in question. To read this one-page essay, which will be free until February 24, click here.

 

2017-02-10T11:45:50+00:00 February 10th, 2017|Nursing, Patients|0 Comments

Dialysis Patients’ Very Different Life or Death Choices

Illustration by Barbara Hranilovich. All rights reserved. Illustration by Barbara Hranilovich. All rights reserved.

This month’s Reflections essay is called “Sitting with Death.” The subtitle provides a little context: A social worker on a dialysis unit bears witness to patients’ life or death choices. Despite the sad stories the author tells, this remembrance doesn’t leave a reader feeling disheartened.

Retired social worker Linda Converse writes that starting work at a dialysis center was at first daunting. How could she talk to patients about such an ultimate choice as whether or not to give up dialysis?

But over time she began to understand that there was usually no right answer. For each person, there was a different personal algorithm that guided the choice, one based on such factors as quality of life, obligations to loved ones, values, and much else. Writes Converse:

I’ll never forget some of the patients who chose to stop dialysis, nor will I forget those who chose to hold on for as long as possible. There was no consistent logic when it came to an individual’s choice. What one person considered an impossible quality of life, another wouldn’t.

[…]

2016-12-05T08:57:58+00:00 December 5th, 2016|patient engagement, patient experience|0 Comments

Nurse-Led Evidence-Based Sleep Program Helps Hospitals and New Mothers Keep Babies Safe

Photo © Associated Press. Photo © Associated Press.

I can remember, when I was pregnant, reading everything I could get my hands on about every mother’s fear—sudden infant death syndrome (SIDS). My mother, who followed the norms of her time when I was born, was surprised that my son’s crib was bare—no blankets, pillows, toys, or bumpers. He wore a sleep sack and was placed on his back to sleep until he began to roll over by himself.

To add to what I learned from my preparatory reading, the nurses at the hospital I gave birth in set a standard for how to care for my newborn—explaining the abovementioned safe sleep tips, and much more. After all, nurses are probably a mom’s first stop for this information, helping new mothers navigate the choppy waters of caring for their newborns.

This month’s Cultivating Quality article, “An Evidence-Based Infant Safe Sleep […]

2016-11-21T13:00:48+00:00 November 18th, 2016|Nursing, patient safety, pediatrics|11 Comments