Those Special Moments Nurses Sometimes Talk About

Before I became a nurse, I heard that nurses have special moments with their patients and families that they never forget, but I never truly understood what that meant.

My first neonatal code occurred about six months after I completed my orientation in the pediatric emergency department. I remember that shift being a particularly busy one. In the midst of the hustling and bustling of assessing and medicating patients and reevaluating and discharging them, I heard banging on the triage door and saw a mother and father wheeling in their baby carriage, frantically crying out that their baby Skye was blue in color.

By S.Hermann and F.Richter/Pixabay

I remember quickly removing her clothing and seeing how cyanotic she was, all while an electrocardiogram was being obtained and she was placed on the cardiac monitor. I recall hearing the doctors paging overhead for pediatric respiratory and anesthesiology to assist with resuscitation. Other team members included a CNA and a medical student who tried to relax the parents but were understandably not successful.

There were multiple unsuccessful attempts to obtain peripheral vascular access in Skye. I can still see the look of terror on Skye’s parents’ faces as the drill gun used to insert the intraosseous access whirled into baby Skye’s bone, […]

2020-10-23T10:48:41-04:00October 23rd, 2020|family experience, Nursing, Patients, pediatrics|0 Comments
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Patient Input on Obstacles to Sleep Helps Focus One Unit’s Improvement Efforts

Do you know anyone who’s ever had a good night’s sleep in the hospital? As nurses, we hear the complaints; as patients ourselves, or as family members of patients, we’ve been there.

Differing views on the source of a unit’s sleep problem.

After their hospital’s 20-bed telemetry unit received a low HCAHPS survey score on a quiet-at-night question, nurse practitioner Christian Karl Antonio and his colleagues at a northern California community hospital took on the challenge of improving patients’ sleep experience on the unit.

Before designing an intervention, they spoke with patients as well as staff, and were surprised to learn that the two groups see the problem differently.

“Patients perceived being awakened for vital signs, blood draws, and medication administration as the most frequently occurring factors that contributed to noise at night. On the other hand, staff members perceived that noise at night came from staff conversations, equipment with alarms, announcements on the paging system, and delivery carts, among other sources.”

[…]

2020-10-08T10:01:55-04:00October 8th, 2020|family experience, Nursing, nursing research, Patients|0 Comments
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How Do You Feel When Your Patients Can’t Afford Care?

“Every day in the United States, nurses watch patients forgo beneficial treatment they cannot afford despite nursing’s moral standard to treat patients without regard to financial condition.”

How often have you been left, pretty much on your own, to figure out a way that your uninsured and/or homeless patients have access to something (anything!) that will maintain their health when you aren’t with them? Are there meds they can’t pay for? Do they need prenatal care that they can’t afford? Can they possibly function without home care of some kind?

Moral distress as a call to seek systemic change.

In “Ethical Issues: The Moral Distress of Nurses When Patients Forgo Treatment Because of Cost” in this month’s AJN (free to access until October 7), Douglas Olsen and Linda Keilman discuss the moral distress of nurses when we are unable to meet the needs of patients who don’t have the money to pay for care in our for-profit health care system. […]

2020-09-17T07:03:34-04:00September 17th, 2020|health care policy, Nursing, nursing perspective, patient experience, Patients, Public health|0 Comments
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Building Back Better: Constructive Nursing Regulation

As governor of the first COVID-19 epicenter in the country, Andrew Cuomo challenged New Yorkers to think about how the state could “build back better” after the crisis. As registered nurses with experience in health law and policy, we have recommendations for transforming the boards of nursing. The manner in which nurses are regulated must be reformed, not just in New York, but throughout the country. It must begin by understanding the dangerous environments in which nurses are working.

Staffing, safety issues affect both nurses and patients.

In May, for example, Governor Cuomo reported that 12.2% of health care workers in New York city had been diagnosed with COVID-19. Nationwide, more than 164 nurses have died, often because they lacked adequate personal protective equipment. But COVID-19 is not the only dangerous situation. Long-term and psychiatric care facilities, as well as hospitals, are often dangerously understaffed, exposing nurses to violence. Nurses and other workers have been attacked and sometimes killed because they lack necessary resources and protections. Workplace violence is a growing threat which has not been adequately addressed by health care managers and administrators. Danger to patients occurs when nurses are expected to accept assignments outside of their areas of expertise. Nurses cannot care for […]

2020-07-27T07:08:18-04:00July 27th, 2020|Nursing, nursing career, nursing perspective, patient safety|2 Comments
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The Baby with Tetralogy of Flow

It is a good day so far—none of the 16 critically ill babies in the neonatal intensive care unit has coded or died. So far, the shrill electronic alarms for dying babies have been silent.

As the neonatologist on call, this gives me the opportunity to talk to Anna and Jake, Baby Milo’s parents. Milo peers up at them with big brown eyes as Anna leans over his crib and whispers to him. A small transparent plastic mask covers Milo’s tiny nose to help him breathe, and a cluster of saliva bubbles percolate between his lips. Despite a sleeve of tape securing his right hand, his tiny fingers tug the orange orogastric tube taped to his cheek.

Milo’s father, a brawny man wearing scuffed brown shoes, ripped blue jeans, a T-shirt, and a tattered Green Bay Packers cap, sits in a chair and nervously taps his knee while he stares with bloodshot eyes at the vital signs on Milo’s bedside monitor.

“Milo is adorable,” I say from the doorway. His parents look over to me as I step into the room.

“We think so,” Anna says with a smile.

“How are you both doing?” I ask. “Being in the NICU can be pretty stressful.”

Milo’s parents glance at each other and nod. Anna takes a seat next to Jake, who touches her shoulder.

I pull up a chair. “Can you tell me Milo’s story? How did you end up in the NICU?” I say.

“We were celebrating my birthday at a steakhouse,” Jake says. “Right after they brought […]

2020-07-15T11:23:21-04:00July 15th, 2020|family, family experience, pediatrics|0 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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