When Children Hurt

As an ER nurse, I saw a lot of people in pain, either arriving at our door to have their pain relieved or enduring the pain of needed treatments, knowing that the interventions were necessary. In my experience, though, there’s nothing worse than seeing a child in pain, and the younger the child, the more awful it was.

You began the encounter with a sick or injured child who was already frightened by the circumstances that had caused their parents or guardians to bring them to the hospital. It’s hard to get past the frightened eyes and tears, the little ones trying to burrow into their mother’s shoulder and not wanting to be put down on a paper-covered table. And this was before even attempting any assessment.

Nurse uses Wong–Baker FACES Pain Rating Scale to help assess patient’s pain. Photo by Gerry Melendez/The State/MCT via Getty Images.

Factors to consider in assessing a child’s pain.

We were taught that “pain is what the patient says it is,” and that still seems to be true of children’s reports of pain. But there are many factors that need to be considered, such as the […]

2019-05-23T10:18:37-04:00May 23rd, 2019|Nursing, patient experience, Patients|1 Comment
Read More

Daughter or Nurse? Caught Between Roles When a Father Is Hospitalized

“Word moves quickly that a patient on the unit has a daughter who is an RN.”

That’s from this month’s Reflections essay, “The Other Side,” in which a nurse struggles with her own mounting helplessness as her father’s hospital stay following surgery is unexpectedly prolonged.

On the other side.

The author finds herself in an uncomfortable in-between position, one that may be familiar to other nurses who have had family members in the hospital.

“I am an outsider, a family member on the other side. I know there is information not shared with me, information the health care team keeps to themselves. These conversations take place in whispered voices outside the room—conversations I have been a part of in the recent past, on my unit.”

[…]

2019-05-02T10:59:38-04:00May 1st, 2019|family experience, narratives, Nursing, nursing perspective, writing|0 Comments
Read More

The ECRI Top 10 Patient Safety Concerns of 2019

A list grounded in data and expert opinion.

Atlantic Training/Wikimedia Commons

Each year, ECRI Institute creates a list of top 10 patient safety concerns in order “to support organizations in their efforts to proactively identify and respond to threats to patient safety.”

The list isn’t generated out of thin air. The ECRI Institute relies both on data regarding events and concerns and on expert judgment. Since 2009, ECRI and partner patient safety organizations “have received more than 2.8 million event reports.”

2019 Top 10 Patient Safety Concerns

  1. Diagnostic Stewardship and Test Result Management Using EHRs
  2. Antimicrobial Stewardship in Physician Practices and Aging Services
  3. Burnout and Its Impact on Patient Safety
  4. Patient Safety Concerns Involving Mobile Health
  5. Reducing Discomfort with Behavioral Health
  6. Detecting Changes in a Patient’s Condition
  7. Developing and Maintaining Skills
  8. Early Recognition of Sepsis across the Continuum
  9. Infections from Peripherally Inserted IV Lines
  10. Standardizing Safety Efforts across Large Health System

[…]

2019-04-15T08:16:15-04:00April 15th, 2019|digital health, Nursing, patient safety, Patients|0 Comments
Read More

Are Your PCA Pumps Accurate, and Working?

Device malfunction happens.

After orthopedic surgery several years ago, I awoke in the PACU to find nurses working frantically on one side of my stretcher. Simultaneously, I realized that my leg hurt. A lot. And with another moment’s awareness—awake enough now for my nurse’s brain to begin to kick in—I understood that all of the activity concerned my PCA pump.

neeta lind/flickr creative commons

One of the nurses noticed that I was stirring. “Your pump has malfunctioned. We can’t get the replacement to work. A third pump is on the way. I’m so sorry!”

The scramble for a replacement, and then another, probably lasted less than five minutes, but it was a pretty wild ride. My deep breathing in an attempt to control the pain gave me something to focus on, but it was a pretty weak effort up against bone pain in the immediate post-op period. I’m grateful that my nurses—there were at least three involved at that point—regarded the pump failure as an emergency.

But operator errors are more common.

Needless to say, then, I was particularly interested in a new study that appears in this month’s AJN. In “Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study,” Yoonyoung Lee and colleagues examined […]

2019-04-10T09:29:43-04:00April 10th, 2019|Nursing, nursing research, patient experience, Patients|0 Comments
Read More

A Call to Address Fatigue to Protect Nurse Health and Patient Safety—from 1919

The evidence on nurse fatigue has been there all along.

During Women’s History Month, which is about to end, I’ve been posting (here and here) on nursing history (and in the process exploring its close confluence with women’s history). For this last post, I’m highlighting an article published in the March 1919 issue of AJN—exactly 100 years ago. The evidence on fatigue from long working hours has been there all along.

“The Movement For Shorter Hours in Nurses’ Training Schools” (free until April 15; click on the pdf version in the upper right), was written by Isabel Stewart, who was professor and then director of the nursing program at Teachers College, Columbia University, and coauthor of the National League for Nursing Education (the forerunner of today’s National League for Nursing) Standard Curriculum for Schools of Nursing.

A call for 8-hour work days for nurses.

In this article, which is in some ways disturbingly relevant today, Isabel Stewart notes that major nursing organizations recently met and were seeking “to enlist the support of a great many influential organizations and the general public in establishing an eight-hour day and a fifty-two hour week for pupil nurses.” (As a reminder, hospital nursing staff at that time were mostly nursing students.)

Fatigue undercuts […]

2019-03-29T11:07:06-04:00March 29th, 2019|Nursing, nursing history, patient safety|3 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top