Through Song, a Nurse’s Renewed Connection to An Ailing Mother

Illustration by Barbara Hranilovich for AJN.

Millions of Americans are now acting in some capacity as caregivers for an ailing parent. This month’s Reflections column is by a nurse who describes a moment in time as she helps to care for her home-bound and dying mother. Her mother remains, on occasion, as judgmental and offputting as the mother of her childhood.

But in such cases, there’s little to gain by dwelling on old disappointments and hurts—and in this instance, there are good memories as well.

The common language of song.

These good memories are primarily associated with her mother’s love of and talent for singing. “Moon River and Mom” describes this nurse’s experience of tending her mother’s leg wound as the Meals on Wheels man visits, and what happens afterward when the author prompts her mother to sing. […]

2017-11-03T07:50:46-04:00November 3rd, 2017|family experience, Nursing, nursing stories|0 Comments
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Despite Outreach Cuts, Open Enrollment for the ACA Underway

Open enrollment for insurance through the Affordable Care Act (ACA) starts tomorrow, and ends December 15, allowing people half the time to enroll compared with previous years. There is much confusion and misinformation surrounding the ACA, particularly after recent executive orders by President Donald Trump to stop cost-sharing reduction (CSR) payments.

In addition, budgets for ACA advertising and outreach have been slashed by the Trump administration this year, which will inevitably lead to fewer people getting covered.

Bridging the ACA outreach gap.

To help bridge the gap left by the reduction in outreach, advocacy groups such as Get America Covered are reaching out to inform the public about enrollment. And nursing groups such as the American Nurses Association have stated their commitment to informing patients on how and when they can enroll. Below is some information for patients who might be confused about the law and how it currently stands. […]

2017-10-31T11:36:37-04:00October 31st, 2017|health care policy, Patients, Public health|0 Comments
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The CAPABLE Program: Supporting Aging in Place

Determining what matters to homebound elders.

Sarah Szanton

This month, AJN profiles Sarah Szanton, who created a program known as CAPABLE—Community Aging in Place, Advancing Better Living for Elders—that helps low-income seniors to remain at home with the aid of a unique home care team.

Szanton, an NP who has provided care for homebound elders, notes that “[b]eing in someone’s home gives you the opportunity to see what matters to them.”

The “person–environment fit.”

Szanton’s keen interest in the “person–environment fit” of her frail elderly patients led her to a different perspective on managing illness—one focused less on the “medical model” and more on “function and being able to do what they would like to do.”

In 2008, after the NIH requested proposals for projects to help the newly unemployed, Szanton wondered whether people with home-building skills could be paired with elders to improve their independence and quality of life. And the idea for CAPABLE began to form.

A unique home care team: nurse, occupational therapist, handyman.

CAPABLE’s home care teams are made up of a nurse, an occupational therapist, and a handyman. The patient identifies functional goals such as “to be able to stand long enough to prepare a meal,” and the team devises a plan based on these goals. […]

2017-10-13T10:10:47-04:00October 13th, 2017|Nursing, nursing perspective, patient engagement, Patients|2 Comments
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Are We Hearing the Questions that Patients and Their Families Don’t Ask?

“The spoken and unspoken messages we give patients and families are powerful.”

Viewpoint author Juanita Reigle

As a ‘frequent flyer’ of late, accompanying a family member on the long trek through cancer treatment, I’m acutely aware of the ways in which doctors and nurses communicate with us. Some have never mastered the art of interacting with people in stressful conditions. Others have remarkable radar and a special ability to “read between the lines,” identifying concerns that he and I haven’t yet voiced.

In ‘She’s Fine,’ the Viewpoint essay in AJN’s October issue, Juanita Reigle reflects upon how we respond to the questions patients and family members don’t raise. Some are left unasked because people are too overwhelmed to formulate a question. Some people aren’t ready to hear the answers. And sometimes, sadly, families sense that this doctor or nurse really doesn’t want to engage with them.

[…]

2017-10-09T09:48:08-04:00October 9th, 2017|Nursing, patient experience, Patients|0 Comments
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Student Errors in the Clinical Setting: Time for Transparency

Mistakes happen.

When I was working as an ED nurse, we often had nursing students assigned to the area. One day we had an elderly man with asthma in one of the treatment rooms. The physician ordered aminophylline suppositories. After reviewing the “5 rights”—right patient, right medication, right dose, right time, right route—I directed the student to administer the suppositories. All seemed well.

Imagine my surprise when the student proceeded to insert the suppository into the man’s nose! She explained that since it was a breathing problem, she naturally thought they would be inserted nasally. It never occurred to her that these were rectal suppositories and it never occurred to me to ask if she knew what to do with them. We all had a good laugh and that was that.

Undocumented errors.

Another day, another patient, another faux pas: a physician said to “cut the IV,” which everyone knew (that is, we assumed everyone knew) meant to discontinue the patient’s IV. One of my colleagues intervened when she saw a determined-looking student, with bandage scissors in hand, approach the patient’s room, ready to “cut the IV.” We again marveled at the student’s interpretation of the phrasing, and that was that.

And that’s the problem—that was that. There was no documentation of these as “near-miss” errors, and while some […]

2017-10-04T09:57:24-04:00October 4th, 2017|Nursing, nursing students, patient safety|2 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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