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, “

2016-11-21T13:00:48-05:00November 18th, 2016|Nursing, patient safety, pediatrics|11 Comments
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All Saints’ Day Blessing for Health Care Providers

Autumn Angel / photo by Julianna Paradisi 2016 Autumn Angel / photo by Julianna Paradisi 2016

November is the strangest of months. Its days are shorter, darker. It begins with All Saints’ Day, a day of remembering our dead, of loss and grief, followed late in the month by Thanksgiving, America’s celebration of abundance with gratitude.

This year on All Saints’ Day I attended a discussion of health care professionals. The audience included nurses, physicians, pharmacists, social workers, and hospital administrators. The conversation ultimately centered on the emotional difficulties of patient care.

It wasn’t a debriefing as much as collective acknowledgment that, rather than accepting help, some patients or their family members view us as the enemy, sometimes disrupting our best efforts in the name of misguided advocacy.

Nurses spoke of being labeled as “bad” and played against each other by angry patients or family members. Physicians related episodes of verbal abuse from patients or family members demanding inappropriate procedures, medications, or dosing. Some spoke of needing to take refuge to center their thoughts before ordering the appropriate care.

Like most nurses, I’ve experienced similar treatment at the hands of difficult patients, but physicians don’t generally discuss with us how they are treated. Nurses and physicians suffer silently, instead of lending support […]

2016-11-21T13:00:49-05:00November 10th, 2016|Nursing, Patients|1 Comment
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Behind the Curtain: A Patient’s Evolving Relationship to Illness

Illustration by Eric Collins/ecol-art.com. All rights reserved. Illustration by Eric Collins/ecol-arts.com. All rights reserved.

Having edited it, I’d like to recommend AJN‘s November Reflections essay, “Behind the Curtain.” In it, author Leigh Pate looks back to an early experience in her own cancer treatment. Sitting in a chemotherapy bay receiving an infusion, she overhears a conversation between a cancer patient and his nurse that she will remember years later.

The central insight of this essay can’t be put into a few words, but it has something to do with the fact that the way we think and feel about an illness changes over time as we ourselves change.

The metaphors we use to talk about an illness change as the years pass. We develop a relationship to the illness that isn’t as simple as it seemed at first. Is it really always a battle? Are there always clear winners and losers? What do we really want? What is it to be strong? […]

2016-11-21T13:00:52-05:00November 4th, 2016|Patients|0 Comments
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Dosing Cups, Oral Syringes, or Spoons: A Pediatric Medication Safety Recipe for Disaster?

pediatricdosingA recent article I came across in Pediatrics said that researchers found (during laboratory experiments) that four out of five parents made at least one dosing error when using either a dosing cup or an oral syringe to dispense liquid medication meant for children. As a new parent who has grappled with multiple dosing tools, I can’t say I am surprised.

Growing up, I remember syrupy medicines being doled out by my mother on spoons of varying size—a teaspoon or tablespoon—not a very accurate method when you also factor in that most spoons differ in shape and, probably, actual volume.

After my son had his first round of vaccines, the nurse told me that, in case he had a fever that night, the standard dose of Tylenol for his size and age was 80 mg. He didn’t get a fever in the end, and I didn’t think about what she’d told me until he had his first fever from a cold several months later.

When I went to open my box of Tylenol, I saw that the syringe that came with it did not use the dosage the nurse had told me (in milligrams), but rather, milliliters. I looked on the box for instructions but it only listed the […]

2016-11-21T13:00:52-05:00November 1st, 2016|patient safety, pediatrics|0 Comments
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Information for Nurses on Voluntarily Stopping Eating and Drinking (VSED)

The New York Times recently published an article by Paula Span called “The VSED Exit: A Way to Speed Up Dying, Without Asking Permission.” VSED stands for voluntarily stopping eating and drinking, an end-of-life option that is, on the surface, as simple as its name suggests. Span, who recently attended the first conference devoted to VSED, gives an overview of one mother’s choice to end her life using this method. She also does an excellent job enumerating the ethical, practical, and legal implications of choosing to stop eating and drinking.

screen-shot-2014-11-05-at-4-39-13-pmWhich types of patients is such a choice appropriate for? How much suffering does it involve? Are there legal pitfalls of involvement in the VSED process by nurses and physicians? We can expect that all of these questions and more will be receiving growing attention in the coming years.

Late in the article, Span quotes Judith Schwarz, PhD, RN, now clinical coordinator of End of Life Choices New York. In 2009, AJN published a CE article, “Stopping Eating and Drinking,” by Schwarz. This substantive article centers around a detailed case study. “Gertrude,” we learn, has lived a very full life. All the things that give her pleasure and a modicum of freedom are gradually being removed […]

2016-11-21T13:00:53-05:00October 24th, 2016|Ethics, Nursing, patient experience|0 Comments
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