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 […]

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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‘She’s Alive Because Of You’: A Nurse’s Advocacy Pays Off

Katie L. George, DNP, RN, AG-ACNP, CCRN. Photo courtesy of Katie L. George. Katie L. George, DNP, RN, AG-ACNP, CCRN

While attending this year’s American Association of Critical-Care Nurses National Teaching Institute meeting, AJN editor-in-chief Shawn Kennedy heard a story that she felt all nurses needed to hear as a reminder of the impact a nurse’s advocacy can have on a patient.

Critical care nurse Katie George, just a few years into her career when the events in the story took place, was caring for Ms. A., a young woman whose spinal cord had been nearly severed in a car accident.

Faced with a prognosis suggesting that Ms. A.’s quality of life would be poor and that she would have to remain on a ventilator, Ms. A.’s family made what they felt was the humane decision to have her removed from life support. But Ms. A.’s fiancé—and her nurse Katie George—were convinced that Ms. A., who seemed to be able to communicate by blinking in response to questions, should at least be given the chance to make the decision for herself.

Ms. A. was suffering from locked-in syndrome, a condition in which the patient is conscious and eye movement […]

2016-11-21T13:00:53-05:00October 20th, 2016|Nursing, nursing perspective, patient experience|1 Comment
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The Primary Care Confessions of Traumatized Patients

drawing of patient in waiting room Illustration by Hana Cisarova. All rights reserved.

In this month’s Reflections essay, “The Traumatized Patient,” family nurse practitioner Margaret Adams delves with sympathy into what she calls the “primary care confessions” of a challenging subset of patients. Writes Adams:

I’ve come to recognize patients like you—sometimes by your disturbingly long and detailed allergy lists, but more often by the frequency with which you come in for the same constellation of symptoms: fatigue, headaches, dizziness, general malaise. Something happened to you— maybe years ago, maybe recently—and it left its mark on you in irredeemable ways, . . .

While symptoms often do have underlying physiological causes, Adams is likewise attuned to the emotional subtext behind certain seemingly fruitless patient encounters. And with many specific examples, she makes the case here that the life of trauma plays itself out over time in the body and mind. […]

2016-11-21T13:00:53-05:00October 18th, 2016|Nursing, nursing stories, patient engagement, Patients|0 Comments
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Quality: The Anonymous Superhero of Nursing

“Clark Kent has his Superman cape, while I have my spreadsheets of data and the ability to set goals and track them.”

This guest post is by Tasha Poslaniec. A registered nurse for 16 years, Tasha has worked in multiple areas, including obstetrics and cardiology. She currently works as a perinatal quality review nurse. She is one of the most viewed nursing writers on Quora, and has had essays published by the Huffington Post.

sm1018-0021In the world of comics, Superman’s alter ego is the incognito Clark Kent. But in fact, that nerdy, data-oriented, and unassuming reporter, whose mission is to “bring truth to the forefront, and fight for the little guy,” could very easily be a quality review nurse.

The comparison between the two might seem a stretch at first, but there are some parallels that are worth pursuing—especially in the context of understanding who and what your quality nurse is, what quality nurses do, and how Clark Kent’s mission isn’t far from quality nurses’ own motivation for what we do.

An anonymous nursing role.

First, let me put into perspective exactly how anonymous most quality nurses are. Do you know who works in your quality department? Do you know where your quality department is? Did you even know that you have a quality department? If you said no to all three of those questions, then […]

2016-11-21T13:00:54-05:00October 11th, 2016|career, Nursing, nursing roles, patient safety|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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