Dark Water, Wild Winds: Notes of a Flight Nurse

I must see new things
And investigate them.
I want to taste dark water
And see crackling trees and wild winds.
—Egon Schiele

IMG_2650Repatriation

I’m standing on the tarmac in Manaus, Brazil, where there is indeed a wild wind; it blows debris across the runway yet does nothing to stave off the nearly intolerable heat. Sweat soaks my back and drips down the center of my chest. My limbs are heavy with lethargy. The heat index is 110 but it feels much hotter—even the Learjet fails to provide a haven from the equatorial sun.

We’d come to Brazil to repatriate an Englishman who’d been visiting family and was struck down by sudden and severe seizures. He’d spent weeks in the hospital, sustaining scans and diagnostics to pinpoint the cause, and endured the addition of one antiepileptic medication after another.

While the seizures finally ceased, he was left disquieted and uncomfortable, unsure which symptoms were due to the 7 cm brain mass that had been discovered and which were side effects of the myriad of antidotes. By the time we were dispatched for this mission, he was medically stable and ready to go home to deal with the ominous findings. Biopsies awaited and treatments would […]

2016-11-21T13:01:03-05:00July 27th, 2016|career, Nursing, nursing stories, patient experience|0 Comments
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Appropriate Use of Opioids in the Management of Chronic Pain

Painted by Martin Edwards as part of the Paint Your Pain program initiated by the Pain Management Center at Overlook Medical Center, Atlantic Health System, Summit, New Jersey. For artwork of other patients in the program, go to http://bit.ly/ 1Ns0PxL.The dangerous misuse of prescription opioids and drugs like heroin has been much in the news, but millions of patients continue to suffer both acute and chronic pain. For many, prescription opioids play a vital role in alleviating that pain. How can health care providers most effectively and safely use opioids in the treatment and management of chronic pain? Some answers can be found in a CE article in the July issue of AJN: “Appropriate Use of Opioids in Managing Chronic Pain.”

Related questions on opioids and chronic pain addressed in the article include:

2016-11-21T13:01:03-05:00July 22nd, 2016|Nursing, pain management, patient safety|0 Comments
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Moral Distress: An Increasing Problem Among Nurses

moral distress

An ICU nurse struggles to reconcile repeated surgeries and transfusions for a comatose patient who has little chance of recovery. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she’s not giving needed care to patients because of poor staffing.

Situations such as these are all too common and can give rise to moral distress. Moral distress occurs when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

As explained in “Moral Distress: A Catalyst in Building Moral Resilience,” one of the CE articles in our July issue, this “inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as a whole.” […]

2016-11-21T13:01:03-05:00July 18th, 2016|Ethics, Nursing, patient safety|0 Comments
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Daniel

jen promesJennifer L. Promes is a gerontological clinical nurse specialist and Magnet Program director in Omaha, Nebraska. In this post, she describes an experience she had early in her career while working as a certified nursing assistant in a nursing home’s memory support unit.

Daniel had a kind, mild-mannered disposition, but because of his advanced dementia he would sometimes become agitated and belligerent, especially at night. Most of the staff didn’t want to help him prepare for bed. I knew Daniel was much more cooperative if you distracted him by talking about his past, so one night I volunteered to help him with his personal care.

All of the residents had just finished their evening meal and were waiting patiently at their tables to be assisted back to their rooms for the night. As I approached Daniel–a short, stocky bald man in his late 80’s with thick-rimmed glasses, always dressed in a button-up flannel shirt, polyester slacks, and square-toed, diabetic shoes—I could tell he was “working on something.” He had a table knife in his hand and was prying at the seam between the two leaves of the table. He was quietly muttering something under his breath as he worked, his head nodding as he grew more tired.

Daniel would “fix” anything he could get his hands […]

2016-11-21T13:01:06-05:00July 12th, 2016|narratives, Nursing, nursing perspective, patient engagement|1 Comment
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The View from the Other Side: When the Daughter is a Nurse

I knew where we were heading and it scared me. I didn’t want to have to think about decisions that would have to be made in the not so distant future. I didn’t want to be a nurse; I just wanted to be the daughter.

Flowers_in_the_field_(5832054482)I knew Marie was special the moment I met her. Her home was one where all were welcome, the coffee always hot and fresh, the house filled with family and friends, and everyone left with a full belly. She freely shared her opinion, whether or not a person sought out her advice.

I knew Marie for nearly 30 years. She was my mother-in-law. She was also my cheerleader, proud that I had come so far in my nursing career. She told everyone I was a nurse and often referred to me as her daughter rather than specifying that I was her daughter-in-law.

Fiercely loyal and loving of her large family, she always put their needs before hers. I worried about her because she smoked and rarely visited a doctor. With regard to health, she believed in the notion that if it ain’t broke, don’t fix it. But slowly, health problems began cropping up. After a hospitalization for heart failure, she was diagnosed with COPD and hypertension.

Still, she […]

2016-11-21T13:01:07-05:00June 30th, 2016|narratives, Nursing, nursing perspective, patient engagement|1 Comment
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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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