Recent End-of-Life Care Links of Note, by Nurses and Others

nature's own tightrope/marie and alistair knock/flickr creative commons nature’s own tightrope/marie and alistair knock/flickr creative commons

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

End-of-life care and decision making have been getting a lot of attention lately. The Institute of Medicine released a new report earlier this year, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life (available for free download as a PDF).

Nurses who write often write about end-of-life matters. A couple of recent examples:

On the Nurse Manifest Web site, a look at the realities and challenges of futile care in America. Here’s a quote:

“I am currently teaching a thanatology (study of death and dying) course for nurses that I designed . . . to support students to go deeply in their reflective process around death and dying, to explore the holistic needs of the dying, and to delve into the body of evidence around the science and politics of death and dying.”

Or read another nurse blogger’s less abstract take on the tricky emotional territory nurses face when a patient dies.

Elsewhere on the Web
Vox reporter Sarah Kliff collects five strong end-of-life essays that recently appeared in various sources.

And here’s something very practical that might catch on: according to a recent

2016-11-21T13:02:42-05:00April 13th, 2015|career, Nursing, nursing perspective, patient engagement|0 Comments
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Bedpans and Learning: Nursing Basics Still Matter

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Photo by Morrissey, via Flickr. Photo by Morrissey, via Flickr.

There I was, orienting to a busy medical ICU, perplexed over a bedpan. You’d think, since I was just graduating from nursing school, that bedpans would be my area of expertise. Critical thinking and vent strategies came easy; how could I possible admit I had no idea how to give a bedpan to a patient?

Frightening, to graduate from nursing school and a competitive externship program without this competency. Somehow, though, every unit I’d experienced offered patient care assistants, or patients who didn’t need this age-old tool. I’d certainly helped patients to the bathroom and cleaned incontinent ones. Despite the barrage of clinical learning, the basics of offering the pink plastic tool hadn’t sunk in.

Paralyzed, I stood with it in my hand, looking at my intubated, awake patient. I’d had the wherewithal to ask the family to step out, but couldn’t figure out which end went first. The horror of my preceptor finding it backwards would end me. Did the pointed end go towards the patient’s back? The larger end toward the feet for better coverage? Why couldn’t I remember?

Somehow, I managed to decide, and […]

2016-11-21T13:02:43-05:00April 8th, 2015|career, narratives, Nursing, nursing perspective, patient engagement|7 Comments
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Morgellons: Whatever the Cause, the Suffering Is Real

Image, magnified 60 times, depicts fiber-embedded skin removed from a facial lesion of a 3-year-old boy who the Morgellons Research Foundation says has Morgellons. Image, provided by Morgellons Research Foundation to AJN in 2008, described as depicting fiber-embedded skin removed from facial lesion of 3-year-old boy with Morgellons (magnified 60x).

By Jacob Molyneux, senior editor

As you may have read, Joni Mitchell was recently found unconscious in her home and is now in the hospital. She has attributed her health issues to a syndrome called Morgellons—a condition in which sufferers experience what they describe as fibers emerging from their skin, along with intense itching, sores that won’t heal, and a host of nonspecific symptoms such as fatigue and concentration problems.

Whether it’s a clinically verifiable illness or, as some have argued, a manifestation of a psychological condition known as “delusional parasitosis,” Morgellons is plenty real to those who experience it.

We covered this controversial illness several years back in an article called “AKA ‘Morgellons.’” I interviewed two nurses and several others about their experiences. One of the nurses (see this sidebar) was convinced she had caught the condition from a patient. I also spoke with Michele Pearson, MD, the lead investigator of a then-pending […]

2016-11-21T13:02:44-05:00April 2nd, 2015|Nursing, nursing perspective, patient engagement, Patients|1 Comment
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Two Sons, Similar injuries—Two Very Different Experiences of Pain

Vincent-2015-AJN_The_American_Journal_of_NursingWe are often amazed by the richness of the archives here at AJN. In the April issue, we reprint an essay originally published in the February 2002 issue. “Morphine. Now.” by Peggy Vincent, touches on topics as relevant today as ever: inadequate pain relief and the costs to patients of certain nursing scope-of-practice limitations.

It’s also a story, written by a nurse, of encountering very different attitudes to human suffering in two different health care institutions after injuries sustained by her own children. There may or may not be clinical details or matters of protocol that don’t accord with every reader’s current clinical experiences, but the human interactions are as familiar as ever. Here’s a brief excerpt: […]

2016-11-21T13:02:45-05:00April 1st, 2015|Nursing, nursing perspective, Patients|0 Comments
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Interprofessional Collaboration and Education: Making an Ideal a Reality

Photo courtesty of Penn Medicine. Photo courtesty of Penn Medicine.

We hear a lot about interprofessional collaboration, the potentially dynamic and enlightening process of sharing knowledge across disciplines to improve patient care, but what’s being done to make this a reality?

The promotion of interprofessional collaboration is one focus of an ongoing national initiative by the Future of Nursing: Campaign for Action, as described in “Interprofessional Collaboration and Education,” an article in the March issue of AJN.

To close the gap between policy bullet points and the reality of daily work for nurses is neither impossible nor inevitable; it depends on smaller coalitions and the engagement of multiple organizations—but also, one imagines, a willingness to engage in inquiry and to try new and imperfect processes at the local level that may need refinement over time. The article is free, but here are a couple of paragraphs that give an a good overview of why it matters and where we are:

Interprofessional collaboration is based on the premise that when providers and patients communicate and consider each other’s unique perspective, they can better address the multiple factors that influence the health of individuals, families, and communities. No one provider can do all of this alone.

However, shifting the culture of health care away from the “silo” system, in which […]

2016-11-21T13:02:49-05:00March 25th, 2015|career, Nursing, nursing perspective, Patients|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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