Patients Archives - Page 50 of 70

Storytelling as a Vital Source of Knowledge and Connection in Nursing

I’m not saying that nurses should abandon the quantitative and evidence-based practices that we know have saved many lives. But we should also seek to balance and contextualize this approach through humbly listening to the stories of those we care for. Some of my greatest learning has come from individual client stories and from the rich meaning of their experiences. Stories from clients about their lives can have both a tangible and an intangible effect on the care we provide. A story may create an atmosphere of openness, closeness, and warmth that is both soothing and healing during the most trying times.

Lascaux cave painting/via Wikipedia

That’s an excerpt from “He Told Me a Dream of Animals Leaving His Heart,” this month’s Viewpoint essay by Mary Smith, a nurse practitioner and PhD student who writes of caring for a traditional healer as a community health nurse working in a First Nation community in an isolated northern area in Canada.

Smith discusses the many roles storytelling can play: it’s a way to inspire nursing students and explore ethical issues, a source of knowledge about patients and communities, a way to bridge cultural differences, and much more. The piece is direct, short, and written with clarity and insight. Give it a read and see if it gets you thinking or speaks to your own experience.—Jacob Molyneux, senior editor

Jacob Molyneux, senior editor/blog editor2017-05-27T10:30:57-04:00December 5th, 2014|Nursing, patient experience|2 Comments

Patient Safety, Patient Advocacy: In Pediatric Nursing, A Tricky Balance

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

CT Scan ink and watercolor on paper 2014 by jparadisi

I was precepting a new nurse. She’d earned a job in our PICU during her student clinical rotation. New grads weren’t routinely hired, but her competency led to her recruitment. Precepting her was a joy.

This particular shift, we were assigned one of those midafternoon admissions with the potential to keep us overtime: rule out meningitis. The preschool-aged patient had been brought to the ED after having a first-time seizure. When he reached the PICU, however, we were relieved that he presented more like a febrile seizure.

Besides a fever and runny nose, the only other remarkable characteristic about the child was his utterly charming personality. We drew his labs while starting an IV. An antibiotic infusion was started, and acetaminophen administered. Feeling better, and not the least postictal, he played with our stethoscopes.

This was many years ago. There were standards in place that accompanied certain diagnoses. ‘Rule out meningitis’ came with a CAT scan and lumbar puncture.

Both seemed excessive, given the child’s presentation, but there was the order for CAT scan. He sat upright in his crib singing, as […]

Julianna Paradisi, RN, OCN2016-11-21T13:03:24-05:00December 3rd, 2014|career, Nursing, nursing perspective, Patients|3 Comments

Widespread Support for Nurse’s Refusal to Force-Feed: Grounded in Ethical Principles

By Maureen Shawn Kennedy, AJN editor-in-chief

Nasal tubes, gravity feeding bags, liquid nutrient Ensure used in Guantanamo force-feeding/Wikimedia Commons

Last week, reports hit the news media of a nurse in the U.S. Navy facing possible discharge for refusing to participate in force-feeding a hunger-striking prisoner at Guantanamo Bay. An early discharge, two years shy of the 20-year mark, could cost him his pension and other benefits.

The nurse had initially volunteered for duty at the Guantanamo facility, but then, as we noted in a blog post examining the ethics of his decision back in July, decided he could not continue to participate in force-feeding detainees in violation of professional ethics.

In a letter to Chuck Hagel, U.S. secretary of defense, the American Nurses Association has supported the decision of the naval nurse. ANA president Pam Cipriano reaffirms that a nurse’s primary commitment is to the patient and “in addition, this commitment is present regardless of the setting in which nursing care is provided. The military setting does not change the nurse’s ethical commitments or standards.” […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-11-21T13:03:29-05:00November 24th, 2014|career, Ethics, Nursing, nursing perspective, Patients|2 Comments

A Nurse’s Legal Duty to Discern Potential Harm and Protect Patients

Illustration by Janet Hamlin for AJN.

By Jacob Molyneux, AJN senior editor

The November installment of AJN’s Legal Clinic column by nurse and attorney Edie Brous, “Lessons Learned from Litigation: The Nurse’s Duty to Protect,” describes a case in which nurses were held responsible for not adequately protecting a sedated patient from a sexually predatory physician. The case description begins this way:

NX was a young woman who underwent a laser ablation of genital warts at Cabrini Medical Center in New York City. While still under the effects of general anesthesia, she was transferred to a small, four-bed section of the recovery room. Shortly after her admission to the recovery room, the nurses admitted another patient to a bed two feet away from NX. The curtains were not drawn and there were no patients in the other two beds.

A male surgical resident, Andrea Favara, entered the recovery room wearing Cabrini scrubs and Cabrini identification. Residents were not directly assigned to the recovery room and were seldom called there. The nurses knew all of NX’s physicians but did not know Favara; he wasn’t one of NX’s physicians . . .

The details that follow are disturbing. After describing the case and the failure of nurses to confront this unknown physician or actively monitor his […]

Jacob Molyneux, senior editor/blog editor2017-06-22T18:59:56-04:00November 7th, 2014|career, nursing perspective, Patients|0 Comments

Nurses, Brittany Maynard, Methods of Hastening Dying: No Easy Options

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

Last weekend, 29-year-old Brittany Maynard died, in her bed, in her bedroom, with her husband and immediate family beside her. I learned of her death on Twitter, along with millions of other readers. Several weeks earlier, Maynard had publicly announced, in a YouTube video, the way she planned to end her own life: using a lethal dose of medications prescribed to her for that purpose.

Maynard, while a compelling public advocate, is not the first to choose to die this way. Compassion and Choices, the organization that worked with Maynard to publicize her choice, lobbies for the drafting and passage of “death with dignity” laws, which currently exist in some form only in Oregon, Washington, Vermont, New Mexico, and Montana. ~~Arizona~~.

In Oregon, where Maynard moved in order to be able to legally end her life before she was incapacitated by the effects of terminal brain cancer, approximately 71 other people made the same choice in 2013, the most recent year of reported data—the peak of a gradual increase from the law’s inaugural year of 1998, when 16 people did so.