When There’s a Disconnect Between Good Nursing Practice and Reality

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

shawnkennedyThis is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

2016-11-21T13:05:54-05:00December 6th, 2013|career, nursing perspective, patient engagement|15 Comments
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Family Pet Visitation: A Nurse-Led Project at One Illinois Hospital

AJN1213.Cover.Online

We hear a lot about therapy dogs that are specially trained to visit patients in the hospital. But I for one would want to see not just any dog but my own dog, if I were gravely ill and in the hospital. I know I’m not alone, and some nurses set out to determine the pros and cons of making pet visits happen for some patients in their hospital. What safety concerns might there be? According to the current available research, what benefits might patients experience? What protocols would be necessary if it were to happen?

Nurses from Memorial Hospital in Belleville, Illinois, set out to answer these questions and bring such a program to life. They give the details in “Family Pet Visitation,” a feature article in the December issue of AJN (free for a month), along with some moving photos of patients and their pets. Here’s a quote from the start:

[…]

2016-11-21T13:05:55-05:00December 4th, 2013|nursing perspective, nursing research, patient engagement|1 Comment
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Measuring Dyspnea Upon Unit Admission: Is It Feasible?

Do You Ask Your Patients about Dyspnea?

Photo by Thomas Northcut. Photo by Thomas Northcut.

As a CE article this month, we feature a report of a pilot study on routine assessment of dyspnea on admission to a patient unit. It’s routine to take vital signs on all patients on admission, but really, how many nurses actually stand there and count respirations for all patients? And even if you are the exceptional nurse who does, that doesn’t necessarily tell you if the patient actually feels any shortness of breath. And then, of course, there’s the issue of whether it’s a good idea to add to the burden of documentation that many nurses are already concerned about.

This article reports on one group’s experience piloting a short dyspnea assessment tool for all admissions on several units. Here’s the abstract:

The assessment of dyspnea, like that of pain, depends on patient self-report. Expert consensus panels have called for dyspnea to be measured quantitatively and documented on a routine basis, as is the practice with pain. But little information is available on how to measure and record dyspnea ratings systematically. Consequently, the prevalence of dyspnea in hospital settings may be greater than is generally recognized, and dyspnea may be insufficiently managed. This article describes a pilot study that sought to test the feasibility of measuring dyspnea as part of the initial patient assessment performed by […]

2016-11-21T13:06:08-05:00November 4th, 2013|nursing perspective, nursing research, Patients|0 Comments
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A Patient’s Take on Patient Satisfaction Surveys

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By Amy M. Collins, editor

As an editor at AJN, I come across a lot of information on performance measures and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. It’s a hot topic that we’ve covered several times, with some health care providers railing against these surveys and questioning whether satisfaction during a hospital stay is the same as quality care (see the September Editorial and the July 2012 Viewpoint for more on this).

Yet as usual, reading about a topic isn’t entirely the same as experiencing it. A few days after undergoing a small, non-emergency, in-office medical procedure, I was surprised to find a patient satisfaction survey in my e-mail inbox. Busy and flooded with many other e-mails, I was tempted to banish the survey to the trash can, especially since I didn’t feel I had much to say. But curiosity got the better of me.

The survey started off easily enough, as I clicked through questions such as “Was your waiting room time under 15 minutes?”; “Were the receptionists polite?”; “Was our facility clean?”

But as the survey crept forward, I began to feel overwhelmed by the sheer number of questions. Many questions seemed redundant; for example, I answered about five related to waiting times. Are they trying to catch patients out on inconsistent answers? All the while a green bar at the top showing […]

2016-11-21T13:06:17-05:00October 14th, 2013|patient engagement|1 Comment
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They’re Not Taking Away Our Puppies (And God Help Them If They Do)

By Jacob Molyneux, AJN senior editor/blog editor

I am amazed at the amount of time being wasted on the relatively mundane matter of health care exchanges. It seems we are now facing a government shutdown; there are creepy and misleading advertisements funded by conservative billionaires like the Koch brothers in order to scare people from signing up for insurance; some red states have actually enacted laws forbidding the health care navigators from helping people understand the new system and sign up for it, and many of these states have refused to create their own exchanges to help their citizens comply with the new law.

The ACA is a law. You can’t just ignore it if it doesn’t meet your personal preferences or political ideas. Given the heated rhetoric the Republicans are trotting out about it, you’d think the government was trying to take away our puppies, instead of implementing ideas originally floated by Republicans themselves to make life a bit easier for millions of Americans whose life decisions are unduly ruled by crazy health care billing practices, byzantine insurance regulations, discrimination against those who have chronic conditions, insanely varying pricing for simple tests, and the like. […]

2016-11-21T13:06:26-05:00September 30th, 2013|health care policy, Patients|9 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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