The Huddle: A New Mother’s Experience of Discharge Planning

By Amy M. Collins, AJN managing editor

John Martinez Pavliga/Flickr Creative Commons By John Martinez Pavliga/Flickr Creative Commons

Three months ago, I gave birth to my first child under somewhat traumatic circumstances. After a fast and furious labor onset, I was all set to be given an epidural when I was informed the baby’s heart rate had dropped dramatically and I needed to have an emergency C-section. Thankfully, everything turned out okay, and my son was born healthy.

Nurses changed shifts every 12 hours during my four-day hospital stay, and each of them provided excellent care. They spent massive amounts of time with me, helping me to get up and walk around, showing me how to expertly swaddle my baby like a burrito, and even helping me get the hang of feeding my child.

On my last day, two nurses were assigned to get me ready for my discharge. They had tons of printed information for me on postnatal care, wound care, postpartum depression, etc. I was told by one of the nurses that we were going to now have a “mother–child huddle.” She then said to the other nurse, with what I took to be a little irony in her tone, “Are you ready for the mother–child huddle?” Curious, I asked why the emphasis on the word.

“I just think the word ‘huddle’ is silly,” she said, […]

The Challenge of Bearing Witness to Patient and Family Suffering

“How do I honor this pain so that it teaches and blesses and does not destroy?”

By Jacob Molyneux, AJN senior editor

Illustration by Neil Brennan. All rights reserved. Illustration by Neil Brennan. All rights reserved.

This month’s Reflections essay (Why?) is by a pediatric chaplain. As the title indicates, it’s about the questions we all ask in the face of suffering and loss. The precipitating event for the author is the baffled, enraged cry of a father who has lost a child, and her own struggles with the impossibility of giving an acceptable answer—to the child’s parents, or to herself as a daily witness of loss and suffering.

How does a chaplain, or for that matter a nurse, witness the pain of patients and their families time and again and keep from either shutting down or being overwhelmed by the stress and emotion? As we’re often reminded, self-care matters or there’s nothing to give the next time: yoga, gardening, humor, family, cooking, whatever works for a person. Is it enough? Yes, and no, says the author. Here’s an excerpt:  […]

Surveys Aside, One Crucial Precondition for Real Patient Satisfaction

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

During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
1. Never
2. Sometimes
3. Usually
4. Always
5. I never pressed the call button

Everyone is talking about patient satisfaction these days. Purposeful rounding, responsiveness, and customer service are discussed in meetings, on blogs, and in conversations at work. An entire science has been created out of satisfaction, with whole journals devoted to patient experience and paid officers tracking scores and strategies. Since hospital reimbursement is linked to how happy patients are, we’ve suddenly gotten serious about satisfaction.

But behind the sterile questions on the HCAHPS survey, real stories about real people reside. I find myself often forgetting the flesh and blood that’s represented by each checked box, and am learning to realize that, while satisfaction is something to be striven for, dissatisfaction is something to be learned from.

In a series of posts, starting with this one, I’ll share stories of my own missteps—ones that may have caused my patients to answer never instead of always to questions about my care. The events described here helped me realize that, score or no score, responding to call bells actually matters at the human level:

Sarah […]

Nurses Aren’t Just Healers, They’re Teachers Too: A Patient’s View

Illustration by Jennifer Rodgers. All rights reserved. Illustration by Jennifer Rodgers. All rights reserved.

A teeny red bump had mysteriously appeared on my left index finger. It hurt when I pressed on it. I figured it was nothing. . . .

That’s the start of the June Reflections essay in AJN, “Ms. Lisa and Ms. MRSA,” a patient experience narrative by freelance writer Shannon Harris. As luck would have it, the bump on her finger, it turns out, is not nothing. It’s MRSA.

The diagnosis takes a while. Finally the situation worsens, and surgery is needed. The author takes it all in stride, at least in retrospect:

The third physician stood out to me most. He asked to take a picture of my green and black, staph-infected finger with his iPhone. “Sure. Look at it! I thought this only happened to pirates,” I told him as he snapped away. He glanced at the young, button-nosed nurse standing beside him. “Don’t you want a picture? For your records?” he asked.

She shook her head, squinting and gritting her teeth. “I know. Yuck,” I said. I later shared photos of my infection journey online, to the great wonder and disgust of my friends and family. Before that, though, came surgery.

The author’s tone is light, but the situation […]

AJN in June: Gastrostomy Complications, Nursing and Mindfulness, Cultural Competence, More

01AJN0615 CoverAccording to one of the authors of “Cultivating Mindfulness to Enhance Nursing Practice,” the Cultivating Quality article now available in our June issue, mindfulness can be understood as a practice centered around “remembering to pay attention with care and discernment to what is occurring in your immediate experience.” On the cover of our June issue (left), nurses at the Dana-Farber Cancer Institute in Boston practice mindfulness in a spacious garden, as part of a multifaceted program to help nurses manage stress and make the best of opportunities to more fully connect with patients and families. The article discusses the outcome of the program and how nurses in all settings can use mindfulness-based techniques to enhance their well-being and the care of patients.

Also in the June issue, a continuing education (CE) feature article, “Early Percutaneous Endoscopic Gastrostomy Tube Dislodgment,” describes the details of a case study of early percutaneous endoscopic gastrostomy tube dislodgment, attempted replacement, and subsequent sepsis that resulted in the patient’s death. This case is used to better inform nurses about gastrostomy techniques, complications, preventive strategies, and proper tube management. […]

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