Long-Distance Coaching

Patrice Gopo is a writer living in North Carolina.

The author Patrice Gopo

Moments ago I’d been crouching on my bed, but now I lay wrapped in a thick duvet. My panting began to slow to a normal cadence. Then a sharp rush. My midsection hardened, followed by intense cramping. With a swift motion, I moved from lying on the bed back to all fours.

“Find your point and focus.”

I heard my mother’s words through the speakers of the computer. My eyes locked on where the edge of the metal curtain rod met the white wall.

Around me, voices and images drifted away.

Before I gave birth to my first child, I didn’t know that between a tightening abdomen and waves of pain, Skype conversations were possible.

While I appreciated that technology could bring someone distant close, my mother wasn’t supposed to be a face on the computer. She was meant to be by my side and not in a living room 10,000 miles away. But my daughter had decided to slide down the birth canal 12 days before expected.

My mother describes herself as a practical person. “I’m a nurse. It’s in the job description,” she often says. When pregnant with her own firstborn—my older sister—her contractions began in the midst of an overnight shift in the labor and delivery unit. She completed the night’s job […]

2016-11-21T13:03:15-05:00January 9th, 2015|Nursing, nursing perspective, patient engagement, Patients|2 Comments
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New CE for Nurses: Understanding the Origins of the Obesity Epidemic

By Gaulsstin/via Wikimedia Commons By Gaulsstin/via Wikimedia Commons

One of our two December feature CE articles, “The Obesity Epidemic, Part 1: Understanding the Origins,” is about a pervasive and complex issue that nurses see the health consequences of in every practice setting:

. . . more than 35% of adults and 16% of children ages two to 18 are obese. Obesity disproportionately affects racial and ethnic minorities as well as people at lower income and educational levels, though it is prevalent among men and women in every segment of society. Obese children and adults are at risk for type 2 diabetes, cardiovascular disease, musculoskeletal dysfunction, and certain types of cancer. The Centers for Medicare and Medicaid Services estimates the annual national health care expenditure on obesity to be about $147 billion, with per capita spending on obese people averaging $1,429 more than spending on individuals of normal weight.

Knowledge about this epidemic continues to evolve. This article is part 1 of a two-part series and provides readers a concise overview of current theories about the pathophysiologic, psychological, and social factors that influence weight control. As the overview points out, ” [t]o contribute to obesity’s treatment and prevention, nurses must be conversant in a wide range of theoretical and clinical perspectives on the problem.” […]

2016-11-21T13:03:22-05:00December 10th, 2014|nursing perspective, patient engagement, Patients|0 Comments
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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.

Illustration by Denny Bond for AJN. All rights reserved.

2016-11-21T13:03:35-05:00November 5th, 2014|Nursing, nursing perspective, patient engagement|8 Comments
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Presence, Improvisation, Dark Humor: Crucial Skills of a Hospice Nurse

Illustration by Pat Kinsella for AJN. Illustration by Pat Kinsella for AJN.

Here’s the start of “Molly,” the Reflections essay in the November issue of AJN, written by hospice nurse Thom Schwarz.

Late evening, early spring, the peepers not yet trilling. I am in my car, rain streaking the windshield, reading a New Yorker essay about war writing, an ironic distraction from my visiting hospice nursing work.

This is a piece that doesn’t offer any easy answers for the facts of suffering and death. But it does posit a certain consolation in staying present, undaunted, engaged, and resourceful when faced with the power and mystery of each patient’s encounter with impending death.

All Reflections essays are free, so give it a look.—Jacob Molyneux, senior editor 

2016-11-21T13:03:36-05:00November 3rd, 2014|narratives, Nursing, nursing perspective, patient engagement|3 Comments
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Choosing Wisely: American Academy of Nursing Highlights Unnecessary Nursing Practices

The American Academy of Nursing (AAN) recently announced that it has joined the ABIM Choosing Wisely campaign with a list that focuses specifically on nursing interventions or practices that are not supported by evidence. The list is called Five Things Nurses and Patients Should Question. Here it is in short form—full explanations of the rationale for each item are available at the above link.

  1. Don’t automatically initiate continuous electronic fetal heart rate Screen Shot 2014-10-24 at 11.10.10 AMmonitoring during labor for women without risk factors; consider intermittent auscultation first.
  2. Don’t let older adults lay in bed or only get up to a chair during their hospital stay.
  3. Don’t use physical restraints with an older hospitalized patient.
  4. Don’t wake the patient for routine care unless the patient’s condition or care specifically requires it.
  5. Don’t place or maintain a urinary catheter in a patient unless there is a specific indication to do so.

The Choosing Wisely initiative encourages health care provider organizations to create their own lists of tests and procedures that may be overused, unsafe, or duplicated elsewhere. Using these lists, providers can initiate conversation with their patients to help them choose the most necessary and evidence-based care for their individual situations. The lists are not meant to be proscriptive, and also address situations where the procedures may be appropriate. […]

2016-11-21T13:03:40-05:00October 24th, 2014|health care policy, nursing perspective, nursing research, patient engagement, Patients|6 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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