Staffing and Long Shifts – Some Recent Coverage

By Shawn Kennedy, AJN editor-in-chief

by patchy patch, via flickr by patchy patch, via flickr

The March issue will soon be published and be featured on the home page of our Web site, so before the February issue is relegated to the archive section, I want to highlight two articles. Knowing that some readers of this blog may not be regular readers of AJN (I know, hard to believe), I wanted to bring them to your attention.

I don’t usually blog about my own editorials, but the February editorial (“It All Comes Back to Staffing”) has apparently resonated with many readers. I’ve received several letters and a request to reprint it from a state nursing association. (The editorial includes a portion of a poignant letter I received from a reader in response to an editorial I’d written for the December 2013 issue, “Straight Talk About Nursing,” in which I discussed missed care—that is, the nursing care that we don’t get to but is often at the heart of individualizing care.)

The February editorial ties in with a special report, “Can a Nurse Be Worked to Death?”, by Roxanne Nelson from Van Insurance, which addresses the recent death of a nurse who was killed in a car accident while driving home […]

2017-05-11T21:22:34-04:00February 24th, 2014|nursing perspective, nursing research, patient engagement, patient safety, safe staffing|2 Comments
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Questions Dementia Patients Can’t Answer

by Ann Gordon, via Flickr Photo by Ann Gordon, via Flickr

By Amy M. Collins, editor

A few weeks ago I visited my grandmother, who suffers from dementia, at her assisted living home. In her room, my family and I noticed a complicated form with instructions for residents to get their flu vaccination. Residents had to fill it out, sign it, and bring it to the person administering the vaccine on a certain date. For my grandmother, this would be impossible—she can no longer remember what day it is, when or if she has eaten, who she’s spoken to within the last five minutes, or where her room is located.

When this concern was broached with the front desk of the facility, they seemed to be adamant that she needed to have the form with her on the day of vaccination. We could, of course, help her fill it out—but since it had been given directly to my grandmother, who was to say we would have ever learned of it except by chance? And who would make sure she brought it with her on the day of vaccination?

While the facility offers assisted living, they often remark that they are not a “dementia facility.” Looking around, however, one is hard-pressed to find a resident […]

2016-11-21T13:05:26-05:00February 11th, 2014|patient engagement|14 Comments
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The Hospital as Foreign Country

Capture“A Foreign Place,” the February Reflections essay by Barbara Sosman, delves into one patient’s experience of the sometimes inscrutable, sometimes terrifying, sometimes humorous events and encounters in one small corner of a hospital.

Below are the first two paragraphs, but as always, it’s worth clicking through and reading the entire essay (the PDF version is best). This one would be particularly hard to summarize; it takes us to unexpected places.—Jacob Molyneux, senior editor

The flow of life and death in a hospital is mysterious, like the sound of a foreign language, and the mysteries that bring us here are profound. Stretched out in an unfamiliar hospital bed, I suppress realities, aware that tomorrow a scalpel will remove an enlarged node for a biopsy. The biopsy will show what I sense, a cellular chaos that threatens my life. Soon my disease will be presented like an offering. What will I do with it?

A room can become a universe and time there an infinity. This room is inhabited by women, of whom I am the youngest by decades  . . .

As always, comments are welcome.

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2016-11-21T13:05:27-05:00February 7th, 2014|nursing perspective, patient engagement, patient experience|0 Comments
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Patient Decisions: When You’re Just Not Up to Making the Call

By Karen Roush, MS, RN, FNP, clinical managing editor

Photo by the author Photo by the author

For most patients and in most clinical situations, decision making is and should be a shared process between the patient and the clinician (and often the family). But there are some cases when we, expert clinicians versed in scientific and experiential knowledge, need to make a decision for the patient—not out of some paternalistic idea of our authority or superiority, but because the patient really wants or needs us to take on that burden.

I was six months pregnant with my second child. The pregnancy had gone smoothly, which was a blessing after having delivered my first child 10 weeks premature following two weeks spent in a tertiary care center. That pregnancy had been problematic from the beginning—early bleeding, and then a hemorrhage at five months, at which time they’d diagnosed me with placenta previa. It was one of those pregnancies where you were thankful for each additional day that brought you closer to the nine-month mark.

But this time, everything was going smoothly—no bleeding or cramps, an active baby that ultrasounds confirmed was growing well . . . until one morning in February, when I started with cramps that progressed to pain and a lot of pressure. An hour later, I was in the labor and […]

2016-11-21T13:05:37-05:00January 17th, 2014|career, nursing perspective, patient engagement, patient experience|1 Comment
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The ‘Dialectic at the Heart of Healing’

Capture
By Jacob Molyneux, senior editor

Here are the opening paragraphs of the short intro I wrote for our special December edition of the Reflections column. Since the illustrations are an important part of this column’s presentation, I’d suggest clicking through to the PDF versions of the articles linked to below:

“There is a dialectic at the heart of healing that brings the care giver into the uncertain, fearful world of pain and disability and that reciprocally introduces patient and family into the equally uncertain world of therapeutic actions.” —Arthur Kleinman, The Illness Narratives: Suffering, Healing, and the Human Condition

In recent years, the role of narrative in medicine and nursing has gained (or perhaps regained?) a certain amount of respect.

Some advocates value the stories of patients and practitioners because they bring us in from the cold, reminding us of the human side of an increasingly technology-driven field. Others argue for narrative as a crucial source of knowledge about disease processes and best practices, yet another form of evidence in the constant quest to improve outcomes. Others focus on the therapeutic aspect of such writing, our deep need to make sense of encounters shaped by loss, pain, and suffering, whether witnessed or experienced.

The Reflections column has been appearing monthly, with rare gaps, since 1983, when AJN debuted this and other new columns (as well as its editorial board). […]

2016-11-21T13:05:51-05:00December 13th, 2013|nursing perspective, patient engagement, 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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