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

Family Pet Visitation: A Nurse-Led Project at One Illinois Hospital

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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:

[…]

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 […]

2016-11-21T13:06:17-05:00October 14th, 2013|patient engagement|1 Comment

My Supporting Role

In nursing as in acting, connecting is key.

The Actor, by Picasso/Wikimedia Commons

When I graduated from nursing school, I was given a pen, stethoscope, tape, and scissors. In my current practice as a pediatric nurse in acute care, I’ve found that it’s all too easy to let technology with all its conveniences and safety measures take center stage. I have a bedside computer, cell phone, and cardiac monitor, among many other technical tools.

Yet the importance of creating a therapeutic milieu for patients and families has remained unchanged. Now the challenge I have is how best to use technology as a prop and a backdrop and not as the main event, how to prevent data collection from creating a barrier between me and my patient.

Of course technology has many advantages. In the past, I had to spend long stretches of time away from the bedside, creating written medications sheets and care plans. I remember spending hours looking up each medication dose and side effects in reference books. Transcribing written doctor’s orders and medication information was an art form. Now we obtain the most current doctor’s order and medication information in seconds with a click of a button.

Making technology an asset, not an obstacle.

While these conveniences have given me more […]

House of Death, House of Life: Reflections of a Hospice Volunteer

Perhaps the fundamental requirement for hospice volunteers is an open mind. Assumptions and first impressions rarely predict reality. I met a soft-spoken woman who was once a nun, then later became a theme park belly dancer. I met an ex-Marine officer and small-town police chief, a self-described “soldier by nature,” who denounced all wars after 1945 as senseless bloodbaths. I met a former civil rights activist upset that minorities were moving into his neighborhood.

lllustration by McClain Moore. All rights reserved. lllustration by McClain Moore. All rights reserved.

That’s from the August Reflections essay in AJN, “House of Death, House of Life.” The author, Ezra Ochshorn, explores the moments of tragedy and levity he encounters in his work as a hospice volunteer, the powerful impression made on him by people who are either at peace or full of “bitterness and regrets” as they approach death, his realization that his most important task is to be in the “here and now” with each person—and then to do his best to take this lesson back into his own life.

But why not read the entire short essay, since it’s free? Just click the link above.—JM, senior editor

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