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 […]

2020-02-07T11:15:00-05:00September 16th, 2013|digital health, nursing perspective, patient engagement, Patients|3 Comments
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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

2016-11-21T13:06:47-05:00August 9th, 2013|patient engagement|1 Comment
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Obesity as Disease and the Health Care Culture’s Take on Personal Responsibility and Suffering

Doug OlsenBy Doug Olsen, PhD, RN, associate professor, Michigan State University College of Nursing, and AJN contributing editor. Olsen regularly addresses topics related to nursing ethics. His most recent article for AJN was “Helping Patients Who Don’t Help Themselves” (July issue; free until August 15).

Why does the American Medical Association’s recognition of obesity as a disease (AMA, 2013) stir strong feelings? People are just as heavy as before, their health is suffering as much, and the therapies for obesity remain the same. The main difference is that the label may give clinicians a better rationale to seek reimbursement for obesity-related services, which might help increase treatment rates. No one yet knows if the new label will really have an effect on treatment rates; in any case, this is not what people are concerned about.

The issue is what labeling a health problem with a behavioral component as a “disease” implies about personal responsibility—or what people think it means. How does personal responsibility relate to individual suffering?

The relationship between decision making, suffering, and personal responsibility is at the heart of bioethics as it is practiced in the United States. But bioethics didn’t invent our cultural tendency to connect personal responsibility and sympathetic regard for suffering, and our current approach to the issue was developed […]

2017-04-03T12:12:36-04:00July 11th, 2013|Ethics, patient engagement, Public health|0 Comments
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‘Patient Activation’: Real Paradigm Shift or Updated Jargon?

By Jacob Molyneux, AJN senior editor

I attended a Health Affairs briefing yesterday in Washington, DC. Based on the February issue of the journal, it was called “A New Era of Patient Engagement.” A lot of research money appears to have been flowing to this area in recent years.

Our January article on "Navigating the PSA Screening Dilemma" includes a discussion of 'shared decision making' Our January article on “Navigating the PSA Screening Dilemma” includes a discussion of ‘shared decision making’

The basic idea isn’t entirely new to anyone who’s been hearing the term “patient-centered care” for a long time: as Susan Dentzer writes in “Rx for the ‘Blockbuster Drug’ of Patient Engagement,” a useful article summarizing the main ideas raised in the Health Affairs issue: “Wherever engagement takes place, the emerging evidence is that patients who are actively involved in their health and health care achieve better health outcomes, and have lower health costs, than those who aren’t.”

One might add to these projected benefits: better experiences as patients.

Something’s got to change, so why not this? If many nurses feel they’ve heard all this before, the sense of a health care system in necessary […]

2016-11-21T13:08:20-05:00February 7th, 2013|nursing perspective, patient engagement, Patients, personal health practices|1 Comment
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Like ‘Being in Jail in a Way’: A Study Investigates How Anorexic Adolescents and Their Nurses View Inpatient Treatment

By Sylvia Foley, AJN senior editor

Bar the View by HereStanding, via Flickr

For adolescents with severe anorexia, experts have long relied on treatment in specialized pediatric acute care settings, using programs that are based on behavior modification principles and that promote stability through refeeding.

But what is it like to be a young inpatient in such a program? And how does the behavior modification approach affect the nurse–patient relationship? To learn more, nurse researcher Lucie Michelle Ramjan and colleague Betty I. Gill conducted a study in an Australian acute care facility. Their findings are reported in this month’s CE: Original Research feature, “An Inpatient Program for Adolescents with Anorexia Experienced as a Metaphoric Prison.”

The research. Ramjan, the study’s principal investigator, conducted in-depth, face-to-face interviews with 10 adolescent patients being treated for anorexia and 10 pediatric nurses. The interviews were audiotaped; the tapes were then transcribed verbatim, read and reread, and subjected to thematic analysis. As another writer has noted elsewhere, in qualitative research, metaphors often “illuminate the meanings of experiences.” In this study, the researchers found that both nurses and patients “consistently used the metaphor of prison life to articulate their experiences.”

That striking metaphor offered Ramjan and Gill a framework for […]

2016-11-21T13:09:31-05:00August 6th, 2012|nursing research, patient engagement|3 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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