Bearing Witness: April’s ‘Art of Nursing’ and Cover Art

By Sylvia Foley, AJN senior editor

In “Palm Sunday,” the poem featured in this month’s Art of Nursing, nurse and poet Rachel Betesh evokes the prolonged anguish of those who tend the dying. A man lies “sick and stained” in a bed, leaves his food untouched, and “hardly speaks anymore.” His wife and sons lament “the sin of the too-long moment”; time does not heal, but gapes like an “open wound between sickness and dying.”

A lesser poem might have slipped into sentimentality. But Betesh’s characters are a lively, indomitable bunch. “Pop!” the man’s sons say, visiting; you can feel their vigor. His wife remembers a baked potato he’d once given her, and her response: “You gonna marry me or what?” Indeed, it’s through witnessing, hearing the family’s stories, that the nurses can offer some comfort. They cannot heal the man, but they can “pack the wound, and listen.” (Art of Nursing is always free online—just click through to the PDF file.)

This month’s cover art, a work of embroidery by nurse and fiber artist Paula Giovanini-Morris, explores the concept of memory and illustrates its mechanisms, the neurons and synapses through which the brain registers, encodes, and retrieves events. The piece, titled “Windows and Doors,” was prompted by another kind of witnessing: the artist’s visits to her mother, who was suffering from the early stages of dementia.

AJN senior editorial coordinator Alison Bulman spoke with […]

You Mean You Want to Talk? A Patient’s Perspective on Speed Psychiatry

With over 2 million U.S. adults living with panic disorder, and twice as many women as men suffering from it, health care providers should ensure they give patients all available options for treatment. Medication may work for some, but there are alternatives. I know because, despite what my psychiatrist said, I did get better.

Alone, Isolated, At Risk


By Shawn Kennedy, AJN editor-in-chief

I saw the following headline this week: “LA woman dies in her cubicle at work; body is not discovered until the following day.” The article said it was unclear how she had died. I hope it was at the end of the day after everyone had left; I really hope they don’t find out that she died midday, amidst coworkers who were going about their business. Maybe they were so busy that they never noticed the silence from her cubicle.

This story reminded me of two articles I read recently. One was an article that will be published in the Emerging Infections department in our March issue, which goes live at the end of next week on ajnonline.com. “The Contact Precautions Controversy” examines the issues around placing patients on contact precautions and in isolation—an approach that many hospitals use almost routinely for some patients. (We covered this issue in a news piece last July as well.) Recent studies are raising questions about this practice and the risks to these patients, who often have fewer interactions, get less care, and may feel neglected because health care providers limit contact.

The other article is one that’s in the headlines now.  The Boston Globe ran a story […]

The Puzzle of Snowflakes: Treatments May Be Uniform, But Patients Are Not

Julianna Paradisi blogs at JParadisi RN; her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” is upcoming in the February issue.

My patient sits in a chair, watching a DVD presentation about caring for his new, surgically inserted, tunneled catheter. In a few weeks, this catheter will be used for his stem cell transplant. I am teaching him how to flush it and change the dressing. He’s from out in the sticks, too far away from the clinic for our nursing staff to provide the care for him. He doesn’t have family or friends for support. After the DVD, I bring out a chest manikin and dressing kit to demonstrate the sterile dressing change. As I explain the technique of donning sterile gloves, he stops me with a challenging glare.

“I can’t do sterile.”

I stop what I’m doing to explain the dangers of infection if the dressing isn’t sterile. Like a car stuck in a snowdrift, he remains unbudged. “I can’t do sterile,” he insists. I puzzle over what to say next. My coworkers flurry by in their white lab coats. I’m wearing a white lab coat, too. My patient is lost in a health care blizzard. He doesn’t see snowflakes. He only sees snow.

‘The Birthplace’: Showcasing a Collaborative Practice Model

By Sylvia Foley, AJN senior editor

Photojournalist Alice E. Proujansky reports in AJN this month on The Birthplace, a collaborative care practice model at Baystate Franklin Medical Center in Greenfield, Massachusetts, where a team of five nurse midwives, three obstetricians, and 35 nurses attend some 400 to 500 births annually. Except for preterm and other higher-risk deliveries, the nurse midwives manage all deliveries and monitor fetal and maternal health. Patients complete detailed birth plans that afford them various care options. Physicians are called in only when necessary; as one nurse midwife told the author, “There’s an awful lot that we can do on our own.”

How well does the model work? The Birthplace has lower-than-usual rates of medical interventions such as episiotomy, epidoral anesthesia, and cesarean section. The patients have greater autonomy and decision-making capabilities. And the practitioners “relish the collaborative approach,” says Proujansky, who interviewed several clinicians and patients for the article; her photographs appear alongside the text and on the December cover. Proujansky’s last piece for AJN, a photo essay on a Dominican maternity ward, appeared in our December 2008 issue; read it here.


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2016-11-21T13:14:38-05:00December 21st, 2010|Nursing, patient engagement|0 Comments
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