Cast Into the Shadows: COVID-19’s Power Over Non-COVID Cases

As a pediatric ICU nurse in a hospital that has not experienced an overwhelming surge of COVID-19 patients, it has taken me some time to register the ways this pandemic has affected my perspective and practice.

Non-COVID diagnoses left in the shadows.

Photo by Unjay Markiewicz/ Unsplash

I recently took care of two young patients, each with acute and unexpected conditions. One was under post-operative care after a brain tumor had been removed the day before. The other had been newly diagnosed with acute lymphoblastic leukemia. What stood out to me as I interacted with their families was that these were some of the only people I would interact with in this period who did not have COVID foregrounded in their mental and emotional space. This feeling was followed by the sobering realization that this was only because they found themselves dealing with something just as insidious, if not more so.

In both cases, the families observed confusing symptoms in their children and had to wrestle with whether or not to go to the ED in the midst of a pandemic. Only when the symptoms became so severe and concerning did these families decide they could no longer avoid the ED. Now facing an inpatient hospital […]

2020-06-02T09:32:44-04:00June 2nd, 2020|family experience, infectious diseases, Nursing, nursing stories, patient engagement, Public health|1 Comment
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‘Worth Its Weight in Gold’: The Small, Unexpected Triumphs of Nursing

“Nursing is a job that sometimes finds you investing emotionally in things you never expected to care about.”

How many times have you waxed enthusiastic at work about something that people who aren’t nurses would find weird, or even downright gross? Eyeing a patient’s Foley bag and exclaiming about how great her urine looks…praising a young man for coughing up gobs of sticky sputum….

Illustration by Pat Kinsella for AJN.

The challenge of obtaining a specimen.

In this month’s Reflections column, “Worth its Weight in Gold” (free until July 7), visiting nurse Jonathan Robb describes his efforts to obtain a urine sample for culture from an elderly woman who has minimal bladder control.

Most of us are familiar with the balancing act of obtaining a specimen under conditions that cause discomfort or embarrassment to a patient. We cajole and gently press for whatever has to be done, trying to maintain a relaxed atmosphere while hiding any urgency about completing the task that we might feel. This delicate pas de deux has the potential to be very stressful for both parties.

Robb’s sometimes comical descriptions of the contortions necessary to meet his particular challenge will ring true to nurses.

“…despite the […]

2019-06-17T10:16:20-04:00June 17th, 2019|Nursing, nursing stories, patient engagement|0 Comments
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Self-Disclosure in the Nurse-Patient Relationship

“How much of ourselves should we share with our patients?”

Illustration by Jennifer Rodgers for AJN

The ‘therapeutic use of self.’

Early nursing theorists wrote about how the “therapeutic use of self” helps us to forge close working relationships with our patients. Today we talk about authenticity, and it’s been noted that “the essence of nursing care comes from bringing our authentic selves to the nurse-patient relationship.”

We each develop a nursing “style,” weaving our own identities into the way we relate to patients and families. But where do the parts of ourselves that are very much “us” but not immediately evident to others come into the picture?

“Would a single mother hesitate to share her story of adopting a child without
a male partner? Would a widower refrain from correcting the assumption that
his spouse is still alive?. . . . I am compelled by the belief that sharing truth in either
scenario would enhance the authenticity of the relationship. Nevertheless, I remain
reluctant to correct my patients’ misperceptions of my family life.”

To disclose or not to disclose?

In this month’s Reflections column, “A Lie by Omission?“, nurse practitioner Charles Yingling takes a thoughtful look at what we choose to share with our patients, and what […]

2019-01-18T09:31:02-05:00January 18th, 2019|Nursing, nursing stories, patient engagement|0 Comments
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Low Physical Activity Among Chinese American Immigrants with Prediabetes and Type 2 Diabetes

“…compared with the general population, people who have or are at risk for type 2 diabetes are significantly less likely to engage in regular physical activity.”

On this month’s cover, group practices tai chi during snowfall in Shenyang, China. ©Photo Reuters/Stringer.

We all know that physical activity is important for maintaining health—for everyone. It’s especially important to prevent or manage prediabetes and type 2 diabetes.

AJN’s February research feature, “Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” takes a special look at the issue among Chinese American immigrants. Diabetes is the fifth leading cause of death among Asian Americans, so researchers wanted to investigate what this population’s knowledge of and barriers to physical activity might be.

Recruiting from a community health center in New York City, researchers conducted interviews with 100 foreign-born Chinese American adults having a diagnosis of prediabetes or type 2 diabete

According to the study authors:

“Chinese American immigrants with prediabetes or type 2 diabetes tend to be sedentary and are less likely to perform moderate or vigorous physical activity than the general population . . . .The findings also highlight some of the barriers to such activity and suggest a need for greater involvement […]

2018-02-07T10:30:12-05:00February 7th, 2018|exercise, Nursing, nursing research, patient engagement, personal health practices|0 Comments
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The CAPABLE Program: Supporting Aging in Place

Determining what matters to homebound elders.

Sarah Szanton

This month, AJN profiles Sarah Szanton, who created a program known as CAPABLE—Community Aging in Place, Advancing Better Living for Elders—that helps low-income seniors to remain at home with the aid of a unique home care team.

Szanton, an NP who has provided care for homebound elders, notes that “[b]eing in someone’s home gives you the opportunity to see what matters to them.”

The “person–environment fit.”

Szanton’s keen interest in the “person–environment fit” of her frail elderly patients led her to a different perspective on managing illness—one focused less on the “medical model” and more on “function and being able to do what they would like to do.”

In 2008, after the NIH requested proposals for projects to help the newly unemployed, Szanton wondered whether people with home-building skills could be paired with elders to improve their independence and quality of life. And the idea for CAPABLE began to form.

A unique home care team: nurse, occupational therapist, handyman.

CAPABLE’s home care teams are made up of a nurse, an occupational therapist, and a handyman. The patient identifies functional goals such as “to be able to stand long enough to prepare a meal,” and the team devises a plan based on these goals. […]

2017-10-13T10:10:47-04:00October 13th, 2017|Nursing, nursing perspective, patient engagement, Patients|2 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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