patient engagement Archives - Page 7 of 25

Psychiatric Nursing: The Seemingly Unreachable Patient

Illustration by Jennifer Rodgers for AJN

In many fields, we must keep doing the same thing over and over without any apparent results. Nurses, for example, may find that their efforts to make a patient safe, to reach a patient, to ease a patient’s suffering have little visible effect. This is just part of the work, but some patients will inevitably pose a greater personal challenge than others.

“Five Words,” the Reflections essay in the May issue of AJN, written by former psychiatric nurse Tania Renee Zayid, is about one of those patients and the feelings of hope and disappointment his nurse experiences in his presence. In it, she writes: […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:12-05:00May 23rd, 2016|narratives, Nursing, nursing perspective, patient engagement, Patients|0 Comments

A Room with A View: Physical Environments and Healing

By Betsy Todd, clinical editor, MPH, RN, CIC

Computers, alarms, automated drug dispensing, complex medical protocols—the ways in which we provide care have changed a lot over the past 30 years. Has forced multitasking made us forget that, buried beneath the printouts and data, there is a human being in need of support?

In this month’s AJN, author Joy Washburn shares the story of David, a man with advanced Parkinson’s disease whose medical condition results in his transfer from a cheerful rehab setting to a long-term care bed in the same facility. While his old room in rehab overlooked gardens and a children’s play area, the new room faces a parking lot. To make matters worse, no one seems to have prepared David for the move, and many nurses erroneously assume that his advanced physical disability means that he is also cognitively impaired. […]

Betsy Todd, MPH, RN2016-11-21T13:01:18-05:00April 13th, 2016|Nursing, nursing perspective, nursing stories, nursing students, patient engagement, Patients|1 Comment

Nursing Insights: The Experience of a Chronic Illness as a Series of Subtractions

Chronic illness is often experienced by patients as a series of subtractions. A progressive illness like Parkinson’s reveals this process vividly as the ability to move, speak, care for oneself, all gradually disappear or diminish.

The grief of lost freedom, lost abilities, lost agency, lost avenues of communication is easy to overlook. But it’s real, and can come out in uncomfortable ways. Here’s an excerpt from the start of this month’s Reflections essay in AJN, “A Room With a View.”

David was in his late 50s and had been diagnosed with Parkinson’s disease several years previously. Following a lengthy hospitalization, David’s wife agreed to a placement on the subacute/rehab unit in the facility where I was the instructor for nursing students during their older adult clinical rotation. . . . Although ravaged by the disease, David seemed to like having students provide his nursing care. . . .

One of his favorite activities was sitting by his room window, which overlooked the facility gardens and a play area for the preschool next door. For several weeks, I discovered a nursing student and David sitting by the window watching the outdoor activities in companionable […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:19-05:00April 4th, 2016|Nursing, nursing perspective, nursing stories, patient engagement|0 Comments

‘Cold Calls’: Tips for Nurses When the Patient Just Got the Bad News

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog. Illustration by the author.

It’s difficult to choose which is more difficult: That moment before dialing the number of someone I’ve never met soon after they’ve received a cancer diagnosis, or the moment standing in the doorway before entering the hospital room occupied by someone I’ve also never met soon after their cancer diagnosis.

These scenarios are the health care version of a cold call. I manage them daily.

The term cold call generally refers to marketers calling someone without prior introduction with hopes of convincing them to buy their product. In the arts community, cold calling refers to an artist walking in off the street with a portfolio in the hopes of convincing a gallery owner to exhibit their art. Rarely are either appreciated.

Most nurses involved in patient care make cold calls. Walking into the room of a patient you’ve never met is a cold call. Starting an IV on someone else’s patient or in one you’ve just met is a cold call. A cold call occurs when the unconscious patient brought to the ED opens his eyes and your face is the first thing he sees.

Lots of things about nursing are difficult. For the novice and experienced alike, walking into a patient’s room after they’ve received news they or their loved […]

Julianna Paradisi, RN, OCN2016-11-21T13:01:20-05:00March 29th, 2016|Nursing, nursing perspective, patient engagement, Patients|0 Comments

CDC Opioid-Prescribing Guideline for Chronic Pain: Concerns and Contexts

by frankieleon/ via flickr

By Jacob Molyneux, senior editor

The CDC’s new Guideline for Prescribing Opioids for Chronic Pain was released this week. The context for this comprehensive new guideline is widespread concern about opioid-related overdose deaths and substance abuse in the U.S.

The guidelines make 12 main recommendations, among them the following:

nonpharmacologic or nonopioid pharmacologic treatments should be considered “preferable” first-line therapy for those with chronic pain.
a daily opioid dosage limit of morphine milligram equivalents should be imposed.
immediate-release opioids should be prescribed before moving to extended-release formulations.
urine testing should precede new opioid prescriptions for chronic pain and treatment goals should be set.
clinicians should prescribe the lowest possible number of days’ worth of medication for acute pain (often three days or less).
prescription drug monitoring program (PDMP) databases should be consulted to determine patients’ past histories of opioid prescriptions.

Some of the recommendations would seem to be no-brainers, such as consulting PDMPs when writing new prescriptions. Others, such as a “one-size-fits-all” daily dosage limit and restrictions on the use of extended release formulations, have raised alarms among pain management experts. See, for example, “I’m Worried About People in Pain,” a recent AJN Viewpoint essay by Carol Curtiss, a nurse and pain management expert, who notes the increased stigmatization experienced by pain patients and the chilling effects of […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:23-05:00March 17th, 2016|Ethics, Nursing, nursing perspective, pain management, patient engagement|4 Comments