Attention to Patients’ Mobility: Low-Tech But Essential

A critical care nurse led a multidisciplinary team to explore the effects of a dedicated ‘mobility team’ on functional and other outcomes in ICU patients.

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

julie kertesz/ via flickr creative common julie kertesz/ via flickr creative common

It’s long been known that immobility leads to deconditioning. Various studies indicate that muscle strength drops by 3% to 11% with each day of bed rest. As most of us have witnessed firsthand in both patients and family members, it can take months to regain pre–bed rest levels of functioning. For some people, the strength and mobility needed for independence never return.

In this month’s issue, a community hospital critical care nurse led a multidisciplinary team to explore the effects of a dedicated “mobility team” on functional and other outcomes in ICU patients. In “Implementation of an Early Mobility Program in an ICU,” Danielle Fraser and colleagues share what they learned.

The mobility team consisted of a physical therapist, a critical care RN, and an ICU rehab aide. Respiratory therapists worked closely with the team. Patients assigned to the early mobility intervention could progress through four successive levels of movement, from passive range-of-motion exercises to full ambulation.

Compared with ICU patients who received routine care, the patients in the intervention group were more functionally independent at discharge. In addition, this […]

2016-11-21T13:01:41-05:00December 7th, 2015|Nursing, nursing perspective, nursing research, patient engagement|0 Comments
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Thanksgiving in the ICU: Woven into the Tapestry of Traditions

By Marcy Phipps, BSN, RN, CCRN. Editor’s note: This post, originally published in 2011, remains as timely as ever. The author is now chief flight nurse at Global Jetcare.) 

cranberries

I’ll be working this Thanksgiving. I’ve worked so many Thanksgivings that the ICU feels woven into the tapestry of my own traditions. I don’t really mind; the cafeteria serves a fitting feast that’s embellished by the homemade treats we bring in, and although we won’t actually be watching it, the Macy’s parade will be on. Somehow, the smells and sounds I associate with the holiday will mix and mingle with the usual bustle of critical care, and it’ll feel like Thanksgiving. It’s actually a nice day to be at the hospital—for the nurses, that is.

For our patients and their families, I know hospital holidays fall far short. We have one patient, in particular, who’s been with us for a while. Her husband’s been a fixture at her side throughout her stay, and I expect to find him stationed there this Thanksgiving. Hospital turkey and television won’t give him the comfort or peace that he seeks, and I don’t know that he’ll be giving thanks. For many weeks I’ve watched him skirt a fine line between gratitude and despair; things could always be worse, but they could certainly be better.

When I stop to count my blessings, I’m overwhelmed. I belong to a profession that I’m passionate about—one that brings me great […]

2016-11-21T13:01:43-05:00November 25th, 2015|career, narratives, nursing perspective, patient engagement|2 Comments
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Imagery: A Safe, Simple Practice Available to All Nurses

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

by Ramon Peco/via Flickr by Ramon Peco/via Flickr

“In our quest to keep up with the latest medical advances, we often forget that the healing art of imagery is available to each of us,” writes nurse practitioner Laurie Kubes in this month’s AJN. In “Imagery for Self-Healing and Integrative Nursing Practice,” Kubes explores some of the evidence supporting this technique and illustrates how it can enhance both patient care and our own self-care.

Imagery builds upon the quiet reassurance and support that we routinely provide to patients in our efforts to make them comfortable and relaxed. The more deliberate practice of imagery engages the power of imagination for deeper relaxation and a potentially more healing experience. And all we need in order to do this, as Kubes notes, is an open mind, a basic knowledge of the practice, and time to dedicate to it.
[…]

2016-11-21T13:01:43-05:00November 23rd, 2015|Nursing, nursing perspective, patient engagement, Patients|1 Comment
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No Longer Alone: Nurses Supporting Family Caregivers

By Susan C. Reinhard, PhD, RN, FAAN, senior vice president and director, AARP Public Policy Institute, chief strategist, Center to Champion Nursing in America; Elaine Ryan, MPA, vice president of state advocacy and strategy integration, AARP government affairs; and Trish O’Keefe, PhD, RN, NE-BC, interim president, Morristown Medical Center, New Jersey

Teaching a daughter to help her mother with range-of-motion exercises. Teaching a daughter to help her mother with range-of-motion exercises

The public trusts nurses to care for them and to teach them how to care for themselves and for those they love. But a 2012 AARP/United Hospital Fund report funded by the John A. Hartford Foundation, Home Alone: Family Caregivers Providing Complex Chronic Care, shows there is a big disconnect. In this first nationally representative study of families providing complex care activities, almost half reported that they had provided medical/nursing treatments, including injections, wound care, administering multiple medications, managing colostomies, and giving tube feedings and nebulizer treatments—among many other tasks that nursing students find daunting when they are first learning how to do them.

Family caregivers are expected to step right in, with little to no instruction or support. Most (nearly 7 out of 10) of those they cared for did not get a home visit by a health care professional, despite multiple encounters […]

2016-11-21T13:01:47-05:00November 13th, 2015|Nursing, patient engagement, Patients, Public health|3 Comments
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Preventing Newborn Falls

Photo by Joseph Sacchetti. Photo by Joseph Sacchetti.

An acquaintance of mine once admitted to dropping her newborn baby while feeding her in the middle of the night. At the time I inwardly scoffed—how can someone be that tired, I thought judgmentally. Fast-forward to a few years later when I can now speak as a new mother—and to being that tired.

Sleep deprivation is no joke. And it doesn’t necessarily begin when the baby is born. The last few months of pregnancy and the discomfort that comes with it make for difficult sleep preceding the birth.

Many maternity units now promote “rooming in,” where a newborn baby stays in the mother’s room rather than with the nurses in the nursery. This makes newborn fall prevention an important issue. Take poor sleep in the last months of pregnancy and the physical and mental exhaustion of labor and add pain and limited mobility from the birth itself, especially a C-section birth; large rails on hospital beds making the transfer of one’s baby from bassinet to the mother’s bed difficult; and possible pain meds for mom, and the recipe could spell disaster.

In my case, with an emergency C-section and limited mobility, I found it very hard to pick my baby up from his bassinet and bring him into my hospital bed for a feeding. Luckily my husband […]

2016-11-21T13:01:48-05:00November 4th, 2015|Nursing, patient engagement|0 Comments
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