Unit Consciousness, the Unseen Hands of Nursing, and the Environment of Care

One afternoon, in the first few years of my practice in the operating room, a spine surgeon asked me to tidy up the room in the middle of a major case.

Some spine surgeries require two or more stages. In this case, after the implantation of vertebral spacers, the patient would be repositioned from a side-lying position to a prone position so that decompression and posterior hardware implantation could be completed. The transition requires a great deal of work. Drapes come down, dressings are applied, and an anesthetized patient must be carefully moved. Many hands are needed and much care must be taken.

All of this work takes place in the aftermath of surgery. Anyone who has seen an operating room at the end of a procedure understands the challenge. There may be spills and splashes, wires, dropped instruments, packaging, and equipment arranged for the demands of the first stage of the case.

When the second surgery was underway, the surgeon asked me, as the circulator in charge of the room, to get the OR put back together.

Becoming aware of the environment of care.

At the time, I did not fully understand why he cared about this. But he understood something that I did not.

In those early years, […]

2026-10-06T09:38:36-04:00October 6th, 2026|Nursing, patient experience, patient safety|0 Comments
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A Nurse Practitioner’s Lesson in Grace

Photo by Katie Moum on Unsplash

It looked as though I had life figured out. I was working my dream job as a nurse practitioner in primary care. I had completed the treatments for thyroid cancer, finished my DNP degree, and was starting a postdoctoral fellowship. Life was great, and I was excited to build my career. I had no idea the challenges I was about to face.

An unexpected shift in personality.

I have always been a laid-back, quirky person. When I was not working, you could find me sewing and crafting. I am even-tempered and not easily angered. Then my usual calm demeanor began to change; I started getting annoyed and angry about things that normally wouldn’t have bothered me. My thoughts became a loop of negative commentary: “You are not good enough,” “You don’t belong,” “Nobody really likes you,” “Everything would be better without you.”

Slowly, I started feeling physically unwell. I was tired, and not a normal tired; no amount of rest would alleviate the fatigue. It became difficult to drag myself out of bed each morning. My body felt sore and stiff, and every muscle ached. I was constantly freezing, even in the summer heat. I had a nagging, throbbing headache, and […]

2026-07-27T10:15:19-04:00July 27th, 2026|Nursing, patient experience|0 Comments
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What ‘Stronger Than Chemo’ Means

During a safety huddle, one of my colleagues, an oncology nurse and breast cancer survivor, spoke honestly about what cancer felt like to her. “Every day you’re scared. Is the treatment or the cancer going to kill me?” she said. “You think about it all the time.” Her words struck me because of how open and exposed they felt. There was nothing polished or inspirational about them. Just honesty.

woman looking at spacious landscapeFor oncology nurses, a day at work may feel like another clinic day, another infusion, another patient assignment. But patients walk into the same space carrying entirely different realities. Fear. Grief. Uncertainty. Hope. Devastating news. Relief. Sometimes all at once. Her words reminded me how important it is to respect that difference and remain mindful of it.

I remember entering a patient’s room smiling ear to ear. She asked me why I was so happy. Without thinking, I answered, “It’s a good day.” Looking back, that response feels insensitive. I later learned that earlier that day she had been told her cancer was metastatic. Shortly after I left the room, I heard her sobbing behind the curtain. That moment stayed with me because what felt like an ordinary good day to me was one […]

2026-06-15T09:57:20-04:00June 15th, 2026|Nursing, nursing perspective, Oncology nursing, patient experience, Patients|1 Comment
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Fatigue in the Infusion Chair: Making Our Teaching Count

Cancer-related fatigue: not ordinary tiredness.

Image via Shutterstock

“I’m just really tired.”

She says it quietly, almost apologetically, while I’m flushing her port. If I’m not careful, I could nod and say, “That’s common,” and move on. But over time, I’ve learned that when a patient says “tired,” they’re often describing something much bigger.

Cancer-related fatigue isn’t the kind of tired that comes after a long day. It’s not fixed by a good night’s sleep. It’s the kind that makes someone say, “If I shower, I have to rest before I can get dressed,” or “If I cook dinner, that’s it for the day.”

In the infusion chair, fatigue is everywhere. During chemotherapy and radiation, most patients experience it at some point. For some, it lingers long after treatment ends. And when fatigue begins to interfere with daily life—cooking, driving, bathing, managing medications—it quietly erodes independence.

Talking to patients about fatigue.

But fatigue conversations are easy to rush. We have vitals to check, labs to review, medications to hang. It’s tempting to treat fatigue as expected background noise. I’ve found that the difference between a rushed fatigue conversation and a meaningful one often comes down to slowing down by just a minute.

Instead of asking only, “How tired are you?” I try to […]

2026-03-04T14:07:41-05:00March 4th, 2026|Nursing, Oncology nursing, patient experience, Patients|2 Comments
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Some Gentle Reminders for Ensuring Appropriate Language Interpretation for Patients

Photo by Ling App on Unsplash

When I began nursing school, I never could have imagined how quickly I would be thrust into the heart of health care, quite literally. During my first semester, I started clinical rotations on a cardiovascular unit, where I began to understand the phenomenal intricacies of the human heart. It was a time of discovery, as I learned to navigate the complexities of blood pressure readings, mean arterial pressures (MAP), electrocardiograms (ECGs), cardiac catheterizations, and even the life-changing left ventricular assistive devices (LVADs).

By the time I began my second semester, I found myself in a cardiovascular surgical intermediate care unit, a place that would push me further into the depths of cardiac care. There, under the watchful eye of my clinical preceptor, I had the responsibility of caring for patients who had undergone some of the most intricate and high-stakes procedures imaginable. It was during this semester that I encountered a powerful lesson that has stayed with me long after graduation and well into my early years as a registered nurse.

A lesson in why clear communication really matters.

A Spanish-speaking Hispanic woman with coronary artery disease was admitted to our cardiac unit. Her electronic medical record noted Spanish […]

2025-08-11T14:15:43-04:00August 11th, 2025|family, family experience, Nursing, patient engagement, patient experience, patient safety|0 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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