Acknowledging Nightingale’s Pervasive Influence on Medicine as We Know It

By Jacob Molyneux, senior editor

Florence Nightingale in Crimean War, from Wikipedia Commons Florence Nightingale in Crimean War, from Wikipedia Commons

There’s a very good article about Florence Nightingale in the New York Times right now (“Florence Nightingale’s Wisdom”)—and it’s by a physician.

The author, Victoria Sweet, writes that Nightingale was the last person she wanted to know about or identify with when she was in medical school. Then she gradually began to realize Nightingale’s extraordinary influence on modern medicine as it’s now practiced. As Sweet point out,

So much of what she fought for we take for granted today — our beautiful hospitals, the honored nursing profession, data-driven research.

It’s a good piece, and though you may already know some of what it covers, it’s well worth reading. For those who want to learn more about Nightingale, let me point out a series of short posts we ran back in the summer of 2010 on this blog. In Florence’s Footsteps: Notes from a Journey, written by Susan Hassmiller, senior advisor for nursing at the Robert Wood Johnson Foundation, detailed the stages of a trip she took that summer as she retraced Nightingale’s steps through England and all the way to the Crimea, all the while contemplating her legacy.

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2016-11-21T13:05:17-05:00March 4th, 2014|career, nursing history, nursing perspective|3 Comments
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NPR Syndrome

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

calligraphy, 36" x 24," mixed media on vellum, 2007, by julianna paradisi calligraphy, 36″ x 24,” mixed media on vellum, 2007, by julianna paradisi

Compassion fatigue is a syndrome commonly known to nurses and other professionals involved in patient care. It is the result of constant exposure to traumatic events occurring to others. Its effects on the psyche of nurses are widely studied, recognized as a factor in burnout and self-medication, and sometimes result in nurses leaving the profession.

My clinical practicum as a nursing student, nearly 30 years ago, was in oncology. There I saw patients succumb to cancer. Many were young adults. One left behind a grieving husband, and an infant. It was heartbreaking. I asked my preceptor, a skilled, compassionate, and uncannily jolly nurse, how did she avoid burnout? I did not know about compassion fatigue yet.

She wisely replied, “You need to develop a happy, fulfilling personal life outside of nursing. You have to shut it off when you leave the hospital.” It was good advice.

I took it to heart, and over the years developed a happy, fulfilling personal life. However, turning it off when leaving the […]

2016-11-21T13:05:21-05:00February 21st, 2014|career, nursing perspective|8 Comments
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A Physician Finally Gets Nursing

RelmanArticleCaptureBy Shawn Kennedy, editor-in-chief

Earlier this month, the New York Review of Books published an article by a patient who described his hospital stay following a life-threatening accident. This was no ordinary patient—the author, Arnold Relman, is a noted physician, emeritus professor of medicine at Harvard, a former editor of the New England Journal of Medicine, and along with his wife Marcia Angell, well known as a critic of the “medical–industrial complex.” His account is very detailed and gives a good example of how it can look when the system works (and when one has access to it).

His understanding of his condition and treatment, his knowledge of the system, and also his relative prominence as an individual, all undoubtedly helped him avoid some pitfalls and make a remarkable full recovery. However, as a number of others have pointed out recently, one comment in his account was surprising.

In reflecting on his hospitalization and recovery, he wrote, “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.” After all his years in medicine, he only realized the value of nursing as a 90-year-old trauma patient.

This week, Lawrence Altman, another physician and author, wrote an excellent

2016-11-21T13:05:23-05:00February 14th, 2014|career, nursing perspective, patient safety|13 Comments
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Not Compatible With Nursing

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN.

photo 1-1 Photo by the author

“His family knows this is not a survivable injury, right?”

This question, posed to me in the doorway of my patient’s room by a trauma surgeon I regard as brilliant, caught me off guard.

“No,” I said. “They don’t know that.”

He frowned at me, mumbled something about false hopes, then moved away to continue his rounds.

This wasn’t the only physician who’d expressed a strong opinion regarding my patient’s mortality—a consultant had deemed his injuries “not compatible with life.” But I’d been caring for this man, as a 1:1 assignment because of his high acuity, for every shift for weeks. It seemed obvious to me that my patient’s continued presence in the ICU—and his relative stability on that particular day—directly opposed the dire predictions. The man’s family did not see his situation as hopeless, and neither did I.

And yet days after the surgeon uttered those words, my patient suffered a complication and became so unstable that for hours he teetered between life and death. The resuscitation effort was massive—and no one mentioned survivability. No one behaved like there was even a shred of futility in bringing to […]

2016-11-21T13:05:28-05:00February 5th, 2014|career, nursing perspective|5 Comments
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Voice of Dissension: When Nurse Teamwork and Patient Safety Diverge

ParadisiIllustrationDissension Dissension (from the series Pareidolia), charcoal & graphite on paper, 12″ x 9,”
2012 by Julianna Paradisi

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.

The term “voice” gets thrown around a lot these days, usually in reference to creative content. Visual artists, writers, musicians, and actors rise to their unique place in the art world on the originality of their voice, not merely for mastery and talent.

In nursing, voice is important too. Hospitals spend a small fortune in paid staff hours for team-building meetings or retreats for nurses to smooth the rough edges of staff members, reducing friction among unit nurses with the ultimate goals of nurse retention and improved patient care. While these are admirable goals, I’m beginning to wonder if too much emphasis on team building may also diminish a nurse’s unique voice, thereby inadvertently interfering with patient safety? A team is only as strong as its individual members. […]

2016-11-21T13:05:33-05:00January 29th, 2014|career, nursing perspective, patient safety|4 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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