Mild Cognitive Decline or Physical Limitations: What’s a Nurse to Do?

Noticing small changes in what’s possible.

I worked for many years in infection prevention and control, and loved it. Still do. But I loved bedside work too, and it was always in the back of my mind that I might one day return to staff work. That is, until I took care of a family member during the last year of his life.

While I think I provided him with reasonably good care—let’s not get into the emotional connection that made me a less objective caregiver than were his fantastic CNAs—there was no fooling myself any longer. After years away from the bedside, my assessment skills have slipped. I’m not used to working while wearing glasses (without which I can’t read labels or check for reddened skin or cloudy urine). And arthritis in my wrists meant that those bed-to-walker transfers were not optimally safe.

What about multitasking, 12-hour shifts?

My difficulty in providing physical care made me wonder whether my cognitive skills, too, might not be up to managing the pace and pressure of floor work today. I may still be good at supporting and teaching, but can I multitask through 12 hours of nonstop problem-solving and decision-making?

In “When Is It Time to Leave Nursing?” in this month’s AJN, nurse Janet […]

2019-05-21T12:18:44-04:00May 21st, 2019|career, Nursing|0 Comments

Can You ‘Stop the Bleed’?

Reconsidering tourniquets.

Bystanders apply pressure to woman’s leg to stop bleeding after explosion at 117th Boston Marathon. Photo by John Tlumacki / Boston Globe via Getty Images.

Have you ever used a windlass tourniquet? I had never even heard of one until recently. The only tourniquets I knew were fashioned from belts, scarves, or neckties, and we were always admonished to use these sparingly, because it was thought that they could cause severe damage to a limb.

In “Leading the Effort to Promote Bleeding Control in Our Communities” in this month’s AJN, James Reed and Margaret Carman dispel myths about tourniquets and share the growing evidence for their safety.

They also introduce us to the Stop the Bleed campaign. Hemorrhage is the second-leading cause of death (head injury, the first) after a traumatic injury, and when an extremity is the source of bleeding, rapid tourniquet application saves lives.

“More than 50,000 casualties sustained in the wars in Central and Southwest Asia have provided evidence that recognizing hemorrhage and controlling it should be the highest priority in caring for […]

2019-05-16T12:15:52-04:00May 16th, 2019|Nursing, Public health|0 Comments

One in 4 Million: The Nurse Who Mentored Me

Hostility among nurses is a well-documented topic of discussion, a phenomenon studied by both academics and hospital administrators wanting to create functional teams. Perhaps the remedy for healthy nurse–coworker relationships isn’t found by studying dysfunctional relationships but by observing the successful ones.

I was lucky to have one.

I excelled as a student, even with balancing the role of nursing student with the role of mother to a preschool-aged daughter.

However, academic success and my talent for multitasking did not prepare me for the reality shock of a new-grad nurse.

Thrown into the deep end.

There was a nursing shortage. I was hired to a pediatric unit before graduation, skipping the two years of adult medical-surgical nursing before entering a specialty that was customary for new grads at the time. I began my first job, pending successfully passing state boards, with an interim permit.

It was an era before nurse residencies or comprehensive orientations. My orientation consisted of accompanying a day shift nurse while she managed her patients.

After two weeks, I began night shift on a 30-bed pediatric unit during the height of the respiratory infection season.

Night shifts were staffed with up to three RNs, overseeing certified nursing assistants. Often the CNAs came from agencies, possessing varying amounts of skill. As a new grad overseeing […]

Amidst Nursing’s Daily Challenges, a Longing for Enduring Meaning

Early ideals, current reality.

I recently co-facilitated a breakout session at a national nursing conference in which we had the participants reflect upon life experiences that sparked their initial desire to go into nursing.

Some knew from a very early age that they were drawn to providing care for others. Others, like myself, were second-career nurses who had spent time in other professions before making our way into nursing.

We spent time talking about our early idealism about the profession and the various experiences or issues that have challenged our ideals over time. I was struck by the deep and broad range of emotions in the room: pride, frustration, hope, discouragement, cynicism, and longing.

‘An almost palpable ache.’

It is the longing that stood out to me the most.

The nurses I met in that room, and nurses I meet everywhere, certainly express longing for better staffing, improved systems that facilitate smoother workflow, and a supportive work environment. But these are all longings that tie into one deeper longing, which is a longing for enduring meaning in our day-to-day work—as hard as some days may be—and a broader […]

Nurses Week: A Time to Reflect on the Incredible Work Nurses Do

The Nurses Week theme this year as set by the ANA, “4 Million Reasons to Celebrate,” points to our numbers. I appreciate the concept, but I’m not in love with this theme—I don’t think our numbers are what make us worth celebrating.

What really matters.

What we should celebrate is nurses’ continued commitment, day after day, to making people’s lives better. Sometimes, that takes effort that goes above and beyond. That’s the focus of my May editorial, “The Unwavering Courage of Nurses.” It’s also depicted in the May issue cover photo (for background, read “On the Cover“): nurses literally running for their lives and the lives of their patient, just ahead of flames from the deadliest fire in California’s history. And it’s what makes some Red Cross nurses so special: see this article by Debby Dailey and Linda MacIntyre (listen to the podcast of my conversation with the authors, too).

I think Nurses Week is important, not so much for the public who, judging by their votes in the most recent Gallup poll, already think highly of us (a good reminder for […]

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