A Call to Address Fatigue to Protect Nurse Health and Patient Safety—from 1919

The evidence on nurse fatigue has been there all along.

During Women’s History Month, which is about to end, I’ve been posting (here and here) on nursing history (and in the process exploring its close confluence with women’s history). For this last post, I’m highlighting an article published in the March 1919 issue of AJN—exactly 100 years ago. The evidence on fatigue from long working hours has been there all along.

“The Movement For Shorter Hours in Nurses’ Training Schools” (free until April 15; click on the pdf version in the upper right), was written by Isabel Stewart, who was professor and then director of the nursing program at Teachers College, Columbia University, and coauthor of the National League for Nursing Education (the forerunner of today’s National League for Nursing) Standard Curriculum for Schools of Nursing.

A call for 8-hour work days for nurses.

In this article, which is in some ways disturbingly relevant today, Isabel Stewart notes that major nursing organizations recently met and were seeking “to enlist the support of a great many influential organizations and the general public in establishing an eight-hour day and a fifty-two hour week for pupil nurses.” (As a reminder, hospital nursing staff at that time were mostly […]

2019-03-29T11:07:06-04:00March 29th, 2019|Nursing, nursing history, patient safety|3 Comments
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Back to the Future of Nursing

A new hashtag: #FutureofNursing2030

In 2010, a committee of the Institute of Medicine (now the National Academy of Medicine), released a report to lay out a vision for nursing for the coming decade. That decade is now almost over. The Future of Nursing: Leading Change, Advancing Health is the most viewed and most downloaded report of the National Academies. On March 20 in Washington, D.C., Victor Dzau, president of the National Academy of Medicine, announced an impending follow-up report for the next ten years: The Future of Nursing: 2020-2030.

Outcomes, not page views, are what matters.

Noting that “success is measured by outcomes and impact, and not by downloads and page views,” Dzau cited a few of the accomplishments that arose from the 2010 report:

  • removing barriers that limited NP practice (21 states and the District of Columbia allow for full practice authority)
  • doubling the number of nurses with doctoral degrees
  • increasing the diversity of nursing students

But Dzau also noted that more needs to be done in these areas, and he emphasized the need for better data about the nursing workforce. The new report will be a consensus study that seeks to chart a new path for nursing “to help our nation create a culture of health, reduce health disparities, and improve the health and […]

2019-03-27T07:35:17-04:00March 27th, 2019|health care policy, Nursing|0 Comments
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April Issue: IV Patient-Controlled Analgesia Errors, Implementing EBP, Nurses and Climate Action, More

“Think about your own workplace: do you take pride in what you do, feel that you and your work are valued, and enjoy the team you work with? Do the good days outweigh the bad days?”—AJN editor-in-chief Shawn Kennedy in her April editorial

The April issue of AJN is now live. Here are some highlights.

CE: Original Research: Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study

The authors describe and analyze the errors associated with the use of IV patient-controlled analgesia at a large medical center in South Korea.

CE: A Historical Review of Nurse–Physician Bedside Rounding

How has the nurse’s role in bedside rounding evolved since the 19th century? This article discusses the challenges of nurse participation in bedside rounding from 1873 to 1973.

Sustaining Nursing Grand Rounds Through Interdisciplinary Teamwork and Interorganizational Partnership

The authors present the implementation of a grand rounds program at their naval hospital, and demonstrate how nursing grand rounds can support professional growth and strengthen partnerships.

New Series: EBP 2.0: Implementing and Sustaining Change: From Strategy to Implementation

Our follow-up to the popular Evidence-Based Practice, Step by Step series (which appeared in AJN from 2009 to 2011) is focused on the most challenging of the seven EBP steps—implementation.

Environments […]

2019-03-25T09:53:59-04:00March 25th, 2019|Nursing, nursing history|0 Comments
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The Complex and Illuminating History of Nurse Participation in Bedside Rounds

This week’s offering in homage to Women’s History Month.

We know from research that interdisciplinary bedside rounds improve communication and create a safer care environment. As noted by the author of a new CE article in the April issue, nurse–physician bedside rounding “has been shown to reduce mortality, medication errors, hospital length of stay, and hospital costs; improve staff and patient satisfaction; expand the health care team’s understanding of the patient’s plan of care; and increase both efficiency and perceptions of patient safety.”

Not your grandmother’s rounds.

In her article, “An Historical Review of Nurse–Physician Bedside Rounding,” Genevieve Beaird notes that while nurses rounding with physicians is not new, the nurse’s role today is vastly different from the early days. At that time, the nurse’s main concern was often preparing the stage, so to speak, for the physician’s appearance at the bedside. Here’s a quote from Dorothea Gothson, RN, in a 1913 issue of AJN:

“There is nothing more distressing to either patient or the earnest hardworking nurse than to be surprised by the attending doctors…. Equally annoying is the experience of patients and nurses being ready, waiting for the doctors, and their not appearing for one or two hours after the appointed time—perhaps not at all—thus […]

2019-03-22T08:39:03-04:00March 22nd, 2019|Nursing|0 Comments
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Updating Your Knowledge of the Many Medications for Type 2 Diabetes

According to the latest figures from the CDC, 30.3 million people in the U.S. have diabetes, and another 84.3 million adults have ‘prediabetes.’ Type 2 diabetes accounts for 90% to 95% of all cases. Are you up-to-date on the new drugs? This month in AJN, Patricia Keresztes and Annette Peacock-Johnson help us find our way through the latest information on the many drugs (other than insulin) used in type 2 diabetes.

Lifestyle, of course, is critically important in the management and prevention of type 2 diabetes. Diet, physical activity, weight control, and whether or not we smoke are all factors in managing the disease.

Keeping track of the many newer antidiabetes drugs.

But drug therapy is central to diabetes control for most people, and there has been an explosion of new drugs for diabetes over the last several years. Do you know which currently available antidiabetic drug (or drug class) . . .

  • is the least expensive?
  • is more likely to cause weight gain?
  • is associated with the greatest risk of hypoglycemia among non-insulin agents?
  • should not be used by people who have (or have had) bladder cancer?
  • is associated with an elevated risk of bone fractures in women?
  • can decrease the effectiveness of hormonal contraception agents?
  • may lead to urinary tract infections or genital mycotic infections?

A CE article to update your pharmacologic expertise.

Update your knowledge of medications for type 2 diabetes by reading this month’s […]

2019-03-18T11:02:58-04:00March 18th, 2019|Nursing|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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