Being a Bully and Being Bullied

‘Didn’t you learn that in school?’

Have you ever worked with a nasty colleague who knew everything? A nurse that the patients loved and showered with thank you cards and notes but was despised by coworkers? Unfortunately, I knew that person all too well. That bully nurse was me. It’s been nearly ten years since I received a wake-up call from another nurse and my then health care organization, making clear that I needed to change or risk heading further down a destructive path.

A few years into my nursing career—I can now admit—I thought I knew everything; the operative word here is thought. ‘Mary,’ a good colleague and still a friend today, would tell me, “I like you. I just can’t stand working with you.”

A kind person, Mary would never elaborate on my faults. In hindsight, it’s obvious to me what Mary was referring to. I could smell the blood of weaker individuals in the clinical setting and I was deliberately inconsiderate. I never raised my voice, but could be curt and make snide remarks: “Why are you bothering me now?” “Didn’t you learn that in school?”

None of the people I bullied stood up to me, so I continued. I really don’t fully understand it today. Was I power hungry? Possibly. Whatever the case, this […]

2019-01-30T14:36:02-05:00January 30th, 2019|Nursing, nursing career|1 Comment
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February Issue: Caring for Hodgkin Lymphoma Survivors, Acute Flaccid Myelitis, Reducing Hospital-Acquired Pneumonia, More

“I experienced the inestimable value of a healing garden . . . Regardless of diagnosis, age, circumstances, or ability to pay, nature willingly extends her gifts and does not forsake us.”—Elaine C. Meyer, author of the February Reflections column

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

CE: Original Research: Midlife Hypertension and Hypercholesterolemia in Relation to Cognitive Function Later in Life in Black Women

In light of a lack of research on the associations between vascular risk factors and cognitive function in black older adults, the authors explored the relationship between two such risk factors in midlife—hypertension and hypercholesterolemia—and cognitive function later in life among black women.

CE: Caring for Survivors of Hodgkin Lymphoma

This article—winner of the 2018 Nurse Faculty Scholars/AJN Mentored Writing Award—provides an overview of Hodgkin lymphoma, the most common late effects of treatment, and current recommendations for survivor surveillance and screening.

Cultivating Quality: A Nurse-Driven Oral Care Protocol to Reduce Hospital-Acquired Pneumonia

The authors describe a quality improvement initiative to implement an oral care protocol in the adult in-patient care areas of a level 1 trauma hospital and evaluate its impact on the incidence of hospital-acquired pneumonia.

2019-01-25T09:58:43-05:00January 25th, 2019|Nursing|1 Comment
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A Hidden History of Sexual Violence Can Complicate the Clinical Encounter

Long-term physical and psychological health effects.

illustration by hana cisarova for AJN

According to the Centers for Disease Control and Prevention, in the U.S., “one in three women and one in six men have experienced sexual violence involving physical contact at some point in their lives.” The report notes the high correlation between sexual violence and a range of adverse health effects like respiratory and gastrointestinal disease, chronic pain, and insomnia.

Not surprisingly, the terror of sexual violence is also correlated with post-traumatic stress disorder (PTSD) and its symptoms. These symptoms fall into four broad categories:

  • reexperiencing
  • hyperreactivity
  • avoidance
  • and negative emotions and thoughts about self or the world

Medical environments as triggers.

For survivors of sexual violence, medical environments can feel dehumanizing and present trauma reminders that intensify underlying post-traumatic stress. In addition, such environments can undermine protective routines and carefully delineated personal boundaries. Physical examination, being undressed, or receiving personal care can trigger powerful automatic fight–flight–freeze responses.

These responses may appear as physiological changes such as alterations in breathing and pulse, involuntary movements, or as hypervigilance, fear, anger, dissociation, withdrawal, or anxiety. Interventions like the insertion of a catheter or medications that decrease alertness or require suppositories can register subconsciously as threatening for someone who has survived […]

2019-01-23T15:58:50-05:00January 23rd, 2019|Nursing, patient experience|1 Comment
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Self-Disclosure in the Nurse-Patient Relationship

“How much of ourselves should we share with our patients?”

Illustration by Jennifer Rodgers for AJN

The ‘therapeutic use of self.’

Early nursing theorists wrote about how the “therapeutic use of self” helps us to forge close working relationships with our patients. Today we talk about authenticity, and it’s been noted that “the essence of nursing care comes from bringing our authentic selves to the nurse-patient relationship.”

We each develop a nursing “style,” weaving our own identities into the way we relate to patients and families. But where do the parts of ourselves that are very much “us” but not immediately evident to others come into the picture?

“Would a single mother hesitate to share her story of adopting a child without
a male partner? Would a widower refrain from correcting the assumption that
his spouse is still alive?. . . . I am compelled by the belief that sharing truth in either
scenario would enhance the authenticity of the relationship. Nevertheless, I remain
reluctant to correct my patients’ misperceptions of my family life.”

To disclose or not to disclose?

In this month’s Reflections column, “A Lie by Omission?“, nurse practitioner Charles Yingling takes a thoughtful look at what we choose to share with our patients, and what […]

2019-01-18T09:31:02-05:00January 18th, 2019|Nursing, nursing stories, patient engagement|0 Comments
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True Grit: A Core Nursing Attribute?

‘Seeing things through.’

In the popular movie named after the attribute, a young girl searches for a man with “true grit”—someone with courage, fortitude, and determination to see things through. She needed someone to find her father’s murderer and believed only someone with true grit would be able to persevere against the odds.

The concept of grit is a good one to describe attributes that a good nurse should possess. How often do we get through challenging days—with short staff and patient crises, for example—just by sheer grit, by having the willpower to soldier on and do what needs to be done?

Helping nursing students develop grit.

In this month’s issue of AJN, Linda Koharchik reflects on the need for grit in nursing and believes nursing faculty can help students develop it. In her article “Helping Students to be Gritty,” she cites several sources that describe ways for clinical instructors to help students. One way is to assign challenging patients or situations, so students can benefit from the instructor’s guidance in handling particularly difficult circumstances.

I agree. As a nursing student, I gained most of my clinical experience in a large municipal hospital that was often underequipped, with basic supplies sometimes hard to come by. We learned to problem-solve and improvise […]

2019-01-16T15:57:20-05:00January 16th, 2019|Nursing, nursing students, students|2 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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