Breaking onto Boards: Tips for Nurses

Photo by Steve Debenport / Istock.com.

A 2014 survey by the American Hospital Association found that nurses—the largest group of health care professionals—held just 5% of hospital board seats (by comparison, physicians held 20%). It goes without saying that health care organizations stand to gain valuable insight and leadership by including more nurses in the boardroom. But as discussed by Blima Marcus in this month’s Professional Development column, nurses face many barriers to getting a seat at the table. These include:

  • the perception of nurses as “background” care providers rather than leaders
  • the tendency of board members and executives to nominate candidates who they are already familiar with and who work in a similar field
  • lacking the knowledge and skills needed to serve on a board (i.e., leadership and organizational skills)
  • not being a part of the socioeconomic class often associated with board membership—often, members are asked to make donations to their organizations

Overcoming the barriers

While these barriers may seem daunting, Marcus notes that there are practical actions nurses can take to […]

2018-12-18T10:03:55-05:00December 18th, 2018|Nursing, nursing career|0 Comments
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How Can Nurses Identify and Assist Human Trafficking Victims?

Wikimedia Commons/ AlvaroGzP

What do sex workers have in common with nannies, housekeepers, farmworkers, janitorial and restaurant staff, and factory and construction workers? They all work in settings where victims of human trafficking are commonly found.

Human trafficking is big business in the United States.

Our country is reported to be the second-largest market globally for women and children trafficked into sex work. Sex trafficking is the main form of trafficking among U.S. citizens, while forced labor trafficking is more common among foreign nationals living here.

Globally, human trafficking is second only to drug trafficking among criminal industries. Because nurses are “everywhere,” we are very likely to come into contact with human trafficking victims at some point. Would you know how to recognize one?

Possible indicators of human trafficking.

In a 2011 AJN article, Donna Sabella shares several possible indicators of human trafficking that warrant further investigation, including:

2018-12-13T08:10:08-05:00December 13th, 2018|Nursing, Public health|0 Comments
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Who Is Doing Advance Care Planning in Nursing Homes?

When I was an ED nurse in a city hospital years ago, we often received patient transfers from area nursing homes. Usually these patients were very elderly, appeared cachectic, and were largely unresponsive (as I recall, many were post-stroke or had dementia). Diagnoses were usually very similar: dehydration, hypotension, UTI, pneumonia; many had contractures. The usual care was rehydration with IV fluids, an NG tube, antibiotics, and often a Foley catheter. Sometimes they were septic and then they were intubated, placed on ventilators, and sent to the ICU, where just about everyone died after a short stay.

What’s the point of this care?

I often wondered, as did many of my colleagues, what was the point of this. It seemed futile, and injurious to the patient. Sometimes, if we could reach family members before nasogastric or endotracheal tubes were placed, we were able to secure an order to dispense with all but comfort measures. Otherwise, all measures were initiated and then things became complicated—legal issues arose about discontinuing futile care and families often couldn’t bring themselves to discontinue life support measures.

Today, a greater focus on advance care planning.

Advance care planning (ACP) was hit or miss in those days—mostly miss—and our patients suffered because of this. It’s only recently that emphasis has been placed on […]

2018-12-10T11:07:41-05:00December 10th, 2018|Nursing|0 Comments
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‘No Illusion of Forever’: A Mother and Nurse Makes Every Day Count

As a nurse in my early twenties, I worked with kids with cystic fibrosis (CF). At that time, we were just beginning to see some teens and young adults in our CF clinic. I was close to them in age, and friendships naturally developed. Some never even reached their twentieth year. I had never seen people my age die, and although as a nurse I knew this was possible and even likely because of their illness, every death was shocking to me.

It’s hard, then, for me to imagine how it must feel to have siblings with a terminal disease. It seems to me that losing just one brother or sister early in life would be devastating. What if you watched six die?

A childhood punctuated with loss.

In this month’s Reflections column, “No Illusion of Forever,” author and nurse Elizabeth Bruno shares her memories of her time with the brothers she lost to agammaglobulinemia. The earliest death was a brother who died at ten years of age; the longest living was her oldest brother, who lived to the age of thirty.

Part nurse, part mother—always remarkable.

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2018-12-06T14:38:20-05:00December 6th, 2018|family caregiving, Nursing|0 Comments
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Managing Movement Disorders: Spasticity, Clonus, and Muscle Tightness

Do you know how to help people with muscle tightness, spasticity, or clonus? And what if someone has more than one of these conditions at the same time?

Little information in the nursing literature.

 

In “Managing Movement Disorders: A Clinical Review,” their CE article in this month’s AJN, Rozina Bhimani and colleagues provide an excellent guide to the assessment and pathophysiology of, and treatment for, each of these conditions. There is very little in the nursing literature on their management, so this article by nurse experts who work with these symptoms every day is particularly enlightening and helpful.

The authors point out that muscle tightness, spasticity, and clonus are not always interpreted accurately by clinicians. This can lead to less-than-optimal treatment.

“Neuromuscular signs and symptoms occur across a multitude of diseases and injuries . . . . Successful symptom management requires effective communication about symptoms, yet there are often discrepancies between patient and provider descriptions of neuromuscular symptoms and manifestations.”

[…]

2018-12-06T14:36:23-05:00December 4th, 2018|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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