Off the Charts

Is the Current Nurse Manager Role Attractive to Millennials and Gen Xers?

Image by TeroVesalainen from Pixabay

A perennially challenging role.

I’ve always found the role of nurse manager to be the most difficult one in health care. Crushed between staff nurses begging for enough resources to do the job and administrators pressing for cost containment, nurse managers often find it hard to make any progress at all.

This job comes with 24-hour responsibility, often (incredibly) for more than one unit. This can mean taking responsibility for, say, 50 patients, and 80 or more staff. Just managing payroll for so many people (as many managers still have to do) can take half the pay period! And all this for the princely salary of . . . less than what many of their senior staff nurses are making.

Redesigning the nurse manager role includes greater role flexibility.

Those of us who’ve been in nursing for decades simply accepted that, if you wanted to move up the nursing career ladder, you would have to accept all of the above. Younger generations of nurses, though, see things differently. […]

Betsy Todd, MPH, RN2019-03-15T10:09:41-04:00March 13th, 2019|Nursing, nursing career|0 Comments

Women’s History is Nursing’s History

We would be remiss not to highlight Women’s History Month—after all, nursing’s history is intrinsically tied to women’s history. As women became more independent, so too did nursing. And it’s important to acknowledge our history of contributions to shaping this country’s health care system. As I note in a March 2015 editorial:

“The story of nursing continues to be one of social commitment, innovation, and problem solving. It legitimizes and supports our inclusion on governing boards and our presence at policymaking tables. It can infuse each of us with pride and energy for the work we do.”

One hundred and nineteen years of archives.

Linda Richards, first American trained nurse

AJN has 119 years of archives documenting nursing’s legacy (all free to read for subscribers). To mark Women’s History Month, each Friday this month we are highlighting an archive article and making it free until April 1. Today we’re sharing “Recollections of a Pioneer Nurse,” which was published in January 1903 (click through to the PDF version for the best version).

First trained nurse in the United States.

The article was written by Linda Richards (1841-1940), considered the first trained nurse in the United States. It’s a vivid first-person account of her experiences in nursing at the turn of the century, and […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2019-03-15T10:04:27-04:00March 8th, 2019|Nursing|0 Comments

In Nursing, What Does It Really Mean to Trust Your Gut?

The March Reflections essay in AJN touches on several big questions:

How can you tell if a patient presents an immediate suicide risk?
What do nurses really mean when they speak of ‘trusting your gut’?
And what are the limits of advocating for a patient when a nurse finds herself in potential opposition to a physician?

by Annelisa Ochoa for AJN

In “Mr. Blue and His Six Cats” (free until April 1), nurse Mariya Rader vividly and economically describes a series of tense events that occurred one shift in the ER where she worked early in her career.

The clock is ticking: should the patient brought in by EMS be discharged because he denies suicidal intent? We follow her persistent search for the right course of action through a series of encounters with the caring team of paramedics who brought him to the ER and are familiar with his ways, the inexperienced new resident physician, and the patient himself.

Trust your gut?

The author had always heard nurses say to ‘trust your gut.’ But what did it really mean?

Remember, I was still relatively new to nursing; I hadn’t yet learned to depend on myself. But I had this sick feeling deep down that I couldn’t […]

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Jacob Molyneux, senior editor/blog editor2019-03-06T09:59:32-05:00March 6th, 2019|Nursing, nursing stories|2 Comments

When Family Caregivers Are Unsure

Those who care for ailing family members are often faced with new symptoms or with changes in a loved one’s condition. They have to decide if it’s a natural progression of the disease and “just” another thing to manage, or if it signals a serious problem like a urinary tract infection, pneumonia, or a COPD exacerbation that needs to be addressed. Often, they end up in the ER, in some cases needlessly.

The authors of the original research CE article in this month’s issue, “New Acute Symptoms in Older Adults with Cognitive Impairment: What Should Family Caregivers Do?,” write:

“If caregivers have a clear understanding and awareness of their loved ones’ existing symptoms, they’ll be better prepared to recognize changes and new symptoms. Early recognition makes it more likely that the patient can be treated in place and trips to the ED can be avoided.”

Are caregivers being adequately prepared?

As I write in the March editorial, with over 43.5 million adults providing care to family members, we need to ensure they are prepared to do so by the time their loved one is discharged from the hospital

These caregivers provide complex care—from injections and ostomy care to managing ventilators and tube feedings—and according to surveys conducted by AARP, they […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2019-03-04T07:29:14-05:00March 4th, 2019|family caregiving, family caregiving, Patients|0 Comments

If We Know How to Prevent Falls, Why Are Our Patients Still Falling?

Falls: at least ‘theoretically preventable.’

Sometimes it can feel as though managing fall risk takes up a big part of the day. You do your regular risk assessments, put safety measures into place, and still—patients fall.

Considering the frailty of some patients, the many meds that contribute to falls, and the fact that even mild cognitive impairment can be made worse by a hospitalization, it’s a tribute to good nursing care that there aren’t more falls.

But because falls sometimes cause serious injury and are, at least theoretically, preventable, it always feels like we’ve failed when a patient ends up on the floor.

A checklist for high-risk patients.

Nurses at one hospital decided that they needed a new way to approach fall safety. In “Using a Fall Prevention Checklist to Reduce Hospital Falls,” authors Madeline Johnston and Morris Magnan describe their use of a 14-item change-of-shift checklist based on the hospital’s existing fall prevention protocol. For a patient known to be at high risk for falls, oncoming staff went through the checklist to be sure that all prevention interventions were in place before taking responsibility for the patient. […]

Betsy Todd, MPH, RN2019-03-01T11:40:56-05:00March 1st, 2019|Nursing, patient safety|2 Comments