December Issue: Nurses’ Advance Care Planning–Related Beliefs, Managing Movement Disorders, Delegating, More

“When despair for the world grows in me…. I come into the peace of wild things who do not tax their lives with forethought of grief. I come into the presence of still water…. I rest in the grace of the world, and am free.”—Wendell Berry, as quoted in the December editorial

The December issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Advance Care Planning: An Exploration of the Beliefs, Self-Efficacy, Education, and Practices of RNs and LPNs

The authors of this study surveyed RNs and LPNs working in skilled nursing facilities to learn about the similarities and differences in their advance care planning–related beliefs, sense of self-efficacy, education, and practices.

CE: Managing Movement Disorders: A Clinical Review

This article discusses the pathophysiology and assessment of three different, common neuromuscular disorders—muscle tightness, spasticity, and clonus—as well as the treatment options for each.

Cultivating Quality: Creating a Culture of Mobility: Using Real-Time Assessment to Drive Outcomes

The authors describe how they implemented an intervention based on the use of three new assessment tools to promote awareness of the importance of early mobility among nurses and […]

2018-11-26T08:38:54-05:00November 26th, 2018|Nursing|0 Comments
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Mental Health Nursing: Transcending the Limitations of Words

When I met Dorothy, she was always counting. Her chapped lips moved nonstop as she chanted random numbers. She’d increase the speed, as if that would help her to reach the end quickly—but since the numbers didn’t appear to be in any sensible order, this loomed before her like an impossible task…

The challenge of mental health nursing.

Illustration by Pat Kinsella. All rights reserved.

This month’s Reflections column, “Dimensions of Dorothy,” begins with this harrowing look at a woman in the grip of a mental health crisis. Author Maureen Bonatch goes on to poignantly describe how this illness can “steal someone’s identity and overwhelm their self-control.”

As a new nurse at the state psychiatric hospital, Bonatch definitely had a “new normal” to adjust to at work. As she observed the manifestations of severe mental illness, she also developed insight into why some had so few visitors: “It had to be difficult,” she writes, “to helplessly observe as an illness crept in to hold the person you knew and loved hostage.”

An inadequately valued area of […]

2018-11-20T10:07:55-05:00November 20th, 2018|mental illness, narratives, Nursing|0 Comments
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As Patient Handling Injury Rates Remain High, Schools Teach Outdated Methods

The old-fashioned way to reposition patients.

I haven’t seen draw sheets in hospitals for years now. “Back in my day,” those narrow sheets we placed across the middle of the bed were considered essential to patient care. Draw sheets were easier to change than the full sheet and they kept the bed neat. They always seemed to be hard to come by—probably because most nurses had stashed their own supply of them in patients’ rooms.

But more importantly, they were what we used to reposition patients. We used to work in pairs on turning rounds—one of us on each side of the bed, rolling the draw sheet tightly to get a grip, then sliding the patient up in bed or turning them on their sides. It was hard work, and no form of “good body mechanics” saved your back or shoulders and neck from strain when you needed to stretch across a bed—or, many times, climb on top of it—to move an unconscious patient. It’s no wonder that nurses and nursing assistants had such high rates of serious musculoskeletal injuries.

The institution of ‘No-Lift’ policies.

Then came electric beds, overhead lifts and transfer stretchers, and “No Lift” policies, which were based on data from the Occupational Safety and Health Administration (OSHA) on the frequency of injuries and supported by nursing organizations. Many hospitals and nursing homes implemented safe patient handling and mobility […]

2018-11-16T07:25:15-05:00November 16th, 2018|Nursing, nursing career, wellness|5 Comments
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To Recruit More Men, Rebrand Nursing as ‘Masculine’? Or Just Stop Oversimplifying the Profession

As a registered nurse for more than 40 years—with experience in pediatrics, public health, and philanthropy—I read a recent article by NPR’s Shankar Vedantam (“Why More Men Don’t Get Into The Field Of Nursing”) with interest. Vedantam essentially argued that more men don’t enter nursing because it’s seen as a “feminine” profession and proposed that we start emphasizing the more “masculine” attributes of the profession.

From youthful contrarianism to a deeper vision of the profession.

When I became a nurse in 1975, my choice was shaped first by my youthful desire to be contrarian: to bend gender norms by being a man in a “woman’s” profession.

When I began practicing nursing, however, I grew in my understanding that a commitment to nursing, particularly in my specialty field of public health, provided me with the means to act every day in concrete ways to further healing and build community. And so I applaud calls like Vedantam’s drawing attention to the need for more men in nursing. The need for diversity (of all kinds) in nursing was highlighted in the 2010 Institute of Medicine’s Future of Nursing report.

The deep-rooted public view of nursing as ‘women’s work.’

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2018-11-14T10:57:09-05:00November 14th, 2018|men in nursing, Nursing|6 Comments
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Acute Flaccid Myelitis: The Investigation Continues

The headlines of the past several weeks about kids with a polio-like illness have been pretty scary. The idea that a healthy child could suddenly be sidelined with extreme muscle weakness is a nightmare scenario for the parents of young children. While frustratingly little is known about acute flaccid myelitis (AFM), the good news is that it remains quite rare, affecting less than one in a million people in the U.S. each year.

According to the CDC, there have been a total of 404 confirmed cases of AFM in the U.S. since 2014, with a median age of eight years. The epidemiologic curve of cases indicates that the illness is seasonal, peaking in late summer and early fall. Oddly, the number of cases spiked in 2014, 2016, and 2018, while there were fewer cases during 2015 and 2017.

Signs and symptoms of AFM.

AFM often follows a respiratory illness or fever. Limb weakness (often unilateral) then occurs suddenly, progressing rapidly within hours or a few days. There may be facial muscle weakness, problems with eye movement, or speech or swallowing difficulties, but mental status generally is not affected. One death has been reported.

No clear cause.

Poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus are known to (rarely) […]

2018-11-12T08:25:04-05:00November 12th, 2018|infectious diseases, Public health|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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