Instructor Incivility Toward Nursing Students

“An anxious student is practicing Foley catheter insertion on a manikin in the nursing skills laboratory. The instructor rolls her eyes as the student nervously fumbles and breaks sterility.”

A less well known type of incivility.

Incivility and bullying in health care have been much discussed in recent years, as they should be. In this month’s issue, Linda Koharchik focuses on a less well known manifestation of this problem:  instructor incivility toward nursing students. This kind of vertical violence can be particularly distressing, given the fact that nursing instructors function as de facto gatekeepers for entry into practice. Student nurses can’t simply refuse to deal with them.

Eye rolling, reprimands within earshot of classmates, criticism of the student in front of the patient, and even frank bullying and intimidation are examples of instructor behaviors that some students have to cope with. It’s not hard to imagine what this kind of anxiety-provoking “guidance” can do to a student’s performance, leading to yet more abuse from the instructor.

Merely a rite of passage?

Koharchik notes that some authors have suggested that dealing with incivility is a “rite of passage” for students, one that will help them better cope with the challenges of their chosen work. But nursing students are already exposed to plenty of stress during their training, especially when […]

2018-07-23T09:15:34-04:00July 23rd, 2018|Nursing|0 Comments

Decreasing the Trauma of IV Sticks – for Patients and Nurses

In my clinical days, I was adept at IV sticks. I had a lot of experience from my days in the ER, but especially from working as a chemotherapy nurse, where I had patients with fragile and damaged veins. I learned every trick to coax a vein to appear and which gauge needle would work the best to avoid puncturing through the vein. I was so “into” IVs at one point, I’d note the veins on people’s arms, judging whether they’d be an easy or hard stick.

Venous access may be difficult to achieve in older adults. Photo © Alto / Alamy Stock Photo.

Little instruction in starting an IV.

But it wasn’t always so. I recall approaching the first time I had to draw blood with much trepidation. There was virtually no training—a more experienced colleague had me watch her and then walked me through it in a few minutes:

“It’s not that hard: see which hand or arm has the better veins; tie the tourniquet around the arm; swab the skin with alcohol; insert the needle, bevel down; pull back and see if […]

A Nurse’s Open Letter to Parents Who Have Lost a Child

“You are never alone as you miss these children, as you laugh recalling moments with them. Don’t worry that the memory of them is fading—their presence is strong and lives even beyond you and your love for them. We remember them, too.”

Illustration by Barbara Hranilovich for AJN. All rights reserved.

In this month’s Reflections column, author Jessica L. Spruit has written an open letter to parents who have lost a child. Spruit, a pediatric NP in a hematology/oncology department, makes it clear that the children in her care are not forgotten and that their deaths are never routine, even on a hem/onc unit. Here, she shares memories of her patients from over the years, recalling the things that made them unique—as children, and not just as “patients.”

In her letter, Spruit describes something that is often hard to convey about our work. In spite of all of the stress and frustrations of nursing today, we still are able to engage deeply with other people. The courage and grace (and fun and joy, too) that we have the privilege to witness become part of who we are. When our patients are children, their gifts to us are particularly memorable.

“Please don’t ever think that we ‘do this all the time’ or that it is ‘just part of our job.’ Please don’t fear that you are the only ones who remember and miss your children.”

Read “We Remember Them, Too” in […]

2018-07-17T14:28:09-04:00July 17th, 2018|Nursing, pediatrics|0 Comments

AJN Wants You! A Call for Peer Reviewers and Authors

nurse typing on keyboardTake your career to the next step—become a peer reviewer or author.

For over 118 years, AJN has presented its readers with timely and informative content to support best nursing practice and to examine issues of the day that are relevant to nurses and the profession. While that’s still our aim today, content development is more complex—it now includes peer review; fact-checking to ensure accuracy; citing evidence from the literature; ethical guidelines that govern editor, reviewer, and author behavior; careful editing to meet standards for quality writing; transparency to avoid bias and conflicts of interest. We’re proud of our commitment to high standards, and our success is borne out by the many awards we’ve received—more than any other nursing journal.

All of this wouldn’t be possible without the help of peer reviewers and authors, who commit to making the content we publish the best that it can be: timely, accurate, readable, and useful.

Peer reviewers are essential to any scholarly journal.

Peer-reviewing is also an excellent way for fledgling writers to better understand what editors look for in manuscripts. We welcome new reviewers who have expertise in nursing, are current with the literature and practice in their area of expertise, have a master’s degree or higher (or a BSN and certification in a specialty area), and are willing to review three to six manuscripts a […]

Making Sense of the Breast Cancer Screening Guidelines Controversy

“In a time of uncertainty about breast cancer screening, the role of the nurse in communicating information to patients about screening’s health risks and benefits is more important than ever.”

Few diagnostic rituals loom as large—or generate as much anxiety—as an upcoming mammogram appointment. Until relatively recently, most of the concern surrounding the procedure was about what it might reveal. What most women older than age 40 haven’t generally questioned since routine screening began in the 1980s was whether they should have a mammogram each year.

Confusion for patients and providers.

Sandra Brennan, director of radiology at Memorial Sloan Kettering Westchester, West Harrison, New York, reads mammogram results with a technician. Photo courtesy Memorial Sloan Kettering Cancer Center Graphics Team.

Yet many women, particularly those in their 40s, are now struggling with this very issue. Recent changes in the breast cancer screening guidelines of major organizations have moved away from a population-based approach to screening, which has historically begun at age 40 and been repeated annually for most women.

Based on data from clinical research and cancer registries, the current recommendations reflect an effort to […]

2018-07-09T07:57:28-04:00July 9th, 2018|Nursing|0 Comments
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