When Brokenness Transforms Nursing

photo by Karen Roush/all rights reserved

I’ve had opportunities to sit in peer interview panels for new grad nurses looking to start their career in our unit, an experience which prompted me to consider what it takes to be a good nurse.

The obvious qualities were, well, obvious: critical thinking skills, strong communication, compassion, teachable, team player. But I’ve had a sense for a while that we nurses have been missing something when we consider what it takes to be a good nurse. While this something is strongly tied to empathy, it’s still a bit different. I tend to think of it as the nurse’s recognition and embrace of his/her own brokenness, even as the nurse looks to take care of others who are in some manner broken.

By brokenness, if the term is unfamiliar, I simply mean the awareness that we all know what it is to suffer, to struggle, to feel lost or wounded or weak. So in speaking of brokenness, I don’t mean it as a condescending lens through which we view everyone as objects to be fixed. I use the term brokenness to acknowledge the humbling reality that every person will crack a bit under enough pressure; every person who has been tossed around enough by […]

2018-01-18T10:03:17-05:00August 9th, 2017|Nursing, nursing perspective|4 Comments
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Intimate Strangers: A Pediatric Intensive Care Nurse Reflects

By Lisa Dietrich for AJN.

“How do I talk about these things with a stranger unless I know how to be intimate?” asks pediatric intensive care nurse Hui-wen (Alina) Sato, the author of “Intimate Strangers,” the Reflections essay in AJN’s August issue.

Sato writes about “walking intimately . . . through the most devastating hours of her life” with a woman she’s only just met—even as her role as a nurse involves ending the life-sustaining treatments of this mother’s child.

Nurses will tell you such experiences can be common in their profession. But essays like this remind us that such experiences are also remarkable. Sato is the type of nurse who ponders her role, who stops after the fact to wonder what it means to be a participant at such moments in others’ lives. […]

2017-08-04T10:51:54-04:00August 4th, 2017|Nursing, nursing stories, patient engagement|0 Comments
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Antibiotic Stewardship: Inherent to Good Nursing Practice

neutrophil interacting with two pink-colored multidrug-resistant Klebsiella pneumoniae bacteria

Although most nurses are aware of the urgent problem of antibiotic overuse in hospitals, some may be unfamiliar with terms like “antibiotic stewardship.” This is partly because few nurses besides those working as infection control preventionists have had a formal role in stewardship programs, explain authors Rita D. Olans, Richard N. Olans, and David J. Witt in “Good Nursing Is Good Antibiotic Stewardship,” which appears in this month’s issue as a Special Feature. In the article, the authors detail how bedside nurses are vital to the success of these efforts.

What Is Antibiotic Stewardship?

Antibiotic stewardship programs offer a formal approach to addressing the current crisis, in which an increasing number of organisms are developing resistance to antimicrobial medications. In the absence of new drugs, stewardship programs have been established to improve the way currently available antibiotics are used in hospitals. These programs aim to:

  • optimize antibiotic therapy.
  • shorten the duration of use of broad-spectrum antibiotics.
  • reduce the number of adverse events.

According to the authors, “because nurses are not typically prescribers of antibiotics, they often don’t see themselves as participants in antimicrobial stewardship programs.” Yet, even though they may not know it, “staff nurses are already performing many critical […]

2017-08-02T11:36:27-04:00August 2nd, 2017|Nursing, Public health|1 Comment
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Nurse-Author Theresa Brown Reflects on Recent Book About Doctor-Patient Communication

Nurse and frequent contributor to the New York Times Theresa Brown writes a column for AJN called What I’m Reading, in which she reflects on a recent book about an aspect of health care. This month she examines What Patients Say, What Doctors Hear (Beacon Press, 2017), by physician Danielle Ofri.

The book is about communication with patients, about real listening and the kinds of listening that often substitute for it, sometimes to the real harm of patients. Brown also considers some differences between the ways physicans and nurses tend to talk to patients. Here’s a brief excerpt, but we recommend that you read the short article, which is currently free:

Can any of us, nurses or physicians, say that we always listen as well as we should, giving each patient’s story our full attention? Like physicians, nurses feel the unrelenting pressure of time constraints. Although I try very hard to listen well, I’m sure there are times when I fail. Ofri’s book reminds us that it is clinically important to listen to what our patients say. Ironically, such listening can save time in the long run. But the main reason for doing so is simple: in order to give patients the best care possible, we need to hear what they’re actually trying to tell us.

Brown’s column is not a book review; while she draws readers’ attention to books that are well worth reading, the column goes beyond this purpose, […]

2017-07-31T09:33:35-04:00July 31st, 2017|Nursing|0 Comments
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August Issue Highlights: TB Screening, The Baby-Friendly Hospital Initiative, Antibiotic Stewardship, More

The August issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States

The U.S. Preventive Services Task Force (USPSTF) recently issued a new recommendation statement on latent tuberculosis infection testing that expands nurses’ opportunities to identify at-risk populations for tuberculosis prevention. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents pre­ventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF rec­ommendation’s applicability to public health and primary care practice in the United States.

CE Feature: Beyond Maternity Nursing: The Baby-Friendly Hospital Initiative

The Baby-Friendly Hospital Initiative (BFHI) is a program developed by the World Health Organization and the United Nations Children’s Fund to promote breastfeeding in hospitals and birthing facilities worldwide. Since the program was launched in 1991, breastfeeding initiation, duration, and exclusivity have increased globally, a trend largely attributed to changes in hospital policies and practices brought about by the BFHI. This article provides an overview of these practices and policies, the insti­tutional benefits of achieving BFHI certification, and the process through which health care facilities can do so.

Original Research:

2017-07-28T09:41:48-04:00July 28th, 2017|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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