Connecting Emotional Intelligence, Team Communication, and Patient Safety

An Early-Career Nursing Memory

Photo by Barry Diomede/Albany Stock Photo.

Many years ago, fresh out of nursing school, I was in charge one night, with no other RNs on the unit. We had an “active GI bleeder” who needed hourly boluses of either ice water or iced milk through an NG tube. (Yes, the standard treatment at that time was gruesomely uncomfortable for the patient, and in later years determined to be counterproductive.) I had more than a dozen other patients to care for, but everyone got their meds and, miraculously, the bleeding man made it through the night.

When my supervisor made rounds at the end of the shift, I reported that all was well and that my critical patient had survived. Her only response: “Mrs. Todd! There is blood on your shoes!”

This senior nurse, standing there in her starched whites and impeccable shoes, didn’t recognize that I had feared I would be inadequate to the task, or even acknowledge my pride as a brand-new nurse in actually saving someone’s life. In retrospect, I can’t help wondering if her choice to focus on a superficial fact, irrelevant to the crisis, could be interpreted as an […]

2017-07-17T16:49:20-04:00July 17th, 2017|Nursing, patient safety|1 Comment
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The Inner Stretch of Nursing

There is a level of discomfort nurses are pushed to that goes beyond tight staffing, busy 12-hour shifts, and mental tracking of our patient’s disease process. It is the inner stretch of our emotional, relational, and spiritual muscles. We are pushed to wrestle with questions and issues beyond what we find comfortable, and then we must learn to live with a certain unresolved level of discomfort. We can’t go back to a perhaps safe naïveté about life as we knew it before we saw how indiscriminate some forms of suffering and death could be. Our own theological wonderings come to light, and our capacity for vulnerability and intimacy is tested when certain patients find a way past the self-protective walls we put up. Sometimes, all the big questions of life loom over us in the course of one 12-hour shift.

We are stretched in how we think about quality of life.

My everyday thoughts about quality of life usually revolve around the quality of my relationships, how much free time I had to enjoy my hobbies, what delicious food or special coffee treat I might enjoy today, how much traffic I encountered, and whether my kids seem to have everything they need. I’ve had my share of personal trials and tribulation, but overall I live a life of […]

2018-01-18T10:06:13-05:00July 14th, 2017|Nursing|4 Comments
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Nursing Protocol for Stroke Increases Survival, Reduces Disability

image via Flickr / Vormingplus Gent-Eeklo vzw

As we report in a July news article, a new study showed that a nursing care plan for stroke, implemented in the first 72 hours after admission, reduced deaths and disability compared with standard stroke care. The protocol—which was implemented on 19 acute stroke care units in New South Wales, Australia—treated fever, hyperglycemia, and dysphagia using the following interventions:

  • Fever: Temperature monitoring every four hours; administration of paracetamol to lower temperature when needed
  • Hyperglycemia management: Blood glucose monitoring and saline or insulin infusion if indicated
  • Dysphagia detection: Nurses were trained by speech pathologists and assessed to test competency in screening for swallowing problems.

The study included 1,076 patients and confirmed the protocol’s positive outcomes four years later. (The same research group had conducted an earlier study showing the benefits after 90 days.) The authors hypothesized that rigorous implementation of the protocol in an organized stroke services setting helped preserve key tissue. […]

2017-07-12T10:20:34-04:00July 12th, 2017|Nursing|0 Comments
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The Reality of Depression Following Stroke

Photo by David A. Grossman.

This month’s CE article, “Early Intervention in Patients with Poststroke Depression,” hit home for me. It brought back memories of my Aunt Rita’s decline from a once-vibrant and independent career woman. As authors Gwendolyn Hamid and Meredith MacKenzie note, poststroke depression “often goes unrecognized and untreated because the physical and cognitive repercussions of stroke make it difficult to identify.”

Aunt Rita lived alone in an old Victorian house in Massachusetts. She was fun-loving and lively and enjoyed going to the theater and dinner in Manhattan, shopping, and sipping a beer and rooting for the Red Sox and Boston Bruins—especially when she was with her New York nieces and nephews. When she had cardiac bypass surgery in her 70s, however, things changed drastically. She didn’t bounce back from surgery. Aunt Rita was slow and tentative in moving about and became quiet and withdrawn. A niece came to live with her as a caregiver, but Aunt Rita didn’t seem to want to eat, drink, or even bathe. Her physician diagnosed organic brain disease secondary to the effects of a stroke.

About three months later, I drove up from New York to […]

2017-07-10T09:31:27-04:00July 10th, 2017|Nursing|0 Comments
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A Nurse Takes a Fall, and Loses More than Her Mobility

The Reflections essay in the July issue of AJN, “An Inconsolable Loss,” tells the story of a traumatic event that interrupts and forever changes a retired nursing professor’s relationship with her mother, “whose gentle touch and approving smile” she had always craved. Writes author Brenda Kelley Burke:

For a number of years, I’d made daily trips after work to a nursing home to visit my mother . . . .The roles of child and mother were now reversed because of her dementia. I felt acutely aware of the mother–child bond and how it transcends time and circumstance. How could I measure up to this wise and loving woman, who so many years ago would kiss my small feet before she put on my socks and whisper, ‘God, guide them to the safe places’?

But one bitterly cold and snowy night, writes Burke, “like the famous nursery rhyme character, I too had a great fall that left me broken.” Sometimes the seemingly fixed patterns of our lives depend on the most fragile of balances—one change can lead to many others, and suddenly nothing seems the same. […]

2017-07-05T11:03:05-04:00July 5th, 2017|narratives, nursing stories|1 Comment
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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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