There from the Start: A Hospice Nurse Looks Back

A painting of Dianne Puzycki, RN, hangs in Connecticut Hospice in New Haven.

At age 82, Dianne Puzycki has yet to retire from nursing—she still works the night shift once a week at Connecticut Hospice in Branford, where she’s been employed since the organization’s inception in the 1970s. Founded by Florence Wald, it was the first hospice in the United States.

Puzycki started her career in 1955 at Memorial Hospital in New York City, caring for patients with cancer at a time when death and dying wasn’t openly discussed. “We weren’t allowed to talk about that. It really haunted me for years,” she told AJN in a July profile. Several years later, she encountered two influential women: Dame Cicely Saunders, who founded the first modern hospice, and Elisabeth Kübler-Ross, who introduced the concept of the five stages of grief in her groundbreaking 1969 book On Death and Dying. Seeing them speak piqued her interest in the hospice movement, and she began volunteering for Connecticut Hospice, which eventually led to a full-time job.

Throughout the decades, says Puzycki, she’s witnessed hospice care constantly change and improve. She recalls that in the past, more patients used to stay up […]

2017-07-26T09:35:44-04:00July 26th, 2017|Nursing, nursing career|1 Comment
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The Human Microbiome: A Primer for Nurses

Image courtesy of Bard Medical Division.

​The human microbiome is a collection of organisms living on the skin and in our GI and reproductive tracts. Nurses know these “germs” are there, and traditionally we have regarded them as potentially dangerous. We try to eliminate as many as possible when we disinfect skin before injections, surgery, or other procedures. Yet, as noted by the authors of a continuing education (CE) feature in the July issue of AJN, “Health and the Human Microbiome: A Primer for Nurses,” new research increasingly demonstrates that these microbes affect our health in significant and often positive ways.

​” . . . once unequivocally regarded as dangerous invaders, [microbes] often serve us as integral companions, providing critical functions in fundamental human processes.”

​In this article, Katie Gresia McElroy and colleagues share many thought-provoking research findings about the human microbiome that are relevant to nursing. Some examples: […]

2017-07-24T10:33:11-04:00July 24th, 2017|Nursing|0 Comments
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AJN’s Recent Awards: As Always, It Depends on Strong Writers and Editors

Because AJN‘s reputation depends on the conscientious work of numerous authors and editors, we’d like to note here the awards AJN has been awarded in 2017 so far, both for content published in the journal and on this blog, AJN Off the Charts. We are grateful to be recognized by the following organizations:

Winning journal articles, entire issues, and covers:

2017-07-21T08:59:42-04:00July 21st, 2017|Nursing|0 Comments
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PTSD and Falls: For the Elderly, a Lost Sense of Safety and Control

Jack lowers his head and presses his temples with his thumbs. He whispers, “Am I going crazy?”

In the weeks after his fall and trip to the emergency department, something has gone painfully awry. He’s been having episodes of anxiety when transferring from bed to chair as well as difficulty sleeping. His once unflappable optimism has been blunted by intrusive memories and ruminations about the fall and a sense of foreboding about the future.

Psychological Aftereffects of a Fall

Though he sustained no serious injury and had been quickly returned to the assisted living facility where he lives, the fall has left him with symptoms of posttraumatic stress disorder (PTSD). Most health care professionals are unaware that falls in the elderly can cause posttraumatic stress symptomatology, acute stress disorder, even PTSD. Indeed, in some settings falls occur frequently enough to insulate nurses and other medical staff from the awareness of how terrifying such an event can be or how it can undermine one’s sense of safety and control, particularly when it results in injury and/or invasive medical treatment.

Although Jack was under hospice care at the time of his fall, the facility sent him to the hospital because of its policy on ruling out head injury. Most hospices and facilities have protocols governing their response to falls. These typically include timely […]

2017-07-19T07:34:30-04:00July 19th, 2017|Nursing|2 Comments
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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 indication that […]

2017-07-17T16:49:20-04:00July 17th, 2017|Nursing, patient safety|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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