Off the Charts

All Unhappy Patients Are Not Alike

illustration by the author

The first sentence from Leo Tolstoy’s novel Anna Karenina is one of the most famous in literature:

“All happy families are alike; each unhappy family is unhappy in its own way.”

It can easily be applied to patients. Happy patients tend to love their doctors, feel they received the best possible care, and consider their nurses invaluable.

Unhappy patients are unhappy in their own way. The challenge for busy nurses is resisting the temptation to turn a deaf ear or feign listening, in effect reducing patients’ concerns to “waa, waa, waa.”

A common thread among unhappy patients is unmet expectations.

Sometimes the patient’s expectations are unrealistic because they’re based on incorrect assumptions—but they do not know this. Responding requires a willingness to listen and the patience to tease out why a patient is unhappy with their care. Let patients tell their stories. Most bedside nurses have limited time; it’s okay to enlist help from a case manager, social worker, or nurse navigator if necessary. However, investing time up front to improve communication with a patient may pay off in dividends by smoothing the rest of your shift.

Begin by listening. Sometimes, I’ll take a seat, and write what the patient says while they talk. This simple act conveys […]

Julianna Paradisi, RN, OCN2016-11-21T13:00:58-05:00September 6th, 2016|Nursing, nursing perspective, patient engagement|0 Comments

AJN News: Whole Grains, Antidepressant Use, Global Stroke Burden, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue (news articles in AJN are free access):

The more whole grains, the better, but even moderate increases help. Photo © Thinkstock.

Eating Whole Grains Can Reduce Disease, Mortality Risks

In a new study, researchers who sought to quantify the relationship between whole grain intake and the risks of coronary heart disease, cardiovascular disease, cancer, and premature mortality found that increasing the daily intake of whole grains by 90 grams (equal to three servings) was associated with reduced risk for all of those conditions.

Are Nurses Being Nudged Out of Policymaking?

Setbacks in the representation of nurses in policy roles are raising concerns—particularly in the United Kingdom, where the Department of Health’s nursing, midwifery, and allied health professions policy unit is being eliminated, and within the World Health Organization, which has seen a drop in the percentage of nurses on staff in professional or higher categories.

Evidence Weak for Antidepressant Use in Children […]
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Diane Szulecki, editor2016-11-21T13:00:58-05:00September 2nd, 2016|Nursing|0 Comments

Injurious Falls in the Hospital Setting

by Maureen Shawn Kennedy, AJN editor-in-chief

Patient falls are, unfortunately, a frequent occurrence in hospitals and the consequences can vary from none to serious life-threatening injuries. There has been a lot of attention focused on identifying those at high risk for falls and effective prevention measures, but according to our September CE feature, there’s been little attention focused on falls that cause injuries. In this original research study, Predicting Injurious Falls in the Hospital Setting: Implications for Practice, Amy Hester and colleagues at the University of Arkansas for Medical Sciences conducted a retrospective review of medical records to see if they could pinpoint which patient factors were associated with falls with injuries. Their results may surprise you.

Here’s the abstract:

Background: Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet a majority of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls.

Purpose: The purpose of this retrospective study was to determine which patient factors are associated with injurious falls in hospitalized adults.

Methods: The study site’s adverse event reporting database was used to identify 1,369 patients who fell between January 1, 2006, and October 31, 2013. Of these, 381 (27.8%) subjects suffered injurious falls. Variables of interest included age, sex, fall history, use of diuretics, use of central nervous system medications, cognitive impairment, primary discharge diagnoses, abnormal laboratory values, impaired mobility, and […]

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Diane Szulecki, editor2016-11-21T13:00:58-05:00August 31st, 2016|Nursing, nursing research|0 Comments

AJN in September: Predicting Injurious Falls, Military Sexual Trauma, Recognizing MI, More

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

CE Feature: “Original Research: Predicting Injurious Falls in the Hospital Setting: Implications for Practice”

Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet most of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls. In an attempt to identify which patient factors are associated with injurious falls in hospitalized adults, the authors of this retrospective study analyzed 10 variables. Their findings may help hospital clinicians to identify at-risk patients and create better fall-related injury prevention interventions.

CE Feature: “Military Sexual Trauma in Male Service Members”

The experience of military sexual trauma (MST), which can result from assault, battery, or harassment of a sexual nature, may jeopardize the mental health of service members. This article discusses the unique ways in which men may experience MST and examines how social stereotypes of masculinity, myths surrounding sexual assault, and military culture and structure often influence a man’s interpretation of an attack and his likelihood of reporting the incident or seeking treatment. It also describes current treatments for MST-related mental health conditions and addresses implications for nurses and other health care professionals.

Diane Szulecki, editor2016-11-21T13:00:58-05:00August 26th, 2016|Nursing, nursing perspective|0 Comments

Information for Nurses Who Help in Disasters

Nurses are often at the front lines of disaster response. How prepared are nurses—and the hospitals and other facilities where they may work?

Louisiana National Guard, Baton Rouge River Center, Aug 15, 2016, after flooding pushed residents from homes. (U.S. Army National Guard photo by Spc. Garrett L. Dipuma/RELEASED)

The television news reports have recently been full of the devastating flooding in Louisiana. Especially heart-wrenching are the images of people, especially frail […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-11-21T13:01:01-05:00August 22nd, 2016|Nursing, Public health|0 Comments