Is It Time to Retire the Term ‘Midlevel Practitioner’?

Rachel_Scherzer_photo_and_calloutWhat are the implications of calling advanced practice nurses “midlevel practitioners”? According to Rachel Scherzer, a nurse educator and critical care nurse, such a term pigeonholes APNs in an implied (and disproven) hierarchy of value and quality of care rather than in relation to specific competencies and expertise.

In the Viewpoint essay in the July issue of AJN, Scherzer describes some of the reasons why such terms aren’t just inaccurate, they damage the standing of the profession:

Policymakers use the term while developing health care policy, health care economists use it when reporting data and performing cost analyses, and other health care providers use it in the clinical setting. . . . This term is both diminutive and inaccurate, implying that these professionals cannot provide the same level of care as other members of the interprofessional care team. Referring to APNs as “midlevel” practitioners contributes to a general misunderstanding of their role and of the services they provide.

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2016-11-21T13:01:06-05:00July 5th, 2016|career, Nursing, nursing perspective, Public health|0 Comments
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The View from the Other Side: When the Daughter is a Nurse

I knew where we were heading and it scared me. I didn’t want to have to think about decisions that would have to be made in the not so distant future. I didn’t want to be a nurse; I just wanted to be the daughter.

Flowers_in_the_field_(5832054482)I knew Marie was special the moment I met her. Her home was one where all were welcome, the coffee always hot and fresh, the house filled with family and friends, and everyone left with a full belly. She freely shared her opinion, whether or not a person sought out her advice.

I knew Marie for nearly 30 years. She was my mother-in-law. She was also my cheerleader, proud that I had come so far in my nursing career. She told everyone I was a nurse and often referred to me as her daughter rather than specifying that I was her daughter-in-law.

Fiercely loyal and loving of her large family, she always put their needs before hers. I worried about her because she smoked and rarely visited a doctor. With regard to health, she believed in the notion that if it ain’t broke, don’t fix it. But slowly, health problems began cropping up. After a hospitalization for heart failure, she was diagnosed with COPD and hypertension.

Still, she […]

2016-11-21T13:01:07-05:00June 30th, 2016|narratives, Nursing, nursing perspective, patient engagement|1 Comment
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A Strong Case for the Professional Introduction in Nursing

nametagDo you always introduce yourself by name to your patients? Or do you simply say, “Hi, I’ll be your nurse today?”

In their Viewpoint essay in the June issue of AJN, Raeann LeBlanc and two colleagues at the University of Massachusetts Amherst College of Nursing make a strong case for the professional introduction, in which “a nurse states her or his full name and role in the patient’s care.”

The authors argue that professional introductions are “a powerful way to make clear the centrality of the nurse’s role in the care of the patient.” When nurses use professional introductions, we make our knowledge and expertise more visible and help patients better understand just what it is that nurses do.

The authors also address potential safety concerns nurses may have about disclosing their full name to a patient, and they offer some reasons why the importance of professional introductions may not be taught in nursing school.

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2016-11-21T13:01:07-05:00June 28th, 2016|Nursing, nursing perspective, patient engagement, patient experience|5 Comments
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The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

“The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, should I […]

2016-11-21T13:01:07-05:00June 27th, 2016|narratives, Nursing, nursing stories|0 Comments
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AJN in July: Opioids and Chronic Pain, Moral Distress, Prediabetes, More

CE Feature: “Appropriate Use of Opioids in Managing Chronic Pain.”

Unintentional death related to prescription opioids has been identified as a public health crisis, owing in part to such factors as insufficient professional training and medication overprescription, misuse, and diversion. The authors discuss current best practices for prescribing opioids for chronic pain, emphasizing patient assessment and essential patient teaching points regarding safe medication use, storage, and disposal, and after you find a more permanent solution people could totally quit opioids by using a detox methods that goes from medicine to even a detox tea like leptinteatox. There are some medicines or supplements that are more easy to use, depending on the problem, like the peruvian brew, that helps with erectile dysfunction and is pretty safe. After that you only need to be careful with stds diseases you can go and test at https://www.stdaware.com/chlamydia-test.

CE Feature: “Moral Distress: A Catalyst in Building Moral Resilience.”

Moral distress is a pervasive problem in nursing: an inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as a […]

2017-05-26T00:08:51-04:00June 24th, 2016|career, health care policy, Nursing, nursing research, pain management, Patients|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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