A Curricular Blind Spot: Skin Assessment for Patients with Dark Skin Tone

The Time to Build Assessment Skills for Dark Skin Tone is Now

As a faculty member teaching prelicensure nursing for nearly three decades and a former adult critical care nurse, I have had the opportunity to review countless nursing textbooks. Unfortunately, we have a serious curricular blind spot regarding caring for and assessing conditions in dark skin tone patients. It is time we provide equitable education and patient care to all human beings of all skin tones for safe and effective care.

Development of Descriptive Terms for Dark Skin Tone Conditions

Consensus is needed for new and revised standard definitions of the terms and protocols currently in nursing textbooks and teaching-learning materials to incorporate dark skin tone. Terms such as erythema, pink, pallor, and non-blanching are some of the terms that need new descriptions reflecting how they represent or manifest in dark skin tone.

In addition, skin assessment protocols, guidelines, images, and overall protocols—pressure injury stages, the skin […]

2023-03-13T09:11:11-04:00March 13th, 2023|equity, Nursing|3 Comments

Tuning in to Humor in Nursing

1. Nurses Don’t Have to Make This Stuff Up

Photo by Kah Lok Leong on Unsplash

During a fire drill the nurse, Kathryn, was closing doors to patients’ rooms. An 86-year-old patient was talking on the phone to her daughter when Kathryn reached her room. As Kathryn started to shut the patient’s door, the woman asked, “What’s that ringing noise?”

“Don’t worry,” Kathryn said. “We’re just having a little fire drill.”

As she was leaving, Kathryn heard the woman tell her daughter, “No, everything’s just fine, dear. The hospital’s on fire but a nice little nurse just came to lock me in my room.”

Having worked as a nurse, as well as having interviewed hundreds of nurses over the years, I can attest that you don’t have to make this stuff up. Yet nurses from coast to coast right now are telling me, “There’s nothing funny happening in my life.”

Having studied the brain and humor for decades, I can tell you that if that is your belief, that will also be your reality. Telling yourself there’s nothing funny around you will wire your reticular activating system to show you just that—nothing funny.

Even during times of chaos—overwhelming patient census, lack of resources, staffing shortages—humorous material […]

March Issue: Preventing Functional Decline in Hospitalized Older Adults, Tumor Lysis Syndrome, More

“Nurses do the big things, but I am thankful for all the small things: for bringing peace in the eye of the storm…for providing us coordinates when we felt lost…for making us laugh—for doing the things that we remember, the things that last years later.”—Holly Bills in this month’s Reflections article, “The Little Things Nurses Do”

The March issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Tumor Lysis Syndrome: An Oncologic Emergency

What nurses need to know about preventing and treating this serious condition, including recognizing its clinical presentation, identifying at-risk patients, and monitoring and managing symptoms and laboratory values.

Original Research: Impact of a Bedside Activity Device on the Functional Status of Hospitalized Older Adults: A Randomized Controlled Trial

This pilot study evaluated the use of a device equipped with exergames—interactive video games that incorporate physical exercise—in preventing functional decline and increasing patients’ independence in basic activities of daily living.

Skin Assessment in Patients with Dark Skin Tone

The authors provide basic information about the assessment of dark skin tone and call for action in academia and professional practice to ensure the performance of effective skin assessments in all patients.

2023-02-27T09:43:34-05:00February 27th, 2023|Nursing|0 Comments

Why Spiritual Care?

Staying connected to something greater.

Photo courtesy of Pexels/Pixabay.

In a world that is constantly asking more of us, how can we stay connected to ourselves, to something greater, to a sense of meaning and purpose in our lives? This question guides most of my work, and my personal practices. Across years of conducting mixed-methods research to explore the role of spirituality among people with cancer, I am constantly presented with ways where our connection to spirit is challenged, and ways that we can remain connected amidst the very real pain, challenge, busyness, stress, and burnout of this modern world.

Making time and space for spirituality may seem elusive or impractical, especially when considering the limitations on our time and capacities. Along with co-authors Katie Addicott, MSN, FNP-C, ACHPN, and William E. Rosa, PhD, MBE, AGPCNP-BC, FAANP, FAAN, my hope for this recent piece in the American Journal of Nursing is to highlight simple, practical, and enjoyable ways to incorporate spirituality into everyday life and everyday nursing care, with the intention of supporting our own well-being and the well-being of patients and families we work with.

Defining spirituality 

While various definitions have been offered, “spirituality” generally refers to a human experience of connection with […]

2023-02-21T10:51:33-05:00February 21st, 2023|end of life, Nursing, Palliative care|0 Comments

40-years of Forensic Nursing and Current Opportunities in Remote Sexual Assault Care

Remembering an influential article.

Patricia Speck

Timing is everything. Forensic nursing service through telehealth is possible today, as reported in a recent Kaiser Health News story, but it wasn’t always that way. Fifty years ago, Ann W. Burgess, a psychiatric–mental health nurse working in the emergency room, wrote a paper with a sociologist colleague about what she was seeing in patients who complained of being raped. “The Rape Victim in the Emergency Ward” (pdf), published in AJN, was reported nationally and informed 1970s kitchen table conversations about what rape is, is not, and when “no means no.”

Naming the trauma and its effects.

The ideas in this article were new at the time. Burgess wrote that sexual assault causes acute emotional trauma, requiring time for recovery, and she named phases of what she eventually called “rape trauma syndrome.” Prior to the article, victims of sexual assault often did not report the assault, and when they did they waited hours for a newly minted physician intern who had been punished with “rape-duty.” These physicians had no knowledge about what to do.

In accordance with societal views at the time, victims were often blamed for their rape—the way you dress, how you act, […]

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