Helping New Nurses Find Their Way: The Art of Saying Yes

A Preceptor’s Example

Photo by Ed Eckstein Photo by Ed Eckstein

AJN’s Transition to Practice column is designed to help new nurses in their first year at the bedside. In this month’s column, “The Art of Saying Yes,” Amanda Anderson explains how as a new nurse she learned the benefits (to herself and her patients) of going the extra mile at work. She describes the surprising personal and professional benefits that come from “the times you choose to say yes when you might just as easily have deferred.”

Anderson paints a vivid picture of her first days on the job as a nurse: The fear of making mistakes, the feeling of being a useless novice, the shame of not always being able to keep up with seasoned staff. She was fortunate, though, to have an expert mentor in those early days. Her preceptor was an experienced nurse who modeled the art of saying yes—an art that might be described as a willingness to leap in to help when not required to do so: to take on a housekeeping task, for example, or pitch in unasked to help another nurse whose day is spinning out of control.

“There is no term for this concept in the literature,” writes Anderson. […]

November 18th, 2016|career, Nursing|3 Comments

Nurse-Led Evidence-Based Sleep Program Helps Hospitals and New Mothers Keep Babies Safe

Photo © Associated Press. Photo © Associated Press.

I can remember, when I was pregnant, reading everything I could get my hands on about every mother’s fear—sudden infant death syndrome (SIDS). My mother, who followed the norms of her time when I was born, was surprised that my son’s crib was bare—no blankets, pillows, toys, or bumpers. He wore a sleep sack and was placed on his back to sleep until he began to roll over by himself.

To add to what I learned from my preparatory reading, the nurses at the hospital I gave birth in set a standard for how to care for my newborn—explaining the abovementioned safe sleep tips, and much more. After all, nurses are probably a mom’s first stop for this information, helping new mothers navigate the choppy waters of caring for their newborns.

This month’s Cultivating Quality article, “An Evidence-Based Infant Safe Sleep Program to Reduce Sudden Unexplained Infant Deaths,” from the Hospital of the University of Pennsylvania, describes a nurse-led community program begun after two infants were lost to sleep-related deaths following discharge from the hospital’s neonatal ICU (NICU).

To develop the program, an interdisciplinary team made up of nurses, a physician, an […]

November 18th, 2016|Nursing, patient safety, pediatrics|11 Comments

Remembering a Tough NYC Detective on the 41st Great American Smokeout

Photo of AJN editor-in-chief Shawn Kennedy AJN editor-in-chief Shawn Kennedy

My uncle Joe embodied the persona of the old-time tough NYC Irish detective—he was over six feet tall, had piercing blue eyes and white hair, always wore a tan raincoat, and always had a cigarette in his hand. As a child, my siblings and I were always a little bit afraid of him. That image faded, though, and my last image of him was hunched over, with an oxygen cannula, trying to breathe. All those cigarettes added up, and after a lifetime of smoking, he died from chronic lung disease. This was before the landmark report on smoking and health issued by the U.S. surgeon general in 1964. Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC) Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC)

Today is the 41st annual Great American Smokeout—the day created by the American Cancer Society (ACS) to help encourage smokers to quit smoking. According to the Centers for Disease Control and Prevention (CDC), smoking is the leading cause of preventable death and is responsible for “more than […]

Taking Skin Tear Prevention and Management Seriously

In the Past, Approaches to Skin Tears Were Inadequate

Many years ago, when I worked in a skilled nursing facility, it seemed my patients were always experiencing skin tears. We didn’t have wound care specialists then. My approach to these injuries, which I didn’t see as serious, was to cleanse them with saline and awkwardly attempt to reposition the detached flap. In retrospect, the nursing care I provided didn’t amount to much more than “a lick and a promise.”

Greater Awareness of Risks, Dangers of Skin Tears

screen-shot-2016-11-14-at-6-09-55-pmToday, we know that skin tears can evolve into serious, complex wounds. Available data indicate that in long-term care settings, these injuries affect up to 22% of residents. Wound care specialists have developed a classification system for skin tears—as for pressure injuries, specific recommendations from wound care specialists guide our nursing care.

In this month’s AJN, author Sharon Baranoski and colleagues from the International Skin Tear Advisory Panel detail the assessment and management of skin tears in “Preventing, Assessing, and Managing Skin Tears: A Clinical Review.” While the authors emphasize the need to involve wound care nurses in the management of these injuries, many readers may find the product selection guide in this article to be especially useful. […]

November 14th, 2016|Nursing|3 Comments

All Saints’ Day Blessing for Health Care Providers

Autumn Angel / photo by Julianna Paradisi 2016 Autumn Angel / photo by Julianna Paradisi 2016

November is the strangest of months. Its days are shorter, darker. It begins with All Saints’ Day, a day of remembering our dead, of loss and grief, followed late in the month by Thanksgiving, America’s celebration of abundance with gratitude.

This year on All Saints’ Day I attended a discussion of health care professionals. The audience included nurses, physicians, pharmacists, social workers, and hospital administrators. The conversation ultimately centered on the emotional difficulties of patient care.

It wasn’t a debriefing as much as collective acknowledgment that, rather than accepting help, some patients or their family members view us as the enemy, sometimes disrupting our best efforts in the name of misguided advocacy.

Nurses spoke of being labeled as “bad” and played against each other by angry patients or family members. Physicians related episodes of verbal abuse from patients or family members demanding inappropriate procedures, medications, or dosing. Some spoke of needing to take refuge to center their thoughts before ordering the appropriate care.

Like most nurses, I’ve experienced similar treatment at the hands of difficult patients, but physicians don’t generally discuss with us how they are treated. Nurses and physicians suffer silently, instead of lending support to each other.

There were no answers. We were simply a large group of health care staff with varying responsibilities, given an hour to talk […]

November 10th, 2016|Nursing, Patients|1 Comment