Asleep at the Wheel: Night Shift and Drowsy Driving

‘The most exhausting year of my life.’

Photo by Jan Baborák/ Unsplash

In my 25-year-plus nursing career, I’ve had the opportunity to work every shift—days, nights, evenings, 8-hour and 12-hour shifts. Without a doubt, my least favorite was 12-hour night shifts, as I am more of a morning person than night person.

When I was a new graduate, it was hard finding a job on the day shift, since it’s typically more popular and there are fewer openings for inexperienced nurses. Because of this, I accepted a position working from 7 pm to 7 am.

It was the most exhausting year of my life. No matter what I tried, I couldn’t sleep well during the day, and by the end of the 12 hours I was wiped out. Although I was lucky enough to live only a few miles from the hospital, I found it difficult to stay awake for the whole ride home. I would catch myself trying to keep my eyelids from closing, and a few times I briefly fell asleep at red lights.

Close calls on the roads.

I am grateful that nothing bad ever happened during my sleep-deprived journeys. I have a friend who wasn’t as lucky and totaled her car one morning on the […]

2021-10-04T11:15:27-04:00October 4th, 2021|Nursing|0 Comments
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Are Fall Prevention Precautions Missing the Mark?

Happy first day of autumn! Let’s have some fall talk.

If you spend any time in the acute care setting, you’ll be inundated with signs of fall precautions: yellow alert armbands, yellow nonslip socks, yellow signs on patient room doors, and of course the constant ringing of bed alarms.

It appears that hospitals put a lot of effort into fall prevention, and understandably so—falls cost hospitals money. These costs include tests and procedures that aren’t covered by insurance, increased length of stay while the patient recovers, and lawsuits from injured patients or from their families.

Checking boxes vs. individual patient needs.

However, the current approach of applying all precautions to all patients at risk for falling isn’t supported by research, and may decrease patient satisfaction. Sometimes it seems more focus is put on checking boxes about having prevention strategies in place than on the actual patient’s preferences or needs. For example, a former patient told me about a time she was in the bathroom of her hospital room and felt lightheaded. Rather than risk falling, she eased herself to the floor and hit the call bell for assistance to get back to bed. Upon finding her on the floor, the staff were so focused on filling out an incident report and assessing her for injury that they ignored her attempts to explain what actually happened.

The ‘next era’ in fall reduction.

2021-09-22T09:47:00-04:00September 22nd, 2021|Nursing, patient safety, Patients|0 Comments
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Demystifying Clinical Research: A Series for Nurses Breaks It Down

No matter where you are working as a nurse, research is impacting the work you do. The articles in our two Evidence-Based Practice (EBP) series (the EBP Step by Step series and the EBP 2.0 series) remain some of the most-read AJN articles. However, you can’t develop or implement EBP projects without reading and understanding research articles.

Like learning a foreign language.

Clinical research can be intimidating for those not familiar with it. I liken it to learning a foreign language. And as with learning a new language, it makes sense to start at the basics and build your vocabulary as you go. Our latest series, Nursing Research, Step by Step, “is designed to give nurses the knowledge and skills they need to participate in research, step by step.” […]

2021-06-24T11:27:57-04:00June 24th, 2021|Nursing|0 Comments
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Caring for Caregivers—We Need More Than Self-Care and Resilience

Mural painted by critical care unit staff to honor patients who contracted COVID-19. The stars represent those who succumbed to the illness and the flowers those who were discharged from the hospital. Mural by the MedStar Montgomery ICU Team; photo by Cherri Walrath.

Self-care is not a panacea.

Since the start of the pandemic, AJN has received many manuscripts and queries related to self-care and resilience to prevent burnout. It’s not surprising, given that this has been a harrowing year for nurses.

But while self-care and resilience are important, and such articles are needed, all the self-care in the world can’t fully address the root of the problem—the systemic issues that lead to burnout. At some point health care administration needs to step in and become part of the solution and offer staff the help they need.

A CE feature in our May issue, “Providing Care for Caregivers During COVID-19,” highlights one hospital system’s efforts to do just that. The Care for the Caregiver program, which existed prior to the pandemic, was created to support ‘second victims,’ defined by the Center for Patient Safety as “healthcare providers who are involved in an unanticipated adverse patient event, medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized […]

2021-05-27T09:19:17-04:00May 27th, 2021|Nursing|0 Comments
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Celebrating Earth Day: Connecting Health and the Environment

Photo by Fateme Alaie via Unsplash

Earth Day, celebrated on April 22, is an annual event to demonstrate support for environmental protections. First held in 1970, it now includes a wide range of events coordinated in more than 192 countries across the globe. The Earth Day celebration that stands out most for me was the 20th anniversary held in Central Park in New York. The event was estimated to have drawn more than 750,000 people—a big incentive being the free concert, which included a performance by the B-52s (who doesn’t love “Love Shack”?).

This year marks the 41st Earth Day, and amidst a global pandemic, activities will look a lot different. (Click here for more information on the virtual events taking place this year.)

Free articles from our environments and health column.

In honor of Earth Day, AJN would like to offer free access to the below selection of articles from our Environments and Health column until May 15. There’s a lot to unpack in these articles—from steps to reduce waste at the hospital level, to how nurses can get involved in fighting climate change, to how patients’ health can be affected by our environment, particularly the mental health conditions that may arise amid extreme […]

2021-04-22T14:42:23-04:00April 22nd, 2021|climate change, environmental health, environmental health, Nursing|0 Comments
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Improving the Response to Mental Health Emergencies

What is a mental health crisis?

Image by Petra Šolajová from Pixabay

As a psychiatric NP, I treat patients with mental illness through medication and therapy, but there are no guarantees treatment will work. It’s often a process to find a medication that both works to control the patient’s symptoms and doesn’t cause the unwanted side effects (such as sedation and weight gain) that can make a patient not want to continue taking it.

While this process is happening, the patient is living his or her life, coping with usual stressors such as working and navigating personal relationships, and possibly more intense stressors like poor living conditions or trauma. These factors can put someone at risk for a mental health crisis.

According to the National Alliance on Mental Illness (NAMI), “a mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.” When a person exhibits these types of behaviors, it’s common for 911 to be called and for police officers to arrive on the scene. This can have dangerous ramifications for the person with mental illness. However, there […]

2021-04-14T10:10:40-04:00April 14th, 2021|Nursing|0 Comments
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With Severe Mental Illness, A Vicious Circle of Stigma and Lack of Support

Although psychiatric facilities no longer treat patients the way movies like The Snake Pit and One Flew Over the Cuckoo’s Nest depicted, society’s treatment of people with mental illness is still lacking.

As a psychiatric nurse practitioner, I provide care for patients coping with the challenges of mental illness. Symptoms are often painful, life altering, and frightening. Sadly, patients experience additional suffering from the guilt, shame, and social isolation that comes with having a psychiatric disorder. That’s because mental illness continues to carry a stigma that inhibits people from seeking help and limits the amount of services available for those who do seek it.

Had they received the support they needed….

In this month’s Viewpoint in AJN, Juliet Hegdal, a family nurse practitioner, discusses the impact severe mental illness has on patients and their family members. The author shares what it was like being raised by a mother with schizophrenia and the lack of resources available to her and her family. She posits that her mother and society would have been better off had she received the support she needed. […]

2021-02-23T13:48:16-05:00February 23rd, 2021|mental illness|0 Comments
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American Journal of Nursing (AJN)

The American Journal of Nursing has been a crucial voice shaping and reflecting the evolution of the nursing profession since 1900. Published monthly in print and online, AJN is considered the profession’s premier journal.

Mission
AJN‘s mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.

Standards
AJN adheres to journalistic standards that require transparency of real and potential conflicts of interests that authors and editors may have. It follows publishing standards set by the International Committee of Medical Journal Editors (ICMJE; www.icmje.org), the World Association of Medical Editors (WAME; www.wame.org), and the Committee on Publication Ethics (COPE; http://publicationethics.org/).

Submissions
AJN welcomes submissions of evidence-based clinical application papers and descriptions of best clinical practices, original research and QI reports, case studies, narratives, commentaries, and other manuscripts on a variety of clinical and professional topics. The journal also welcomes submissions for its various departments and columns, including artwork and poetry that is relevant to nursing or health care. Guidelines on writing for specific departments—Art of Nursing, Viewpoint, Policy and Politics, and Reflections—are available at http://AJN.edmgr.com.

Visit the AJN homepage to see the latest issue, listen to podcasts, browse the archives, and more. And click here to […]

2023-05-25T12:42:15-04:00April 25th, 2016|Comments Off on American Journal of Nursing (AJN)
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Are Job Prospects Improving for New Nurses?

Image via Wikimedia

Back in 2010, we ran a post by our then clinical editor, Christine Moffa. It was called “Prospects for New Nurses: Thoughts On Graduating During a Downturn” and it generated quite a few comments. Below is a sampling of excerpts. Some people were pretty distressed, wondering whether they should take jobs that separated them from their families, facing criticism from people who expected they should find a job easily. After all, they were nurses! And we all know they are always in demand.

We’ve been hearing anecdotally that the prospects for new nurses are getting better overall. Is this your experience?—JM, senior editor

“It costs a lot of money to train nurses, especially new grads. Many employers want experienced nurses. The best piece of advice given to me was to stay with same healthcare system/unit floor I worked with as a student nurse. Even that prospect, however, seems to be circling the drain for the same reason I hear over and over again: EXPERIENCE REQUIRED!!! Relocation may not be an option for some people….I’m sure I will eventually get a job, but it’s the uncertainty of my future that frustrates me. It’s quite aggravating to have worked so hard in school only to be disappointed in the end.”

“I just graduated in March and am really worried about getting a job. Thankfully I will be able to stay at my current job as a RN- I worked there as a LPN for almost […]

2016-11-21T13:10:05-05:00May 17th, 2012|students|1 Comment
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AJN’s Top 10 Blog Posts for the Last Quarter

At this blog we’re not always devoted practitioners of the art of the list. Used too often and too cynically (some of the more mysterious nursing blogs consist entirely of lists of articles and excerpts from other blogs), lists can be just another form of journalistic cannibalism.

But it sometimes occurs to me, as I publish a new post that takes its place at the top of the home page and pushes all those below down another notch (until, after a few such nudges, they gradually fall off the page, entering the purgatory of the blog archives), that this isn’t entirely fair.

While blogs allow for quick reaction to a news story, a public health emergency or controversy, a new bit of published research, they are also places for writing that isn’t so narrowly tied to a specific date and event. Many thoughtful posts by excellent writers have been published here in the past couple of years. With this in mind, here’s a list of the 10 most read blog posts for the past 90 days. It doesn’t mean that these are necessarily the very best posts we published in that time, or that they were even published in the last 90 days . . . but it’s one way of measuring relevance.—Jacob Molyneux, senior editor/blog editor 

1. Dispatches from the Alabama Tornado Zone
This one is actually a page with links to a series of powerful and thought-provoking posts by Susan Hassmiller, the Robert Wood Johnson Foundation Senior Adviser for Nursing, who volunteered with the Red Cross after the devastating Alabama tornadoes in late April of this year.

2. 

2016-11-21T13:12:17-05:00August 2nd, 2011|healthcare social media, nursing perspective, students|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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