How a Nurse Quietly Helped One Intern Out of a Tricky Situation

Illustration by Annelisa Ochoa. All rights reserved Illustration by Annelisa Ochoa. All rights reserved

In this month’s Reflections essay, “My Turn,” a recently retired physician tells a story of how a nurse adroitly helped him through a very disorienting moment when he was still an intern. Here’s a bit of the setup:

Medicine was my first rotation as an intern. . . . [T]he medicine rotation had a particularly intimidating reputation and a red-hot I was not. I was terrified.

On morning rounds every day our entourage of physicians, nurses, and students would go room to room discussing each patient. I can still see the open door to Mrs. Finkelstein’s room near the morning sunlight at the end of the hallway. Mrs. Finkelstein was old and was dying. And every morning when we walked in, her husband was sitting there next to the bed, holding her hand. He told us regularly how many years they had been together. We each dreaded being the one on call when she died.

There are many situations in medicine and nursing that require a certain amount of experience—most readers will agree that this is definitely one of them. At a certain point in the story, the author finds himself being asked a question that absolutely needs to be answered, and answered immediately. It’s not […]

Attention to Patients’ Mobility: Low-Tech But Essential

A critical care nurse led a multidisciplinary team to explore the effects of a dedicated ‘mobility team’ on functional and other outcomes in ICU patients.

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

julie kertesz/ via flickr creative common julie kertesz/ via flickr creative common

It’s long been known that immobility leads to deconditioning. Various studies indicate that muscle strength drops by 3% to 11% with each day of bed rest. As most of us have witnessed firsthand in both patients and family members, it can take months to regain pre–bed rest levels of functioning. For some people, the strength and mobility needed for independence never return.

In this month’s issue, a community hospital critical care nurse led a multidisciplinary team to explore the effects of a dedicated “mobility team” on functional and other outcomes in ICU patients. In “Implementation of an Early Mobility Program in an ICU,” Danielle Fraser and colleagues share what they learned.

The mobility team consisted of a physical therapist, a critical care RN, and an ICU rehab aide. Respiratory therapists worked closely with the team. Patients assigned to the early mobility intervention could progress through four successive levels of movement, from passive range-of-motion exercises to full ambulation.

Compared with ICU patients who received routine care, the patients in the intervention group were more functionally independent at discharge. In addition, this early […]

The Stay-at-Home Nurse

“You may not always take your work home with you, but you take your nurse self everywhere.”

Diane Stonecipher, BSN, RN, lives in Austin, Texas.

by rosmary/via Flickr by rosmary/via Flickr

The proverbial “what do you do?” always flummoxed me. My answer was usually some variation on this: “I used to be a nurse, but I have not worked outside the home while I’ve been raising my sons.”

But most people stopped listening after the “I used to be.” Sure, I could recite some things that I had done during the intervening years, but they were not really vocations I could make a claim to.

Even my children, who I had after first being a nurse for 15 years, never thought of me as a nurse. I did not leave the house for work, I did not get paid, I did not gripe about my job (in front of them), and I was available to them 24/7.

There are many professions that lend themselves to being a good mother. There are many interests, talents, and personalities that contribute to good mothering skills. Look at nature and you will see incredible maternal gifts in every species.

Still, I can’t help but think that I have been a better mother because I am a nurse and that my children have benefited in […]

2016-11-21T13:01:41-05:00December 4th, 2015|career, narratives, Nursing, nursing perspective|3 Comments

Fracking, Health, and the Environment: More Bad News

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

U.S. EPA / via Wikimedia Commons U.S. EPA / via Wikimedia Commons

Last month, Physicians for Social Responsibility and Concerned Health Professionals of New York released the third edition of their Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking. This document summarizes more than 500 peer-reviewed studies on hydraulic fracturing (fracking),  along with many government and investigative journalism reports.

Fracking involves drilling into the earth and injecting a mixture of water, sand, and chemicals into the rock at high pressure to release the gas inside. There is extensive evidence to demonstrate health risks, environmental damage, and contributions to climate change caused by this practice.

The compendium is intended for policy makers, researchers, journalists, and the public. Specific fracking-related problems identified in this body of literature include the following:

  • Public health impacts, including respiratory disease and congenital abnormalities
  • Air pollution
  • Water contamination
  • Soil contamination and its effects on agriculture
  • Radioactive releases
  • Inherent engineering problems
  • Occupational health and safety hazards
  • Impacts from fracking-associated infrastructure, including noise, light, and diesel pollution
  • Earthquakes and seismic activity
  • Climate change (primarily from methane leaks)

[…]

AJN in December: Inside an Ebola Unit, Acupressure, Early Mobility, EHRs, More

AJN1215.Cover.OnlineOn this month’s cover, nurse Elie Kasindi Kabululu cares for a patient at Centre Médical Evangélique in Nyankunde, Beni, Democratic Republic of Congo. Originally, this location served a population of 150,000 and also housed a nursing school; but in 2002, during war in the region, the facility was attacked. About 1,000 people were killed—including patients and staff—and the center was looted and destroyed.

Providing medical assistance in the world’s war-torn and neediest areas is commonplace for health care providers like Kabululu, just as it is for humanitarian organizations such as Médecins Sans Frontières (MSF), which works in 70 countries worldwide—nearly half of these in Africa. Shortly after the recent outbreak of Ebola in West Africa, MSF sent close to 300 international workers to help combat this public health emergency. To read one nurse’s experience traveling to Liberia for MSF to work in a treatment center, see “Inside an Ebola Treatment Unit: A Nurse’s Report.”

Some other articles of note in the December issue:

Original Research: Implementation of an Early Mobility Program in an ICU.” This article, from our Cultivating Quality column, recounts how the effects of an early mobilization program delivered to critically ill patients at a community hospital by an independent ICU mobility team contributed to fewer delirium days and improvements in patient outcomes, sedation levels, and functional status.

CE Feature: Incorporating Acupressure into Nursing Practice.” The effects of acupressure can’t always be explained in terms of Western anatomical […]

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