Off the Charts

Do Schools Still Have Nurses?

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

by woodley wonderworks, via Flickr.

In the December 1903 issue of AJN (reprinted, with an editor’s commentary, in September 2014), Henry Street Settlement nurse Lina L. Rogers described the impact of the first school nurse program in the United States. Ms. Rogers, who worked with Henry Street founder Lillian Wald to establish the program in New York City schools, emphasized that their purpose was not only to improve children’s health but to decrease missed school days.

Wise community leaders have long acknowledged the importance of school nursing in accomplishing these goals. But in recent years, this hasn’t prevented cutbacks that eliminate or severely limit the care that nurses can provide to their school communities.

An October 10 article in the Philadelphia Inquirer describes an acute shortage of nurses in Philadelphia schools. Detailed here are multi-school coverage by individual RNs, wildly unrealistic caseloads for many of the nurses, and the significant responsibilities for “medical care” now borne by non-nurse teachers and administrators. In the article, Terry Jordan, president of the Philadelphia Federation of Teachers, underscores the complexities of school nurse work, noting, “We have so many families living in deep poverty, and for some of these families, the only […]

Betsy Todd, MPH, RN2016-11-21T13:01:51-05:00October 16th, 2015|Nursing|4 Comments

The First 50 Years of NPs: An Illustrated Timeline Shows Triumphs, Continuing Practice Barriers

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

This year marks the 50th anniversary of the nurse practitioner (NP) role. Themes of innovation and sustainability emerge as one examines an illustrated timeline of the history of NPs in AJN‘s October issue and reads the accompanying text. (The first section of the timeline is below. Click to enlarge.)

How did this advanced practice nursing role come into being? As the timeline explains, ” [d]uring the 1960s, health care was becoming increasingly specialized. Physicians were moving out of general practice and into more complex and lucrative specialties, creating a void in primary care and prevention services, and in care of the chronically ill.”

To fill this void, public health nurse Loretta Ford, working with Dr. Henry Silver at the University of Colorado in 1965, launched the first NP certificate program, a seminal moment in the history of this prevention-driven, primary-care-focused nursing role.

Ford wrote about the compelling need for NPs. Calling health care a capital investment, Ford said:

“We have failed to realize the full potential of professional nurses to improve the quality of life. This group has great unused potential for bringing about health care reforms. Properly prepared and effectively utilized, nurses could advance the nation’s health […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:52-05:00October 15th, 2015|career, Nursing, nursing perspective|0 Comments

Case Studies in Effective Care Coordination by Nurses in Rural Kansas

“I did not have a clue how to proceed.”

Care coordinator Burlay Parks meets with a patient at Greeley County Health Services in Tribune, Kansas. Photo by Chrysanne Grund.

The opening sentence of “Pathfinding on the Frontier,” the In the Community column in the October issue of AJN, alludes to the confusion even the most organized and savvy person sometimes feels when navigating our health care system.

In rural settings, referrals to specialists from primary care providers can be difficult for patients and families to follow up on, sometimes requiring that patients travel great distances.

Patient care coordination has been shown to decrease the number of ED visits and hospitalizations. The authors of this article explore care coordination in two Kansas counties, presenting three case studies showing how a nurse care coordinator—as part of a program at a rural primary care practice funded by a two-year grant from the Robert Wood Johnson Foundation—resolved complex issues for seriously or chronically ill patients involving medications, specialists, and diagnoses. […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:56-05:00October 12th, 2015|Nursing, nursing perspective, Patients|1 Comment

One Nurse’s Ode to Fragility

Illustration by Lisa Dietrich for AJN.

For nurses, the world outside work may from time to time seem as fragile and tenuous as the health of patients. Natural disasters threaten homes, illnesses afflict family members, the reminders of impermanence become too insistent. This month’s Reflections essay, “The Robin,” explores such emotional terrain with sensitivity and honesty.

Gentle warning: This is not an essay that neatly delivers a pearl of take-home wisdom at the end. But that’s what we liked about it. Sometimes the best we can do is hang in there and pay close attention. And, if we’re able and willing, write about it. Here are the opening few paragraphs of this short essay: […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:01:56-05:00October 7th, 2015|narratives, Nursing, nursing perspective|1 Comment

Message to Authors: Think. Check. Submit.

By Maureen Shawn Kennedy, AJN editor-in-chief

The above three words sum up the message of a new campaign to increase awareness among researchers and authors about predatory publishers—entities that take advantage of authors by unscrupulous practices that often leave the authors tied up in a contract and owing a large fee to publish in a journal that has little or no standing. (See my related editorial on predatory publishing in the April issue of AJN.)

Promising rapid publication, predatory journals lack peer review and fact-checking, often tout fake metrics, and may adopt names that are deceptively similar to those of established journals. Jeffrey Beall, a librarian at the University of Colorado, has been tracking predatory publishers since 2009 and maintains a list of them on his Web site, Scholarly Open Access.

The Think. Check. Submit. campaign describes itself as an “industry-wide initiative that provides a checklist of quality indicators that can help researchers identify if a journal is a trustworthy.” It’s a new campaign “produced with the support of a coalition from across scholarly communications in response to discussions about deceptive publishing.” In brief, it asks authors to:

THINK about where they should publish their work. Are the journals they are considering reputable?

CHECK the list of questions designed to help determine if a journal is respectable and […]