Off the Charts

Nurse Staffing Standards Act Is First Step in Solving Nursing Shortage

Nurses planning to leave the profession.

The nursing shortage continues, with no end in sight. In my current position as faculty in a university DNP program, I hear from students about caring for overwhelming numbers of patients and fearing for their patients’ safety and health. Nurses are suffering burnout because they are caring for so many patients they know nursing care is being missed. A recent survey found that job satisfaction has been dropping for nurses, while the percentage who say they may leave the profession is as high as 30% overall, with younger nurses most likely to say they may leave.

Nurse educators do our best, but we know that we are sending new graduates into the fire. Retired nurses worry about our family members (and ourselves) when we need nursing care.

Congress recently reintroduced the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act. This bill would mandate direct care registered nurse-to-patient staffing ratio requirements in hospitals. It has been introduced in several prior congressional sessions with little progress. We cannot let this window of opportunity pass.

Nurse staffing and patient outcomes.

Linda Aiken’s two decades of research demonstrate the effects of nurse staffing on patient outcomes. Despite legislative efforts in Massachusetts and […]

Guest Author2023-06-13T06:57:19-04:00May 11th, 2023|health care policy, Nursing, Public health|5 Comments

Mahoney, Thoms, Franklin: Black Nurses and Reformers to Remember

Nursing is a challenging profession that requires expertise, dedication, and compassion. Black nurses have made significant contributions to the field, yet their stories often go untold. In this second post in a four-part series for this Nurses Month (here’s the first post), I continue to highlight the achievements of Black nurses who have worked to provide quality care despite discrimination and prejudice. This post will focus on Mary Eliza Mahoney (1845-1926), Adah Belle Samuels Thoms (1870-1943), and Martha Minerva Franklin (1870-1968) as well as on the collaboration among them.

Mary Eliza Mahoney

One of the most prominent Black nurses in history, Mary Eliza Mahoney, was born in 1845 to parents free from slavery. She became the first Black registered nurse in the United States in 1879 after completing a rigorous training program at the New England Hospital for Women and Children. She was the only Black student in her class and one of only four out of 41 who completed the rigorous program.

Hospitals did not hire Black nurses, nor did public health agencies, forcing her to work as a private duty nurse for mostly wealthy white families. Mahoney spent the next 40 years in clinical practice while fighting for acceptance of Black nurses into the larger nursing community. Her advocacy inspired many other Black women […]

Guest Author2023-05-08T16:01:18-04:00May 8th, 2023|Black nurses, Nursing, nursing history|2 Comments

Black Boxes in the Operating Room: Improving Quality of Care and Patient Safety

What’s covered in this post?

Black boxes record video, audio, and data from multiple sources in the operating room (OR), such as cameras, microphones, patient monitoring equipment, and medical devices.
By offering transparency on the multiple simultaneous processes in the OR, black box data can be used to improve safety and efficiency, train staff, and onboard new nurses.
The data can be used for retrospective analysis of specific events or aggregate analysis to detect patterns and variations in practice over time.
Black box data has been used to improve and standardize OR processes such as handling tissue samples, handoff communication during shift changes, and pre-surgical patient positioning.
The data is de-identified and is normally deleted within 30 days.
Finding what went right and learning from it is the goal, not pointing fingers.

Figures in the OR as recorded and de-identified by an OR Black Box. Image courtesy Surgical Safety Technologies.

Rebecca McKenzie, DNP, MBA, MSN, RN, assistant vice president of perioperative services at Duke University Hospital, recently spoke with AJN about her hospital’s use of black boxes in operating rooms (ORs) to standardize key processes to improve safety and efficiency, train […]

Jacob Molyneux, senior editor/blog editor2023-05-26T15:01:50-04:00May 5th, 2023|Nursing, patient safety, Quality improvement, Technology|1 Comment

Honoring Notable Black Nurses of History

USS Red Rover hospital ship. National Library of Medicine.

Nurses Week is scheduled to correspond with the birth of Florence Nightingale (1820-1910). We do this to honor her work in professionalizing and modernizing nursing. Her contribution to our profession is considerable, and it is right that we pay respect to her. But it is equally right that we put Nurse Nightingale in context so that Nurses Week can celebrate all nurses, and not just the often well-off white women on which most nursing history focuses. This four-part blog series during the month of May will honor a handful of women of color who accomplished remarkable things during Florence Nightingale’s lifetime.

Ann Bradford Stokes

Ann Bradford Stokes (1830-1903) was born into slavery on a Tennessee plantation. In 1863, she escaped and was taken aboard a Union hospital ship. She eventually became one of the first women to be listed as active duty personnel, and the one of the first Black women to serve as a nurse in the navy. Along with five other Black women who had escaped slavery (Alice Kennedy, Sarah Kinno, Ellen Campbell, Dennis Downs, and Betsy Young Fowler), she cared for about […]

Guest Author2023-05-05T11:31:21-04:00May 1st, 2023|Black nurses, Nursing, nursing stories|0 Comments

May Issue Highlights: Febrile Neutropenia, Pediatric Oncology Pain Management, Reducing CLABSIs

The May issue of AJN is now live. On this month’s cover is Day Off, digital art by medical student Brian R. Smith, who explains: “This work depicts an overworked, exhausted health care worker. On their day off they find peace and respite through a walk in the forest.” Here are some articles in this issue that we’d like to highlight. Note that some may be free only to subscribers.

Nurses planning to leave the profession.

Nurse staffing and patient outcomes.

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Mary Eliza Mahoney

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Ann Bradford Stokes

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