The Present: What This Visiting Nurse Has to Give

Illustration by Barbara Hranilovich for AJN. Illustration by Barbara Hranilovich for AJN.

It can be daunting for a visiting nurse to enter a patient’s home, especially if the patient seems less than receptive to the nurse’s efforts. In this month’s Reflections essay, “The Present,” Pia Wolcowitz describes one of her first assignments as a visiting nurse. She’s sent to assess a woman newly diagnosed with lung cancer. Here’s an excerpt:

I rang the bell and heard a voice, but couldn’t make out what she said. I rang again. This time I heard her loud and clear. “If you wanna come in, come in! Door’s open!” Entering, I found a woman in her mid-60s sitting hunched at her kitchen table, surrounded by bottles of medication and a bowl of cereal. It was way past noon.

She had cropped blue-black hair with accents of white. She studied me a moment, then her gray eyes examined my ID. “So, you’re the nurse?”

[…]

2016-11-21T13:02:10-05:00August 10th, 2015|narratives, Nursing, nursing perspective, patient engagement, Patients|1 Comment
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Patient Satisfaction and Nursing: Listening Matters, Whatever the Situation

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN. Her last post on nursing and patient satisfaction surveys is here.

by runran/Flickr Creative Commons by runran/Flickr Creative Commons

During this hospital stay, how often did nurses listen carefully to you?
1. Never
2. Sometimes
3. Usually
4. Always

Listening Carefully About Patients
“Her crit is dropping with each bowel movement, and she just won’t stop bleeding,” said my night shift colleague during the early moments of my shift.

As soon as she finished telling me the rest of my new patient’s care, I got on the phone for the ordered blood. Waiting for the first of many products to be delivered, I went to see her. As I poked around the hanging drips and fluids, checking dosages and orders, setting alarm limits, I heard my patient’s voice:

“Hello, hello? I’m so anxious. I just fell asleep for a moment and now I’ve woken up and I’m terrified. I think I need to be changed again, and I just don’t know what to do, and who are you?”

My colleague, busy with the details of resuscitation, hadn’t said much about my new patient’s anxiety. Anxiety, too often coded as neediness, is clinically important, especially in a patient with questionable stability, and doubly in a patient whose nurse […]

2016-11-21T13:02:10-05:00August 7th, 2015|narratives, Nursing, nursing perspective, Patients|3 Comments
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A Tech-Savvy Nurse’s Initial Take on Uses for the Apple Watch

Megen Duffy, RN, BSN, CEN, is currently working in hospice case management and writes AJN‘s iNurse column, which focuses on technology and nursing.

AppleWatchMegenPhotoBPMI’ve had my Apple Watch for several months now. I ordered it at 12:01 the morning they went on sale, and it arrived the Saturday after its Friday release. I was fairly certain I’d return it or sell it for a profit, but I still have it and keep finding new uses for it. I also have ideas for how it could be handy for a variety of fitness and health care scenarios.

Health tracking. Even at this early stage, though, patients and their families are using Apple Watches to track and enhance their health. The Watch tracks your heartbeat—not every second, but often enough that a useful bank of data results. Rumors say that a mystery port on the back of the watch will allow SpO2 tracking soon. I have already busted out my phone to show my cardiologist my heart rate trends, and it saved me from wearing a Holter monitor. That kind of thing is exciting!

Fitness wearables (e.g., Fitbit) and smart watches (e.g., Pebble) have been around for a few years, with sharply increasing popularity. The (often) colored plastic bands people wear around their wrists are the kind of wearable I mean. Pedometers (included in the wearables category) also come […]

2016-11-21T13:02:11-05:00August 5th, 2015|digital health, nursing perspective, patient engagement, Patients|2 Comments
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AJN in August: Oral Histories of African Nurses, Opioid Abuse, Misplaced Enteral Tubes, More

AJN0815.Cover.OnlineOn this month’s cover, a community nurse practices health education with residents of a small fishing village in rural Uganda. Former AJN clinical managing editor Karen Roush took the photo in a small community center made of dried mud bricks, wood, and straw.

According to Roush, nurses wrote the lessons out on poster-sized sheets of white paper and tacked them to the mud wall as they addressed topics like personal hygiene, sanitation, food safety, communication, and prevention of infectious diseases. The reality of nursing in Africa is explored this month in “‘I Am a Nurse’: Oral Histories of African Nurses,” original research that shares African nurse leaders’ stories so we may better understand nursing from their perspective.

Some other articles of note in the August issue:

CE feature: A major source of diverted opioid prescription medications is from friends and family members with legitimate prescriptions.  “Nurses’ Role in Preventing Prescription Opioid Diversion” describes three potential interventions in which nurses play a critical role to help prevent opioid diversion.

From our Safety Monitor column: More than 1.2 million enteral feeding tubes are placed annually in the United States. While the practice is usually safe, serious complications can occur. “Misplacements of Enteral Feeding Tubes Increase After Hospitals Switch Brands,” a report from the Pennsylvania Patient Safety Authority, reviews cases of misplaced tubes and offers guidance for how nurses can […]

2016-11-21T13:02:11-05:00August 3rd, 2015|career, Nursing, nursing perspective, nursing research, patient engagement|0 Comments
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Medicare Turns 50: Familiar Opposition in 1965, Essential and Continuing to Evolve Now

President Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration. President Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration.

On this date in 1965, exactly 50 years ago, Medicare (part of the Social Security Amendments of 1965) was signed into law by President Johnson. The debate over government-sponsored health insurance is not new, and opposition to the creation of Medicare was similar to the opposition to the Affordable Care Act and driven by many of the same organizations and arguments.

According to a timeline at SocialSecurity.gov, Congressional hearings on the topic occurred as early as 1916, with the American Medical Association (AMA) first voicing support for a proposed state health insurance program and then, in 1920, reversing its position. A government health insurance program was a key initiative of President Harry Truman, but, as with the Clinton health initiative several decades later, it didn’t go anywhere because of strong opposition from the AMA and others.

AJN covered the topic in an article in the May 1958 issue after a health insurance bill was introduced in 1957. Yet again, one of the staunchest opponents was the AMA. In the September 1958 […]

2016-11-21T13:02:12-05:00July 30th, 2015|career, health care policy, Nursing, nursing perspective, Patients, Public health|0 Comments
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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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