When Nurse-Patient Boundaries Blur, in Fact or Fiction
By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May (2012) issue of AJN. She currently has an essay appearing in The Examined Life Journal.
Courtesy of the author
Professional boundaries, as defined by the National Council of State Boards of Nursing (NCSBN), are “the spaces between the nurse’s power and the patient’s vulnerability.” The NCSBN describes the nurse–patient relationship as a continuum, with “too little care provider involvement” at one end and “too much care provider involvement” on the other.
The ideal therapeutic nurse–patient relationship lies in the middle, with “no definite lines separating the zone of helpfulness from the ends of the continuum.” I don’t love the indeterminate nature of that definition, but I understand it.
Some time ago, I was surprised by a friendship that developed between a patient and me. It was an unusual circumstance, in that the patient was in the ICU for a very long time for chronic problems that didn’t affect his mental capacity. I was his nurse many times, and through idle chatter during routine care we discovered not only a shared appreciation of literature in general, but a fondness for many of the same authors and books. I started thinking of books I’d bring him, hoping to augment the tedium of his hospital stay. At some point, I started thinking […]
Article Types, Topics of Interest, and Other Considerations for Prospective AJN Authors
By Maureen Shawn Kennedy, AJN editor-in-chief
I recently wrote a post that attempted to give readers a clearer sense of what we are looking for in article submissions and what we are not looking for: “My Professor Said to Submit My Paper (We Hope They Also Told You This).”
This post will just provide a quick overview of the types of articles we publish, as well as a plug for why it’s good to be published in AJN.
In terms of impact factor, AJN ranks 29/95 among ranked nursing journals, with an impact factor of 1.119. (Nursing journals with higher impact factors tend to be specialty research journals, whereas AJN publishes a broad range of content in addition to research, and for a variety of audiences.) Through our robust print, digital, iPad, institutional, and social media channels, AJN reaches more nurses than any other nursing journal.
We publish original research, quality improvement (QI), and review articles as primary feature articles and as CE articles. We also publish shorter, focused columns. All submissions must be evidence based and are peer-reviewed.
Clinical features should cover epidemiology, pathology, current research/“what’s new” in knowledge and/or treatment, nursing implications. There is no specific limit for word count, though feature articles are usually in the range of 6,000 to 10,000 words. (We have done two-part and three-part series for larger papers.) For examples of feature articles, see any of the CE articles on our Web site, […]
Gel and a Poster: A Hand Hygiene Campaign Gets Tested in Two Outpatient Clinics
By Sylvia Foley, AJN senior editor
Hand by sochacki.info, via Flickr
The trouble with hands is that they get into everything, and rapidly move between mouths, noses, eyes, and other people’s hands.
So says David Owen in his recent New Yorker article “Hands Across America,” which describes the development of the first gel sanitizer—and of course it’s nothing nurses and other clinicians don’t already know, just as they know that the practice of hand hygiene is crucial to reducing health care–associated infection rates. Yet adherence to hand hygiene guidelines among health care workers remains low. Interventions to improve hand hygiene have been tested in hospitals with demonstrated success, but have seldom been evaluated in other settings. In this month’s CE–Original Research feature, authors Kate Stenske KuKanich and colleagues describe their evaluation of a hand hygiene campaign in an outpatient oncology clinic and an outpatient gastrointestinal (GI) clinic.
The intervention. At each clinic, the researchers observed health care workers for the frequency of hand hygiene (attempts versus opportunities). After compiling baseline data, they initiated an intervention, which consisted of introducing an alcohol-based gel sanitizer and an informational poster to each clinic. (The gel sanitizer was provided as an alternative to foam sanitizer and soap and water.) One week later, interventional data were collected for five nonconsecutive days. Afterwards the posters and gel sanitizers were removed, and one month later, follow-up data were collected. Lastly, three months after follow-up observations ended, workers at […]
International Women’s Day: Remembering Lives Shadowed by Violence
Photo by Karen Roush
By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor
She lived in a trailer with her boyfriend and her three children, all under the age of five. He beat her up regularly.
Every few weeks she came in to see me at the health center where I worked as an NP in urgent care. Sometimes she would come in with bruises, but most of the time it was for the less obvious sequelae of violence—unexplained chest pain, palpitations, anxiety attacks, back pain, relentless headaches. There was a policy in urgent care that you couldn’t ask for a particular provider. So she would call to speak to me directly and when the operator put her through she’d know I was on and would come in.
I’m not sure why she came to trust me over the other providers. Maybe she could sense that I understood and didn’t judge her, though I had never told her about my own history of domestic violence. But it was probably because I listened. There was not much else I could do. She had gone to a counselor when I encouraged her to, but that didn’t last long—it was hard for her to find transportation for the 30-minute trip into town. I […]