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Charla Nash Fights On

By Shawn Kennedy, AJN editor-in-chief—This weekend, I saw an article about Charla Nash, the Connecticut woman who was viciously attacked in February 2009 by a friend’s chimpanzee. (Click image at left for article and video at CNN.) She had suffered terrible injuries to her face and hands that left her without hands and eyes and severely disfigured. Last month, she received a face transplant at Brigham and Women’s Hospital in Boston. She also received hand transplants, but they failed to take and were removed because of sepsis.

It’s truly a tragic story. Christine Moffa, our clinical editor at the time, wrote a few blog posts about Charla back in 2009. She’d seen Charla’s brother Steve on the The Today Show, where he’d reported that the first thing his sister had said upon waking from her coma was the name of her nurse, Lisa. As she wrote in that first post, “Steve Nash attributed her response to the nurse to the fact that the nurses had always talked to [Charla] as if she were awake.” (Subsequent posts by Christine included photos of Charla that her brother had been kind enough to share.) […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:12:43-05:00June 13th, 2011|Nursing|0 Comments

A Nursing Report That Deserves More Than The Usual Shrug

By Christine Moffa, MS, RN, AJN clinical editor

The IOM report The Future of Nursing: Leading Change, Advancing Health came out this past October, causing a flurry of excitement among some in the nursing world and groans of “big deal” among others. My immediate instinct was to shrug my shoulders and wonder if yet another report will really make a difference at the bedside.

AJN addressed the report and its implications in our December 2010 and February 2011 issues—so I knew it must be very important. But, for some reason, I had assumed it was going to be a dry, unreadable bore. And I put off reading it until recently, when I needed to use it as a reference. And wow, was I in for a surprise! I especially liked the inclusion of real case studies of nurses from different backgrounds and work experience who are making a difference in health care.

It’s inspirational, and I encourage all nurses out there—and anyone with a stake in health care (that’s pretty much everybody)—to take a look. (Tip: I found downloading the PDF version didn’t take long, and it was much easier to navigate than the HTML version.) If you’d like to hear more on the report and what it means to nurses, sign up for our upcoming […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:13:51-05:00March 14th, 2011|career, nursing perspective, nursing research|5 Comments

Confused About the Charge Nurse Role? You’re Not Alone

Charge nurses—as is often the case, there’s the ideal and the reality. Consider a recent blog post at the nursing blog At Your Cervix, which expresses some honest reservations about acting as a charge nurse—both about the challenges involved, and the lack of compensation for the added duties. Here’s an excerpt:

I’m really not so sure about this charge nurse thing. I was told when I arrived on a recent shift that I was to be in charge. I think I’ve done charge (maybe?) three times. Those times were only because there was no one available who did charge, and I was the most likely choice to do it. I haven’t been trained or oriented to do charge. It was kind of a “toss her in there and do it” situation.

If you read the entire post, you’ll learn that this blogger isn’t so sure she wants to take this role on again anytime soon. As it happens, AJN published a CE article back in September of last year (our clinical editor, Christine Moffa, wrote this post about it at the time) on an initiative which took place at the highly respected New York-Presbyterian Hospital/Weill Cornell Medical Center. Its goal was to figure out this charge nurse thing in a more systematic and sensible way.

Like so many roles in so many professions, there may […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:08-05:00February 3rd, 2011|nursing research|1 Comment

Turkey, Sweet Potatoes, and Living Wills

By Christine Moffa, MS, RN, AJN clinical editor

When I was growing up, my family spent Thanksgiving dinner at my grandmother’s house. She was a star in the kitchen, with cooking and baking skills beyond compare. However, while she made a chocolate cream pie to kill for, her knack for turning every conversation into a newsfeed of various neighbors’ illnesses, symptoms, and near-death experiences, if not actual deaths, stood out more. She did this so much that my brother began referring to her as Grandma Kevorkian.

It turns out that death-and-dying discussions on Thanksgiving might not be such a bad thing, according to Engage with Grace, a nonprofit organization that promotes end-of-life discussions. In 2008 they launched a blog rally timed with Thanksgiving weekend, for bloggers to get the word out about end-of-life discussions. The idea is to have the conversation when most of the family members are together, and the Thanksgiving holiday is a perfect fit. There’s a five-question tool available on the site that can be used as a conversation starter, as well as other resources.

While talking about these topics could potentially clear a room, it’s a lot worse to be sitting at a family member’s bedside in the ICU and not knowing what to choose for them because they didn’t let you know in advance.

For additional information on end-of-life discussions and options, see the AJN articles “Life-Support Interventions at the End of Life: Unintended Consequences,” by […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:50-05:00November 24th, 2010|nursing perspective, patient engagement, Public health|2 Comments

Time to Pause and Commit to Act

By Shawn Kennedy, AJN interim editor-in-chief

Of all the holidays, Thanksgiving seems to me to be the most pure—it began way before the greeting card folks thought of it and commercialized it. And it was born out of something that often gets lost during the course of our busy days—connecting with others and saying thank you for what they do or what they mean to us.

Christine Moffa, AJN’s clinical editor, and I were discussing the holiday at a staff meeting, saying how we had never minded working on Thanksgiving. Patients, visitors, and colleagues—everyone was in a friendly, appreciative mode. Most hospital cafeterias served turkey dinners to the staff, so everyone was happy about that—and everyone got to have a real dinner break for a change!

It also seems that at Thanksgiving we’re still in the “giving” mode, maybe because it’s early in the holiday season. My first request-for-your-support e-mail this season came from photographer Ed Kashi; it’s one I’m glad he sent. Ed is an incredibly talented megastar of documentary photography (in my humble opinion); we’ve been fortunate to have some of his work grace our covers (July 2007 and our 2008 Family Caregiver supplement, as examples) and articles. His e-mail was about an online auction of photographs called Commit to Action, a collaborative project by VII Photo (a photo agency) and Doctors Without Borders/Médecins Sans Frontières (MSF) to generate funds for MSF work around the world.

The […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:51-05:00November 24th, 2010|Nursing|1 Comment

Anti-Antibiotics Week

Not only is antibiotic resistance dangerous and expensive, it’s on the rise. Unfortunately cold and flu season can make people so uncomfortable they’ll do anything to feel better, including insisting their health care provider write a prescription for a medication that can’t help them. In an effort to change this, the CDC and FDA have teamed up for the 3rd annual Get Smart about Antibiotics Week (November 15–21).

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:54-05:00November 18th, 2010|patient engagement, Public health|3 Comments

A Tough Act to Swallow

By Christine Moffa, MS, RN, AJN clinical editor

For most people, eating is a simple pleasure that they usually take for granted. However, for patients recovering from stroke or esophageal disease, getting food down is a pretty big deal. Patients with dysphagia are at increased risk for malnutrition (which can lead to impaired healing), dehydration, and aspiration pneumonia. Unfortunately, liquid, soft, and pureed diets are not only unappealing and unappetizing for many patients, but they also mean different things at different hospitals. Have you ever seen a health worker “prepare” a liquid diet tray for a patient by taking the milk, juice, and mashed potatoes and mixing them together, then wondering why it’s taking an hour to get the patient to eat it? […]

Jacob Molyneux, senior editor/blog editor2016-04-18T15:54:41-04:00November 10th, 2010|Nursing, patient engagement|1 Comment

Harm Reduction or Stigmatization: What’s Your Approach to Drug-Addicted Patients?

[youtube=http://www.youtube.com/watch?v=tDZhVnR3HC8]

By Alison Bulman, senior editorial coordinator

How much of your nursing education focused on how to handle drug addicts and substance abuse? Probably not much, according to speakers at a recent event I attended with my colleague Christine Moffa, AJN’s clinical editor, at the Center for Health, Media, and Policy at Hunter College.

The event was focused around a clip (longer than the one above) from “Bevel Up: Drugs, Users and Outreach Nursing,” an award-winning film by Canadian documentary filmmaker Nettie Wild. (A photo of a street nurse from the program appeared on AJN’s cover in July 2009, along with an article about the program.) Fiona Gold, BA, RN, and Juanita Maginley, MA, BSN, RN, whose work in Vancouver is the subject of the film, spoke on the panel about the value of harm reduction and about the systemic flaws and tendency to stigmatize drug addicts that prevent health care from reaching this population.

The powerful clip showed street nurses searching the city’s alleys and housing complexes for drug addicts, dealers, and sex workers. They carry bags full of syringes, condoms, and crack pipe mouthpieces which they deliver to those willing to take them. They ask street patients whether they might be pregnant, have unsafe sex, may have a disease, and if they want to have the nurses draw blood for testing.

The outreach project started in response to Vancouver’s alarming increase in HIV infections. Medical services were not reaching the most vulnerable people, so nurses devised a plan to […]

Jacob Molyneux, senior editor/blog editor2017-06-28T15:00:01-04:00November 1st, 2010|nursing perspective, patient engagement, Public health|23 Comments

Finding a Job as a Nurse In a Digital Age — and Keeping It

Will at Drawing on Experience manages to post a new comic almost every day. A regular theme is the progress of his career—having finished his accelerated nursing program, he’s now looking for a job. To the left is a thumbnail of a recent drawing he did about one of the more annoying aspects of the process (click the image to visit his blog and see a larger version).

Of course, this isn’t the first downturn we’ve had in the U.S. economy; as AJN clinical editor Christine Moffa wrote back in May, newly minted nurses have struggled to find work before. Once you actually do get a job as a nurse, there’s the small matter of doing it for the first time. Or for the second or third time—but as if it’s the first time, at least in some respects. The October Reflections essay, “Paper Chart Nurse,” gives another perspective on the ways computers have changed the lives of nurses. It’s by an oncology nurse who returned to practice two years ago, at age 66. Her struggles with adapting to using an electronic medical record system were at times profoundly discouraging; she just wasn’t as proficient as the younger nurses at computer use, despite all her skills and experience. Have a look and please, tell us what you think.—JM, senior editor

Jacob Molyneux, senior editor/blog editor2016-11-21T13:15:09-05:00October 26th, 2010|career, nursing perspective, students|4 Comments

Taking Charge Seriously

By Christine Moffa, MS, RN clinical editor

Most hospitals have charge nurses, although how they’re selected and what they do varies not only between hospitals but often between units in the same hospital. For instance, the first time I was in the role of charge nurse it was because none of the usual suspects were working that day! And my manager’s parting words were, “Looks like you’re getting baptized with fire. Good luck.” Thanks to the work of a quality improvement team, the nurses at New York-Presbyterian/Weill Cornell Medical Center in New York City won’t have to go through what I did.

This month’s Cultivating Quality column, An Evidence-Based Approach to Taking Charge, “describes the planning, implementation, and evaluation of a charge nurse initiative in a large academic medical center.” After reviewing the literature and identifying issues through the use of focus groups, members signed up for different quality improvement teams to develop solutions and action plans.

The following are some of the changes implemented by the teams:

The development of charge nurse core competencies and a definition of the role to be used hospital wide.
A standardized hand-off report to be used between charge nurses going off and on shift.
An orientation workshop using interactive case scenarios.

See the full article for a list of the charge nurse core competencies as well as an example of a case study used during the interactive workshop. Here’s a breakdown of the charge nurse role and its responsibilities:

Jacob Molyneux, senior editor/blog editor2016-11-21T13:15:27-05:00October 6th, 2010|career, nursing perspective, nursing research|3 Comments

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