Off the Charts

Notes from the Nursosphere, Plus a Great Palliative Care Discussion

First: Twitter delivered a treasure this morning, from @abbrody (Ab Brody, an RN — and PhD — in San Francisco):

Wow,just wow! RT @DianeEMeier Pallimed:Post from husband of Dr. Pardi http://bit.ly/a3TH0X Do not miss this discussion! #hpm #palliative

What’s the big deal? Well, the New York Times ran a piece this week about Dr. Pardi, a palliative care doctor who fought it out against her cancer up to the end. The article was fascinating, disturbing, powerful, and we posted about it—and a related article we’d run in AJN not long ago—at this blog a few days ago.

What Brody’s Twitter message alerts us to today is an ensuing post and discussion at the palliative care blog Pallimed. The discussion has none of the harshness of tone one sometimes gets on Web discussions. Many of the people in the palliative care community seem to know each other, which always helps keep things civil (you don’t typically insult people you’re likely to meet in person).

A big question in the discussion is whether the Times story oversimplified the issues, creating an “either/or” scenario out of something much more complex, and in the process made palliative care look like it’s all about convincing people to give up and die. But it really gets interesting when Dr. Pardi’s husband pops up in the comments section and attempts to clarify some of the questions and misperceptions raised by the Times story. You’ll […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:18-05:00April 9th, 2010|nursing perspective|4 Comments

To Address High Turnover Among New Nurses, A Virtual Training Tool With Real-Life Problems

At this week’s National Student Nurses Association conference in Orlando, Johnson & Johnson’s Campaign for Nursing’s Future is unveiling a free virtual training program called Your Future in Nursing, which can be found at the Web site DiscoverNursing.com. (Sidenote: the site has many other resources for men in nursing, student nurses, and others, including a fairly vast collection of Profiles in Nursing, which is worth browsing through to get a sense of the really broad range of people who work in the nursing profession.)

You can download the virtual training program for free or order the CD through the DiscoverNursing.com Web site. Designed to address the extremely high turnover rates among first-year nurses who often feel woefully unprepared for the realities of the workplace, the program (full disclosure: we’ve watched a trailer, but we haven’t tried it yet ourselves) sounds intriguing (and a virtuous subsitute for a half hour spent on Facebook):

The interactive training tool allows nurses to select a 3D nurse character and navigate through the rooms of a virtual hospital. As they tour the hospital, nurses interact with animated versions of the people who will shape their first year on the job – hospital administrators, nurse managers, doctors, other nurses, patients and their families. Nurses work at their own pace to respond to different, real-life nursing scenarios they would normally encounter throughout the hospital. In addition to getting immediate feedback on each answer, sections close with a video message from an experienced nurse mentor who […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:19-05:00April 8th, 2010|students|2 Comments

Nursing Handoffs: Do We Know What Constitutes Best Practice?

By Sylvia Foley, AJN senior editor

A systematic literature review on nursing handoffs, written by nurse researcher Lee Ann Riesenberg and colleagues and featured as a CE article this month, might just shock you. The researchers found that although there is “abundant evidence that poor communication and variable procedures result in inadequate handoffs,” surprisingly little is known about what makes nursing handoffs effective. Which is kind of incredible, given how crucial handoffs are to providing safe and effective patient care.

Of the 95 English-language articles that met the researchers’ inclusion criteria, just 20 reported on research on nursing handoffs, and only 3 were found to be of reasonably good quality (scoring above 10 on a 16-point scale). The researchers concluded that although “the Joint Commission is calling for structured handoffs . . . we found very little evidence to support the use of any specific structure, protocol, or method.”

Barriers and Strategies
But the researchers were able to identify, categorize, and list numerous barriers to and strategies for handoffs that were mentioned in the literature. […]

Guest Author2016-11-21T13:18:21-05:00April 7th, 2010|nursing perspective, nursing research|0 Comments

Taking A Stand Against Terminal Illness — Self-Delusion, or the ‘Good Fight’?

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

This week, The New York Times published an article about a young palliative care specialist who, when advised her cancer had progressed to the point where she should consider palliative care, rejected the notion and proceeded to pursue all available options. She was only 40 years old and said she was not ready to die. While the aggressive treatments (which she had plenty of money to pursue) gave her about another year, the article explains that her final days were spent heavily medicated for pain from the tumors throughout her body—even as she continued to request brutally painful procedures with little chance of prolonging her life.

That was her choice, and she knew what she was choosing. But that doesn’t always happen; too often, people really don’t know what it may cost them to take a stand against the inevitable. (For an engaging and comprehensive look at the issue and its implications for nurses, see Life Support Interventions at the End of Life: Unintended Consequences in the January issue of AJN.)

This month, AJN’s Reflections essay describes a scenario when full disclosure of the likely results of pursuing treatment wasn’t forthcoming from health providers. It tells of one nurse’s dilemma in balancing her role as family member and as a nurse during the last days of her […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:23-05:00April 6th, 2010|Nursing|3 Comments

“The Next Time She Needs a Pap Smear at 3 AM . . . “

By Christine Moffa, MS, RN-BC, AJN clinical editor

Vacations are an important part of keeping balanced in life and a good way to prevent career burnout. However, I’m sure that, like me, many of you have had to step out of relaxation mode to come to the aid of some unfortunate vacationer who either injured herself or himself trying a new activity, had a near drowning at the beach, or suffered some other tragedy.

I’ve just returned from a trip with six friends to Turks and Caicos. There was beach, sun, a lot of activities like snorkeling and the flying trapeze, and unlimited food and alcohol; in other words, it was the perfect set-up for a trip to the infirmary. (I once had a three-week nursing gig at a resort, so I know the usual ailments: overindulgence in food, alcohol, and sun; twisted ankles from people playing sports they haven’t attempted in the last 10 years; and the occasional serious accident or heart attack.)

Two days into the trip, one of my co-travelers fell ill with food poisoning, which resulted in a day’s worth of vomiting. At 2 a.m. my phone rang. It was this friend telling me that not only was she sick, but she’d just hit […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:24-05:00April 2nd, 2010|career, nursing perspective|3 Comments