Family Caregivers: Nurses by Default

Caregiver guides family member using safe stair-climbing technique. Photo courtesy of AARP Public Policy Institute.

We all know how compressed hospital stays are. Patients are frequently admitted and discharged within a few days, even for what used to be “big” surgeries. We dutifully send them home with discharge instructions—sometimes, pages of them—and often have only a few minutes to go over them with whoever is taking the patient home. And in many cases, that person is not even the one who will be caring for the patient, so instructions for medications and treatments are given second-hand. And we wonder why there are so many readmissions within 30 days!

Forty million plus unpaid caregivers in the United States.

As I note in this month’s editorial, there are over 40 million unpaid caregivers in this country who are administering complex medical and nursing interventions such as ostomy and wound care,  tube feedings, injections, and tracheostomy care, in addition to taking on bathing, toileting, and other necessary care. Many of these caregivers do so without any real training. Aside from the real danger that they may cause harm to the patient or to themselves, they often live in fear that they are not providing what […]

An Unusual Privilege: A Patient’s Memorable Grace

Jonathan Peter Robb works as a district nurse for the National Health Service in London and has published two essays in AJN‘s Reflections column in recent years, “How I Built a Suit of Armor as a Nurse (and Stayed Human)” and “Verification.”

I was working an evening shift and it was five o’clock when my mobile rang for a call-out. The patient was a woman I’d seen before, who’d been on and off our books for the past few years. She was old, and unwell, and when she last returned home, we were told she was dying. She had been made palliative. Her name was Ruth.

Even with her fluctuating health, Ruth remained incredibly sharp. She was also persistently positive. Ruth was the type of patient you could talk to and forget they were a patient. She asked me questions about myself. Despite the number of people I care for and my enquiries into their health and lives, it is a rare person who asks questions about my life.

I headed out to see Ruth. She was still living at home, her daughter acting […]

2017-12-01T14:06:39+00:00 December 1st, 2017|narratives, Nursing, nursing stories, Patients|3 Comments

Promoting Nursing Students’ Ethical Development in the Clinical Setting

Ethics professor discusses high-fidelity patient simulation exercise with student. Photo courtesy of Linda Koharchik.

I once spent an hour in an ambulatory surgery PACU when interviewing for work at the place. A few minutes into my visit, one of the patients awoke in tears. The PACU RN proceeded to slap the woman across the face. An open-handed, full-face slap. “No crying here!” she snapped.

I was floored, and reported the incident to the clinic’s medical director. This nurse not only assaulted a patient, she did so in full view of a visitor (me). I suspect that if, instead, I had been an instructor from their medical center with students in tow, she would not have behaved differently. And would I have responded differently if students were present? Would I have confronted the nurse while other patients were watching, to make clear to the students that willfully harming a patient can never be tolerated?

Approaches to ethical instruction.

In “Promoting Nursing Students’ Ethical Development in the Clinical Setting” (free until December 13) in the November issue of AJN, Linda Koharchik and colleagues discuss the ways in which we can further students’ understanding of ethical practice—not only in the classroom, but also when we are with them on the clinical units. […]

2017-11-29T15:45:34+00:00 November 29th, 2017|Nursing|2 Comments

AJN in December: Vascular Access Certification, Pressure Injuries from Medical Devices, More

The December issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE: Original Research: Does Certification in Vascular Access Matter? An Analysis of the PICC1 Survey

Although certification by an accredited agency is often a practice prerequisite in health care, it is not required of vascular access specialists who insert peripherally inserted central catheters (PICCs). The authors of this study explored whether and how certified and noncertified PICC inserters differ regarding their practices and views about PICC use.

CE: Pressure Injuries Caused by Medical Devices and Other Objects: A Clinical Update

A review of the etiology, identification, and prevention of pressure injuries caused by medical and other devices, plus highlights from the current National Pressure Ulcer Advisory Panel clinical guidelines.

Supporting Family Caregivers: No Longer Home Alone: Teaching Family Caregivers to Assist Safely with Mobility

Information nurses can use to educate family caregivers on mobility issues, including a tear sheet of key points and links to instructional videos. This is the first article in a new series published in collaboration with the AARP Public Policy Institute. […]

2017-11-27T09:12:37+00:00 November 27th, 2017|Nursing|0 Comments

Sexual Harassment in Nursing: Where Are We Today?

We have a weekly editorial meeting to review current issues and events that we feel are important to bring to nurses’ attention. Given that the headlines are replete with stories about sexual harassment and assault in various settings and workplaces and that nursing is still a profession with far more women than men, we felt this to be an issue of concern.

Before there were policies.

I’m sure many of us can recount experiences, our own or those of colleagues, that qualify as sexual harassment. Many of us may not have recognized it as such—when I began my career, there was no definition or policy that defined sexual harassment or alerted us to our rights if we were faced with inappropriate remarks or behaviors in the workplace. Now that there are requirements for such policies, nurses—men and women alike—should learn what the policies are and processes for reporting such misconduct.

First topic covered on this blog.

We looked to see how we’d covered this previously, and as it happens, the second post we published on this blog, back in February 2009—the one right after the post welcoming readers to AJN‘s new blog—was about the news that a nurse at a hospital in Queens had won a lawsuit for sexual harassment against a doctor and the hospital that […]

2017-11-21T08:11:27+00:00 November 21st, 2017|Nursing|0 Comments