The Gift of Feedback

By Giulia May/Unsplash

In a recent Schwartz Rounds session at my hospital, the facilitators centered the discussion around the theme, “The Gift of Feedback.” As I listened to the panelists share their experiences, I recalled two recent exchanges with colleagues I’ve developed positive working relationships with over the years.

One was with a hardworking care partner (CP) who has been in our unit for about six years. The other exchange was with an attending physician who had been a well-respected leader in our PICU long before my 11 years working there. I find both to be very kind and very professional.

Asking a care partner for feedback.

As one of the more experienced bedside nurses in our unit, about once every four to six weeks I fill the role of relief charge nurse. I’ve done it enough over the years to feel decently comfortable in the role, but I do it so infrequently that each time I find myself relearning aspects of the role.

The charge nurse always sits in the same station as the care partner who manages the front desk. This individual gets a close-up view of how all the different relief charge nurses handle the role. One day towards the end of a busy shift, I […]

2021-12-17T13:21:05-05:00December 17th, 2021|career, Nursing, nursing career|0 Comments
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What Have We Learned About Preventing School Shootings?

On November 30, a 15-year-old sophomore at Oxford High School in Michigan killed four students and injured seven others. Both the student and his parents are presently incarcerated and charged with numerous crimes.

In the days following this tragic event, questions arose regarding what the parents and school might have done to prevent this from happening. The parents are facing charges of involuntary manslaughter and a federal lawsuit, perhaps the first of others to follow, has been filed against the school district alleging that more could have and should have been done.

Warning signs and preventive actions.

With each school shooting we again find ourselves asking ourselves what can be learned in terms of warning signs and actions that could be taken. The September Mental Health Matters column in AJN, which I co-authored with Arlene Holmes—whose son James was responsible for the mass shootings in Aurora, Colorado, in 2012—highlighted warning signs that might indicate potential violence by someone experiencing mental health problems.

What can be learned from the events that unfolded in Oxford that could be applied to a similar scenario, perhaps heading off another tragedy? The following checklist compiled by Sandy Hook Promise, a nonprofit organization that aims to educate youth to prevent […]

2021-12-15T11:43:26-05:00December 15th, 2021|mental illness, Nursing|0 Comments
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Distinguishing Between Delirium and Dementia in a Mother’s Rapid Decline

We now know just how vulnerable older adults in long-term care have been during the pandemic. COVID-19, especially in the pandemic’s early months, cost many their lives far too early. Even today we are seeing the disease bring premature death to the elderly, especially at facilities with lower staff vaccination rates. Just two days ago, NBC news reported the following disheartening NEJM study results:

“People in nursing homes are much more likely to die of Covid-19 if the staff caring for them remains largely unvaccinated, a study published Wednesday in the New England Journal of Medicine found.”

Other forms of decline accelerated by the lockdown.

But the isolation from family members and other external contacts imposed by the many months of lockdown had other less easy to measure costs. This month’s Reflections essay, “Again in a Heartbeat,” by Jeanne Kessler, MSN, RN-BC, details her own dawning awareness that something had begun to change in her mother as time went by during the lockdown at her assisted living facility.

Suddenly her mother couldn’t talk on the phone any longer. This wasn’t like her at all. Her attention span had shortened drastically. There were other worrisome indications. While […]

2021-12-10T07:55:02-05:00December 10th, 2021|Nursing|0 Comments
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Marijuana Linked to Elevated Heart Attack Risk in Young Adults

Photo © Shuttertock.

Association is stronger when marijuana use is frequent.

As the decriminalization of marijuana becomes more widespread, its use is on the rise among young adults. Yet, the effects on overall health have not been well studied, including how marijuana use affects cardiovascular health.

Now a large-scale study in the Canadian Medical Association Journal has found an association between recent marijuana use and increased risk of myocardial infarction (MI) in young people, ages 18 to 44 years. The association was strongest among those who used marijuana at least four times a month, primarily by smoking it. Users who vaped or ingested marijuana through baked goods or other edibles also had a higher incidence of MI compared with nonusers, but only those who smoked frequently showed elevated risk that was statistically significant.

The study was based on 2017 and 2018 behavioral risk survey data from the Centers for Disease Control and Prevention. It sought to evaluate known evidence of cardiovascular effects of marijuana in the context of MI risk for individual users. Marijuana’s chemical components can increase myocardial oxygen demand while simultaneously reducing blood flow to the myocardium. This cannabis-induced oxygen supply and demand mismatch, in the setting of myocardial […]

2021-12-07T11:34:08-05:00December 7th, 2021|Nursing, Public health|0 Comments
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What Can We Do About Addressing Nurse Exhaustion?

“Even when good workplace policies and support exist, without enough staff to meet essential patient needs, nurse fatigue cannot be properly addressed.”

Photo by Matthew Waring on Unsplash

When I was working as an ED nurse, if a colleague was out sick we’d invariably be asked to work a double shift—so, 16 hours instead of our usual eight-hour shift. It wasn’t bad as a one-time occurrence. But I can’t imagine how nurses have managed working five or more days of 12-hour shifts in a row, or even more, during the surges of Covid-19 patients needing hospitalization in various parts of this country. It’s no wonder there are so many stories and reports of nurses leaving the acute care setting.

While the obvious answer is that there needs to be more staff to share the work, not only to improve staff well-being but also to make care safer—and this is not a COVID-induced phenomena; we’ve known this for years thanks to research by Linda Aiken and others—getting that to happen has largely been unsuccessful.

Hospitals staff conservatively as a policy, causing many to be short-staffed on an almost ongoing basis. This makes for a stressful work environment that in turn causes nurses to leave, thus further exacerbating […]

2021-12-03T09:51:29-05:00December 3rd, 2021|Nursing|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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