If Nurses Aged in Reverse

“No—no!” shrieked my 95-year-old patient with dementia as I turned her to her side with the help of my nursing assistant (now called a patient care tech, 30 years later).

The three daughters sitting at her bedside inhaled deeply, their eyes wide. I looked over at them, calmly explaining that their mom was just frightened, and then in a soft voice said to my patient, “Don’t worry, Mrs. Smith, we won’t let you fall,” as she continued to scream. We positioned pillows against her back, and another between her knees. As we saw the family relax, and the patient’s screams turn to a barely audible whimper, I caressed her back and felt satisfied that all was well.

Fast-forward to my retirement. Having inherited my parents’ degenerative joint disease, at age 72 I have certain specific ways to sleep so that my left shoulder doesn’t hurt, my left hip bursitis doesn’t flare, and my right arm doesn’t get numb and tingly from a pillow that’s too puffy, causing hyperflexion of my cervical vertebrae.

Never assume what the patient’s feeling.

I have flashbacks from the days I thought I was an efficient nurse—I dread having someone, someday, assume that I am just frightened in their attempts to keep me on a turning schedule to prevent pressure ulcers. […]

2021-08-30T14:19:59-04:00August 30th, 2021|patient experience, Patients|1 Comment
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AJN September Issue: Ischemic Stroke, A New Approach to Fall Prevention, More

“Pain is a complex experience. Offering patients an opportunity to express their feelings, listening to their words, looking into their eyes and sensing their uncertainty are all part of the compassionate side of healing.”—Barbara Wukovits in her September Reflections column, “My Pocket of Care”

The September issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Acute Ischemic Stroke

A review of ischemic stroke pathophysiology; risk factors; presentation; and the evidence-based treatments, nursing assessments, and monitoring protocols that are critical to patient recovery.

CE: Reimagining Injurious Falls and Safe Mobility

This article by the author of the Hendrich II Fall Risk Model proposes a new approach to fall prevention—one grounded in evidence-based protocols known to positively impact the health of older adults.

AJN Reports: The Troubling State of Public Health

How underfunding, attrition, and COVID-19 are affecting the nation’s public health agencies and nursing workforce.
[…]

2021-08-27T08:48:20-04:00August 27th, 2021|Nursing|0 Comments
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School Nurses During COVID-19: Still Holding the Line

Anything but the normal school year we’d hoped for.

The 2021-2022 school year is upon us and it is anything but the normal year many of us had hoped for. For some kids, it will be the first time going back into the classroom after 18 months at home. As a mom of two kids under 12 who cannot yet be vaccinated, it is a time of anxiety as I send my kids into school with a more contagious COVID-19 variant. Despite the mitigation efforts put in place, I wonder if it will be enough.

In parts of the country, cases are still skyrocketing and hundreds of kids have already had to quarantine or switch to remote learning. Some states have layers of mitigation in place in their schools, while in others, governors are fighting to keep schools from instituting mask mandates. And through this all, the person at the front line is the school nurse.

School nurses on the front lines as the rules keep changing.

In our August issue, AJN Reports highlights how school nursing has changed amid the current pandemic. Adding to the many other challenging tasks that school nurses already have is

2021-08-23T09:23:14-04:00August 23rd, 2021|COVID-19, school nurses|0 Comments
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Food Allergies and COVID-19 Vaccine Facts

Photo by Kelly Sikkema on Unsplash

Life with food allergies (FAs), as with any chronic condition, adds layers of complexity to decisions. As nurses with experience caring for children with FA in our families or in our practices, we understand that choosing COVID vaccination can be a tough decision for some, but are heartened by the overall safety and effectiveness of the vaccines to date.

Rapid access to information (and misinformation) on social media can complicate the vaccine decision-making process. The United States Surgeon General recently called on health care professionals, including nurses, to “take the time to understand each patient’s knowledge, beliefs, and values. Listen with empathy, and when possible, correct misinformation in personalized ways.” As nurses caring for patients who are among the estimated 30 million people with food allergies in the US, you can help patients to make an informed and timely decision.

Concerning data about COVID in children and young adults.

About half of the US population is fully vaccinated, though statistics vary by age group, leaving those who cannot receive a vaccine at great risk. Infection with the Delta variant suggests increased transmissibility and more infections in the unvaccinated, including children and young adults.

To underscore the ongoing need for vaccination […]

2021-08-17T06:54:02-04:00August 17th, 2021|Nursing|0 Comments
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Monitoring for Intolerance to Gastric Tube Feedings

Monitoring GRV is one way to assess gastric emptying in patients with tube feeding intolerance. Here aspirate is drawn from the stomach through the port via a small-bore feeding tube.

At some point in their education, nurses might have read a book or article by Norma Metheny, PhD, RN, FAAN, long considered an expert on fluid and electrolytes and tube feedings. She’s been researching tube feeding placement and assessment throughout her career—her current article in our August issue, “Monitoring Adult Patients for Intolerance to Gastric Tube Feedings,” marks her 12th publication in AJN.

Monitoring GRV.

Nurses have long been taught to check, before administering tube feedings, whether there are any residual contents remaining from the prior feeding. Monitoring gastric residual volume (GRV) was a key indicator to determine gastric emptying and thereby reduce the chance of regurgitation or vomiting and aspiration pneumonia.

Intolerance to feeding, as Metheny notes in her article, can be as high as 36% in critical care patients and approximately 27% among […]

2021-08-13T14:20:21-04:00August 13th, 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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