A Call for a More Balanced Approach to Family Presence During a Public Health Emergency

What would you want for your family?

Nine years ago, AJN published a Viewpoint article asserting the essential role of family caregivers. The article featured an elderly woman recuperating in a hospital, her daughter at her bedside planning for discharge with the care team. The authors argued that family engagement creates the foundation for safer care, better patient outcomes, and greater efficiency for nurses.

The same patient’s experience would likely have been very different during the Covid pandemic, especially during the intermittent surges over the past two years. The patient would be alone in the hospital, her daughter’s assurances communicated through a digital tablet. Overstretched nurses would provide updates to the family over the phone. Discharge education would occur through a car window moments before the patient’s daughter drove her home, feeling unprepared for what came next.

COVID-19’s highly transmissible properties have complicated the family engagement equation. Over the past two years, hospitals and nursing homes have enacted, eased up on, and then reinstated visitation bans, at times leaving questions as to whether restrictions implemented to reduce disease spread may be more detrimental than beneficial.

As we contended in recent months with the extremely contagious Omicron variant, family caregivers who had assumed an essential role as […]

2022-03-02T10:21:04-05:00March 2nd, 2022|Nursing|2 Comments
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March Issue: Assessing Movement-Evoked Pain, Medical Aid in Dying, More

“Hope may be hard to find at times, but it’s what sustains us.”—editor-in-chief Shawn Kennedy in her editorial, “Making It Through March”

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

CE: Assessing Movement-Evoked Pain

This article discusses the importance of assessing pain during movement, especially in postoperative patients; what such an assessment can reveal about the intensity, impact on patient functioning, and tolerability of pain; and protocols and tools for completing these assessments.

Medical Aid in Dying: What Every Nurse Needs to Know

The author provides an overview of aid in dying in the United States—offering an illustrative case report that highlights the struggles of one patient and his family—and discusses the nurse’s role and nursing implications.

Conversations: ‘How Can Acute Care Recover from the Pandemic?’

Four nursing leaders weigh in on the challenges faced by acute care nurses today—and identify opportunities for change.

[…]

2022-02-28T09:46:49-05:00February 28th, 2022|Nursing|0 Comments
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The Particular Pain and Challenge of Educating Patients During a Worldwide Pandemic

Working in a rural community access hospital during the pandemic has been a struggle. Here as in many areas of the U.S., many in the surrounding community have not accepted the the existence of a virus like Covid-19. Against the backdrop of this widespread disbelief in the reality of the virus, the “government-mandated” vaccine was a final straw for many.

Many of these patients wholeheartedly believe that the vaccine is the “mark of the beast” mentioned in the Book of Revelation and that this is the beginning of the end of the world, with getting the vaccine understood as an expression of loyalty to Satan.

This belief is shared by various religious groups in other areas of our country. Many patients in our community also believe the vaccine is made with stem cells and fetal tissue and includes microchips. There are widely circulated rumors of tracking devices in the vaccine itself.

How do we as nurses and advanced practice registered nurses (APRNs) educate patients on the science of vaccinations in the face of the anger and passion we experience daily from a suspicious community?

The many other strains on nurses.

It hasn’t helped that nurses and APRNs alike have had to deal with more than they bargained for on many levels in […]

2022-02-24T14:38:16-05:00February 24th, 2022|Nursing, patient engagement, Public health|0 Comments
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Thinking Outside the Room: An Innovation Saved Time and PPE During the Pandemic

The COVID-19 pandemic forced us to adapt and change from care as usual to thinking outside the box—or in the case of Montefiore Medical Center in the Bronx, New York, outside the room.

Our February CE feature, “Using Smart IV Infusion Pumps Outside of Patient Rooms,” describes an innovation that helped save three valuable commodities that were at risk early in the pandemic—staff’s health, time, and PPE.

Administering medication and IV fluids can be very time-consuming, especially when nurses are required to don and doff a mask and isolation gown every time they enter and exit the patient’s room. However, keeping the IV infusion pump outside of the room makes it accessible in the hallway and eliminates the need for isolation precautions.

Considerations with use of this approach.

The authors recognize that one major concern with having the IV pump outside of the room is the decreased frequency of IV patient assessment. They note, “Standards were modified to allow staff to assess IV sites for dressing integrity and infiltration during the repositioning of prone patients, whose heads needed to be turned every two hours.” And “[i]f a patient’s change in condition coincided with the use of additional extension sets and the relocation of the pump, staff were […]

2022-02-21T10:46:43-05:00February 21st, 2022|Nursing|1 Comment
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A Mother’s Argument for Patient Self-Advocacy in Rett Syndrome Using an Eye-Tracking Communication Device

Kalika using her eye-tracking augmentative and alternative communication (AAC) device. Photo courtesy of the author.

I jerked awake at 1 AM to the sound of frenzied footsteps and insistent beeping in my five-year-old daughter Kalika’s hospital room. She lay in deep slumber, recovering from gastrostomy surgery. Two nurses hovered at the foot of her bed with deep frowns and voices betraying concern. Kalika’s blood pressure had plummeted alarmingly, and she appeared unresponsive.

After several minutes of prodding, she opened her eyes. The head nurse turned to me and said, “We need to see if she’s alert. Can you get her to respond on her device?”

I nodded and grabbed Kalika’s eye-tracking communication device. Holding the device over her, I asked her how much pain she felt. Kalika scanned the “Pain” page in her speech software and said: “Some pain.”

The nurse turned to me and said: “Can you ask her another question? Ask her how she feels.” I flipped to the “Feelings” page and asked, “How do you feel?” Kalika surveyed the screen and said: “Tired, tired.”

Satisfied that Kalika was in fact responding appropriately and consistently, the nurse said, “We’re good. Great job!”

Incorporating patient […]

2022-02-17T10:51:23-05:00February 17th, 2022|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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