Off the Charts

How Should a Nurse Support Patients in Choosing a Time to Die?

Two of my six aunts died from Alzheimer disease (AD). They didn’t live nearby, so when I saw them every few months, the deterioration from the illness was evident. Both showed the same behavioral trends: some mild forgetfulness and repetitive questioning at first, then what seemed a prolonged period of incessant questions and bewilderment and anxiety over not understanding where they were or why they were there, who others were. Wandering outside at all hours, agitation and resistance to hygiene, eventually disappearing into a nonverbal, nonresponsive state.

It was painful to watch these formerly active, smart, and vibrant women decline in such a way. The most painful part was when they still understood that they were becoming confused and how frightened that made them.

Now there are alternatives available for those who don’t want to go down that road—but they are hard to come by, especially if you live in the United States.

People with dementia face particularly high hurdles.

A special feature in the March issue, “Medical Aid in Dying: What Every Nurse Needs to Know,” covers medical aid in dying and the nurse’s appropriate role in many end-of-life circumstances, including the ethically and logistically challenging situations of those with dementia who seek some agency over how […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2022-03-28T09:59:28-04:00March 28th, 2022|Ethics, Nursing, nursing roles, patient experience|0 Comments

Staffing Tops ECRI 2022 Top 10 Patient Safety Concerns List for First Time

Staffing: the problem has ‘grown exponentially.’

Each year, ECRI Institute creates a list of top 10 patient safety concerns in order “to support organizations in their efforts to proactively identify and respond to threats to patient safety.” Over the years, some repeat offenders have made the cut, for example managing behavioral health, patient falls, and issues related to infection control.

Some of these concerns again appear on the 2022 top 10 patient safety concerns list, but the list also has some notable first-time offenders—a fact that reflects the conditions in which we’ve been living over the past two years during this global pandemic: These include COVID-19’s effect on clinicians’ mental health, vaccine coverage gaps, and supply chain disruptions, to name a few.

However, the number one concern this year is one that has been a central and unrelenting issue for nurses, even before the pandemic—staffing shortages.

According to the ECRI:

“The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages…Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically […]

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Amy M. Collins, managing editor2022-03-24T10:04:38-04:00March 24th, 2022|Nursing|0 Comments

We Need Your Help in Improving AJN as a Journal

Dear AJN Off the Charts reader,We are reaching out to subscribers and all the other readers of the American Journal of Nursing (AJN) to better understand how the journal is meeting your information needs (and whether and when it holds your interest, keeps you coming back, engages you and enlivens your understanding, or fails to do so).

This survey, which takes less than 10 minutes to complete, is your opportunity to help us improve the journal and ensure that it continues to assist you in your daily practice. The responses you provide will be taken seriously. As a small token of our appreciation for your time, you will be entered in a drawing to win one of ten $100 Amazon gift cards. Click below to take the brief survey. SURVEYOn behalf of AJN and Wolters Kluwer, we thank you in advance for your time and insight. We really want to know what you think as we prepare to respond to a rapidly changing world in nursing, health care, and beyond.

Jacob Molyneux, senior editor/blog editor2022-03-24T13:50:14-04:00March 23rd, 2022|Nursing|0 Comments

Securing Our Place in History: Nurses and Women’s History

Editor’s note: The text below is from the editorial by Shawn Kennedy published in the March 2015 issue of AJN, “Securing Our Place in History,” and the illustration is that month’s cover image.

Henry Street Settlement Nurse, Lower East Side, New York City

In 1980, after realizing that women were largely missing from the history books, a group of women formed the National Women’s History Project.

They embarked on a campaign to “celebrate and recognize women’s role in history” and, in 1987, were successful in getting Congress to designate the month of March as Women’s History Month.

Each year, the NWHP chooses a theme and honors women who have made significant contributions to society yet have remained unknown.

The organization also provides educational materials and acts as a clearinghouse for multicultural women’s history information. This year’s theme, “Weaving the Stories of Women’s Lives,” reflects the NWHP’s tenet that “[k]nowing women’s achievements challenges stereotypes and upends social assumptions about who women are and what women can accomplish today.”

One might substitute the word nurses for women in this statement.

Most people still don’t understand all that nurses have done—and continue to do—to improve health care. Most would likely recognize the name of Florence […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2022-03-21T09:36:44-04:00March 21st, 2022|Nursing|2 Comments

An ICU Nurse Reflects on ‘Returning Home from COVID Island’

“It’s hard to remember my job before all this began,” writes critical care nurse Deirdre McNally in this month’s Reflections essay, “Returning Home from COVID Island.” As the pandemic abates, she finds herself searching for a coherent narrative to understand what she’s experienced. But it’s not so simple. Memories of patients, moments, stray images from many months before slip unbidden into her head.

The difficulty of making sense of the past two years.

What does it mean to ‘make meaning’ from such an all-consuming experience? Maybe the answer will come with time. For now, she suggests, there are too many events, too many emotions and impressions to really absorb as things slowly resume a semblance of greater normalcy: