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 perspectives […]

2022-02-17T10:51:23-05:00February 17th, 2022|Nursing|0 Comments
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An Impromptu Code Team on the Rugby Pitch

Eighteen months ago, I wrote about my experiences being a COVID-19 ICU nurse during the height of the pandemic, while also training as a member of the USA Rugby Women’s National Team. I focused on the connection between nursing and rugby by discussing the importance of the backline of defense in both the hospital setting and on the pitch.

Much of what I wrote there was driven home for me in a new way one day last fall at a local rugby field in New Jersey. It was a beautiful fall day and I was spending my last weekend home watching my brother’s playoff game before I would be heading to Colorado for a set of international rugby games with Team USA.

Credit: KJ Feury.

It was a typical men’s club division 2 playoff game, where the score was back and forth, and big plays were being created by both teams. It was nearing the end of the game when the away team had a scrum in their half of the field. Their #12, a player who had been making big hits and runs all game, made the decision to kick the ball out of their half to relieve pressure and reset play.

After the rugby […]

2022-02-15T08:54:27-05:00February 15th, 2022|Nursing|0 Comments
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A Small Gesture of Kindness

Illustration by Janet Hamlin for AJN.

In our January Reflections column (free until March 1), “Just One More,” a nurse shares her memory of a family facing one of the most painful experiences imaginable—the death of a child.

In a situation like this, there is so little that can be done, and the usual gestures of expressing condolences or giving a pat on the hand feel inadequate and hollow.   

She writes:

“I knew that no words could lessen the unexpected heartbreak . . . But still, I wished there was something I could say, or do, that might make a small difference.”

Small gestures, lasting effects.

Most nurses can relate to such a situation. You may not be able to do anything to change a patient’s circumstances, and all you have left in your arsenal of care is a small gesture of kindness. […]

2022-02-11T09:39:23-05:00February 11th, 2022|Nursing, pediatrics, writing|0 Comments
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History Is What We Make It

February is Black History Month—officially observed as such by President Gerald Ford in 1976, America’s bicentennial year, to celebrate the contributions of Black Americans to our nation. It began as a week of remembrance established in 1926 by Carter G. Woodson, founder and president of the Association for the Study of African American Life and History. He chose the second week in February because it coincided with the birthdays of President Abraham Lincoln and Frederick Douglass, the former slave who became a famous orator, author, and abolitionist. Later, in 1986, Congress designated the month of February as “National Black History Month.”

I didn’t know about the origins of Black History Month until I was preparing this editorial. This made me wonder about the many other things I wasn’t aware of concerning the history of Black Americans in this country. It wasn’t until last year, on its centennial, that I learned about the massacre that destroyed the Black community in Tulsa, Oklahoma, in 1921. And it was only in the last few years that I learned about the Tuskegee syphilis study conducted by the U.S. Public Health Service from 1932 until 1972. (Yes, 1972!) In this study, originally known as the “Tuskegee Study of Untreated Syphilis in the Negro Male,” participants with syphilis were not […]

2022-02-09T14:26:55-05:00February 9th, 2022|Nursing|1 Comment
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