The First Injection

A nursing professor, now administering Covid-19 vaccinations as a volunteer, looks back on her 40 years of giving injections. The first one was the hardest. 

‘I could have easily given up that day.’

I reviewed the chart the night before—“40 units of NPH insulin subcutaneous before breakfast”—then went home to practice the technique. With a tiny needle and a small volume of medication. I used an orange to simulate the skin and gain confidence in how to puncture the skin and push the plunger to inject the medication.

As I entered the ward with my fellow classmates the next morning, I felt prepared to give my very first injection. I removed the insulin from the refrigerator and began to warm the vial between my fingers. I carefully selected the 100 unit insulin syringe. As I slowly drew up the dose, nervously flicking the air bubble out of the top of the syringe, my clinical instructor watched from the side.

Before we went into the room I checked the record for site rotation—right side of belly. I swallowed hard. We knocked and entered the room, introducing ourselves and our plans for the patient’s morning insulin. The older man lying in bed nodded approvingly. When I pulled up his gown and searched the right side of his belly, I began to have doubts. I hadn’t practiced an injection in the belly and the man’s skin was dry and wrinkled—nothing like the smooth skin of the orange I’d used the night before.

I swabbed the area with the […]

2021-03-12T15:19:08-05:00February 10th, 2021|Nursing|2 Comments

Who’s Going to Smile at My Baby? When the Pandemic Comes to the NICU

From the doorway, I watched the mother gently stroke her newborn’s forehead. “I love you,” she whispered. “I’ll be back soon.”

As a resource parent in the neonatal intensive care unit (NICU) at a large children’s hospital, I am privileged with the task of offering support to families. This was a typical stop in one of many patient rooms. As I gingerly entered the room, the mother glanced up at me, tears welling in her eyes as she scrambled to adjust her mask.

“I’m sorry,” she stammered. “I didn’t want to cry.” A tear rolled down her cheek.

“Not at all,” I replied. “I understand. It’s hard being a mom in the NICU, now more than ever.”

I invited her to share her feelings, hoping to offer some help or comfort. Wiping her cheek with her sleeve, she explained that the pandemic visiting rules had made it difficult to be at her baby’s bedside.

“I have other children, and I need to go home to watch them. The hospital rules say I am the only person allowed to take off their mask in her room, but she needs to see faces for her development. Who is going to smile at my baby when I’m not here?”

Speaking from personal experience.

2021-02-08T09:43:44-05:00February 8th, 2021|family experience, Nursing, Patients, pediatrics|0 Comments

AJN Articles from 1910 to 2020 for Inspiration and Perspective During Black History Month

Bernardine Lacey (middle) and classmates in 1961 at Gilfoy School of Nursing, Jackson, MI. Photo courtesy of Bernardine Lacey.

February is the month designated for remembering the contributions of Black people to our nation and our culture. It’s a good reminder that in nursing, too, we have benefited from many strong Black women (and at least a few men), who often persevered in the face of discrimination in obtaining education and jobs.

The AJN archives have many articles worth revisiting.

This article from 1976, “Black Nurses : Their Service and Their Struggle” (to read, click on the pdf), describes the struggles of several of our profession’s notable Black nurses, including Mary Mahoney (the first Black nurse to be licensed).

This article from our August 2020 issue, ‘You Don’t Have Any Business Being This Good’: An Oral History Interview with Bernardine Lacey,” shares Black nursing leader Bernardine Lacey’s experiences with racism in her education and career and explores some of the difficult truths about racism and the culpable role of nursing in this history:

Building on this perspective, read a conversation from our September issue with nurse, activist, […]

AJN February Issue Highlights: Communication Challenges Due to PPE, Pressure Injury Prevention, Concussions, More

“Nurses are essential to administering the vaccines, and we need to be prepared with accurate information about the science behind them: how they work, what we know and don’t know about them, and what might change as more data emerge.”editor-in-chief Shawn Kennedy in her editorial, “Building Trust”

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

Original Research: Concussions at School: The Experiences and Knowledge of School Nurses

This study explores the pediatric concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State.

Communication Challenges in High-Containment Clinical Environments

The authors discuss the communication challenges that arise with the wearing of PPE and describe strategies they and their colleagues in the National Institutes of Health’s Special Clinical Studies Unit used to improve communication with other staff, patients, and external partners.

[…]

2021-02-01T14:29:13-05:00February 1st, 2021|Nursing|0 Comments

DNR Does Not Mean Do Not Treat

Nurses and the meaning of DNR.

I recall a patient I had as a very new nurse who was designated as do not resuscitate, or “DNR.” The patient had suffered an intracranial bleed and because of his advanced age and untreatable cancer, his family had agreed that no CPR should be used. I remember the nursing supervisor asking me why the patient didn’t have a footboard and foam heel protectors on (that’s what we did back then); my answer was that he was a DNR patient. She basically handed me my head and said that his DNR status had nothing to do with good nursing care.

I never forgot that incident, and when I spoke with the authors of a mixed methods study with direct care nurses on three different units that found that “varying interpretations of DNR orders among nurses were common,” I immediately said yes. Their article is the original research article in AJN‘s January issue, “Nursing Perspectives on Caring for Patients with Do-Not-Resuscitate Orders.”

Families and providers may understand DNR differently.

And it’s not just nurses who may have different ideas and think differently about what should or shouldn’t be done for these patients who hover between life and death—other health care providers and families need to be clear on what that […]

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