Asleep at the Wheel: Night Shift and Drowsy Driving

‘The most exhausting year of my life.’

Photo by Jan Baborák/ Unsplash

In my 25-year-plus nursing career, I’ve had the opportunity to work every shift—days, nights, evenings, 8-hour and 12-hour shifts. Without a doubt, my least favorite was 12-hour night shifts, as I am more of a morning person than night person.

When I was a new graduate, it was hard finding a job on the day shift, since it’s typically more popular and there are fewer openings for inexperienced nurses. Because of this, I accepted a position working from 7 pm to 7 am.

It was the most exhausting year of my life. No matter what I tried, I couldn’t sleep well during the day, and by the end of the 12 hours I was wiped out. Although I was lucky enough to live only a few miles from the hospital, I found it difficult to stay awake for the whole ride home. I would catch myself trying to keep my eyelids from closing, and a few times I briefly fell asleep at red lights.

Close calls on the roads.

I am grateful that nothing bad ever happened during my sleep-deprived journeys. I have a friend who wasn’t as lucky and totaled her car one morning on the […]

2021-10-04T11:15:27-04:00October 4th, 2021|Nursing|0 Comments

Caring for Transgender and Gender Diverse Patients: A Primer

“You must be Olivia! I’m Sara, and I’m going to be your nurse this afternoon.”

The patient looked up, taking a deep breath before speaking. “Actually . . . can you call me Ethan? I’ve been going by Ethan for the past six months, and I use he/they pronouns.” He watched Sara anxiously.

Sara stopped short for a moment, unsure what to do, seeing the name “Olivia” very clearly in the EHR. But she noticed how nervous the patient was, and she wanted to put him—them?—at ease.

Photo by Zackary Drucker/The Gender Spectrum Collection.

Providing informed, affirming care for transgender and gender diverse (TGD) patients can seem complex, especially for novice nurses. As authors Caitlin Marie Nye and Amanda Anderson […]

2021-09-29T08:59:27-04:00September 29th, 2021|new nurses, Nursing|0 Comments

October Issue: Hypertensive Emergency, Proning, Preventing Medjacking, More

“One expects nurses to be better informed than the general public when it comes to science and health matters.”—editor-in-chief Shawn Kennedy in her October editorial, “Getting on Board with Vaccinations”

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

CE: Hypertensive Emergencies: A Review

An overview of the pathophysiology, clinical manifestations, and management of hypertensive emergency, plus nursing considerations for acute and preventive care.

CE: A Prone Positioning Protocol for Awake, Nonintubated Patients with COVID-19

How an interdisciplinary team at one Boston hospital developed and
implemented a protocol for proning awake, hypoxemic patients with
suspected or confirmed COVID-19 on medical–surgical units.

Special Feature: Preventing Medjacking

This article discusses medical device cybersecurity, the risks and consequences of compromised medical and personal data, and what nurses can do to guard against security threats and educate patients. […]

2021-09-24T09:19:42-04:00September 24th, 2021|Nursing|0 Comments

Are Fall Prevention Precautions Missing the Mark?

Happy first day of autumn! Let’s have some fall talk.

If you spend any time in the acute care setting, you’ll be inundated with signs of fall precautions: yellow alert armbands, yellow nonslip socks, yellow signs on patient room doors, and of course the constant ringing of bed alarms.

It appears that hospitals put a lot of effort into fall prevention, and understandably so—falls cost hospitals money. These costs include tests and procedures that aren’t covered by insurance, increased length of stay while the patient recovers, and lawsuits from injured patients or from their families.

Checking boxes vs. individual patient needs.

However, the current approach of applying all precautions to all patients at risk for falling isn’t supported by research, and may decrease patient satisfaction. Sometimes it seems more focus is put on checking boxes about having prevention strategies in place than on the actual patient’s preferences or needs. For example, a former patient told me about a time she was in the bathroom of her hospital room and felt lightheaded. Rather than risk falling, she eased herself to the floor and hit the call bell for assistance to get back to bed. Upon finding her on the floor, the staff were so focused on filling out an incident report and assessing her for injury that they ignored her attempts to explain what actually happened.

The ‘next era’ in fall reduction.

2021-09-22T09:47:00-04:00September 22nd, 2021|Nursing, patient safety, Patients|0 Comments

Mental Illness and Public Tragedy: Recognizing Critical Warning Signs

In 2020, I was asked to review a submission for AJN’s Viewpoint column. Reviewers are not told who the author of a work is, nor are authors informed who is reviewing their submission. But I hadn’t gone very far when I knew exactly who the author was and what she was writing about.

Photo © Shutterstock

In my career I have read and been moved by many articles and first-person accounts, but this time was different. Each word took me closer into what I realized was a very personal viewpoint on an unimaginable national tragedy.

The author of the article was Arlene Holmes, a nurse and mother who was writing about her son James, who on July 20, 2012, opened fire on movie theater patrons in Aurora, Colorado, killing 12 and wounding 70. (Her article, “Why a Nurse (and Mother) Didn’t Know,” was eventually accepted and published in AJN‘s June 2020 issue.)

Asking the same questions over and over.

After completing the review of this article, the questions I asked myself were the same ones I ask each time we hear of such tragic events happening at the hands of someone who has a mental illness:

What could have been done to change the outcome and prevent such […]

2021-09-16T10:05:00-04:00September 16th, 2021|Nursing|0 Comments
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