A Proposal to Ensure Patients Don’t Fall Through the Cracks

As a retired RN who was certified in medical-surgical nursing, I remember the goals of the hourly rounding policy. Our patients were reassured to find out that staff would check on them every hour at a minimum for any needs they might have, and families could rest easy knowing their loved ones would not be ignored. Hourly rounding also helped prevent a patient from falling through the cracks on a busy shift—always my biggest fear, and one that would keep me up at night.

Obstacles to hourly rounding in acute care.

I also remember the challenges to this policy. Because in hospitals we are dealing with humans and not machines, unlike in factories, there are countless variables to sabotage our best efforts. Everyone has heard the line from the Robert Burns poem, “The best-laid plans of mice and men often go awry.”

The patient variables are unique to each primary nurse and her patient care technician (PCT) who have a plan to alternate rounding on those in their care: the patient who codes, the hemorrhaging post-op patient, the incontinent patient, and the cancer patient with intractable pain. The list is endless—situations that keep the primary nurse or PCT tied up in a room during their turn to do hourly rounds.

Some hospitals may have instituted tracking […]

2021-07-15T10:28:41-04:00July 15th, 2021|Nursing|0 Comments

Some Recent APEX and Clarion Award Winning AJN Content

AJN recently learned it had won several publishing awards, both for its social media and journal content. We are grateful to all the writers, artists, (and editors!) who help us keep up with the times. The articles (and AJN cover) noted below are all worth revisiting, and not just because they serve as a window on a time of particular urgency, improvisation, and courage.

APEX Awards

Apex Awards 2021This blog won a 2021 APEX Awards Grand Prize in Social Media for the following three blog posts published during the height of the COVID pandemic in 2020.

Deserted: Note from a Young ICU Nurse as COVID-19 Pandemic Intensifies in U.S.

A Message from Frontline Nurses: Let’s Keep the Real Enemy in Sight

Practicing the ABCDEs of Self-Care in Pandemic Times

AJN also won an APEX Award of Excellence in the writing/news writing category.

AJN Reports: The Politicization of COVID-19 […]

‘Just’ a Backache: Red Flags for Serious Underlying Conditions

A common complaint in the ED.

Years ago, as an ED nurse, I saw many patients whose primary complaint was back pain. Most of these were from recent trauma, such as after the patient had sustained a fall or was involved in a motor vehicle accident or other injury-causing incident. In one dramatic case, a patient came in with sudden, severe back pain, not realizing he had been stabbed!

I remember a young man who came in on a Sunday, complaining of a backache that had developed over the prior few weeks. He assumed it was just a muscle strain from working out, but finally sought treatment because the pain wasn’t letting up and had spread to include pain and numbness down one leg. As it turns out, he had a badly herniated disc.

Emergency departments fill a care gap for many patients.

Today, patients come to EDs not just for emergencies or even “urgencies”—EDs are often the only place an individual may have access to care. For some patients with ongoing health problems, an ED is where they go when the pain or disability has finally become too much to bear.

What red flags should nurses look out for with back pain in the ED?

“[N]onspecific low back pain that does not resolve with self-care and prompts patients to seek treatment in an ED may result from a serious underlying pathology…”

This month’s CE article, “Assessing Back Pain in Patients Presenting to the ED” (free to […]

Journal Watch: Short Takes on Recent Notable Research

This month we’re spotlighting our Journal Watch department. Here you can find short takes giving just the essential take-home points from notable studies that have been recently published in respected journals.

If you need to keep up with current research but don’t have time to do so, we suggest you start here each month.

The following six short articles will be free for the month of July.

Deprescribing in patients with a history of falls isn’t so easy, for either clinicians or patients. “Multifaceted, multilevel approaches are needed to overcome common barriers.”

Many women who have ovarian cancer still receive aggressive end-of-life care despite recommendations emphasizing early palliative care . . . and nonwhite women are more likely to receive aggressive care.

Discontinuation of thyroid hormone replacement is possible in some cases.
“Nearly one-third of patients remained euthyroid after discontinuation.”

Changes in ED use during the pandemic.
“Shifts in the pattern of ED visits . . . highlight the need for mental health, substance abuse, and violence risk screening and prevention during public health crises.” […]

AJN July Issue: Postpartum Depression, Red Flags for Back Pain in the ED, More

“The deeper into the swamp we walked, the greater the stillness. Negativity and angst dissolved. Silence seeped into our spines, relaxing our amplified neural conversations and untying cranky muscles.”—Pamela Sturtevant in her Reflections essay, “Of Swamps and Pandemics”

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

CE: Assessing Back Pain in Patients Presenting to the ED

This article describes the red flags that can alert clinicians to serious underlying conditions in patients who seek emergency care for back pain.

CE: Postpartum Depression: A Nurse’s Guide

The author presents the latest information on this debilitating mood disorder, including risk factors; consequences for the mother, partner, and baby; and screening and treatment options.

Legal Clinic: Crisis Standards of Care

The author discusses the ethical issues that arise when the standards of care shift from conventional to crisis and explains the legal implications for nurses. […]

2021-06-30T09:52:35-04:00June 30th, 2021|Nursing|0 Comments
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