Accepting Patients’ End-of-Life Decisions Can Be Hard

“The most important decision an individual can make may be how much treatment they want at the end of life.”

photo from pxhere

When it comes to end-of-life decisions, it may be hard for a nurse to accept to support only what the patient wants, but it’s also vitally important. In the Viewpoint column in our June issue (Viewpoints are free to read), Nadine Donahue, PhD, RN-BC, CNE, describes caring for an elderly patient in his home as he begins to lose the ability to breathe on his own because of COVID-19.

When she implores the normally spry, physically active retired executive to let her call an ambulance to take him to the ED, he refuses. Writes Donahue, an associate professor of nursing at York College, City University of New York:

“He’d always told me that he believed in a time to be born, a time to live, and a time to die. He was not going to be attached to a ventilator and in a hospital if he could help it.”

[…]

Summertime: Rest, Relax, and Write

With summer stretching ahead, I hope many nurses will take some well-deserved time off—rejuvenating bodies and spirits, processing emotions that were put aside, and reflecting on the long and difficult past year. But time off is also good for doing those “other things”—items that have drifted to the bottom of a to-do list. Perhaps writing is one of them.

As I noted in a 2014 editorial, there are various perspectives on how one should approach writing, and I list some from editors and scholars. I also offer what works for me:

First, spend some time thinking about what you want to say before you start writing. Know what you want to tell readers—the purpose of your paper—so that you can say it clearly.

Next, sit down and start writing. Write anything you want to say about the topic; you can go back and organize later. (Contrary to what many of us were taught, you don’t have to outline first. Some writers write this way, but many don’t.)

Third, leave the work alone for a while. Take a walk or do something else.

And fourth, go back and start shaping and polishing your piece, paying attention to organization and transitions. Aim for a logical flow of ideas. Weed out the jargon, too.

AJN has a collection of writing resources for nurses—we’ve made them free to access through September 1. You’ll also find some great resources at Nurse […]

Pregnancy and COVID: What We Now Know

Meagan Garibay, RN, BSN, CIC, an infection preventionist at Comanche County Memorial Hospital in Lawton, Oklahoma, received the COVID vaccine in December 2020, when she was 35 weeks pregnant. Photo courtesy of WAVE 3 News.

Few aspects of pregnancy and birth have been unaffected by the COVID pandemic. In the past year, pregnant people and their health care providers have had to alter everything from the way they assess risk to the manner in which care is accessed.

Although little information about pregnancy and COVID was available early in the pandemic, emerging evidence is providing a clearer picture. As a result, in the past year recommendations have shifted—sometimes radically so—for both women and their health care providers. Based on the latest available research, this month in AJN Reports we cover what we now know about COVID and maternal health, including guidance about risk and vaccination.

Higher risks for pregnant people with COVID.

As the articles explains, research suggests pregnant people who have COVID are at higher risk of severe […]

Writing as Another Tool for Coping as a Nurse

“I recall wondering where this process had been all my life. Of course, it had always been there. It simply hadn’t occurred to me that writing could be such an effective tool for examining, reflecting, processing, and learning.”

‘Like a girl playing dress-up in a nurse uniform.’

by hannah olinger/unsplash

At age 19, I graduated with an associate’s degree in nursing, passed my boards, and went to work in a regional hospital near my college, in the city where I grew up. My geographical radius was as puny as the range of my life experience. I feigned excitement about the new job, but I was overwhelmed. I knew I needed more of everything: experience, education, tools for coping. Eventually, I discovered one of the missing tools was writing.

I entered every shift with anxiety, certain I would walk in on a patient or situation I was ill-equipped to handle. At night, I tossed with worry. When sleep came, dreams became nightmares of IVs running dry and patients coding.

I had only myself to blame. As a teen, I wasn’t ready to decide what to do with my life. I knew nursing was a noble profession, and my parents nudged me toward a program that was economical, efficient, and allowed me to live at home. At age […]

Caring for Caregivers—We Need More Than Self-Care and Resilience

Mural painted by critical care unit staff to honor patients who contracted COVID-19. The stars represent those who succumbed to the illness and the flowers those who were discharged from the hospital. Mural by the MedStar Montgomery ICU Team; photo by Cherri Walrath.

Self-care is not a panacea.

Since the start of the pandemic, AJN has received many manuscripts and queries related to self-care and resilience to prevent burnout. It’s not surprising, given that this has been a harrowing year for nurses.

But while self-care and resilience are important, and such articles are needed, all the self-care in the world can’t fully address the root of the problem—the systemic issues that lead to burnout. At some point health care administration needs to step in and become part of the solution and offer staff the help they need.

A CE feature in our May issue, “Providing Care for Caregivers During COVID-19,” highlights one hospital system’s efforts to do just that. The Care for the Caregiver program, which existed prior to the pandemic, was created to support ‘second victims,’ defined by the Center for Patient Safety as “healthcare providers who are involved in an unanticipated adverse patient event, medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by […]

2021-05-27T09:19:17-04:00May 27th, 2021|Nursing|0 Comments
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