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.

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

2021-01-27T11:35:45-05:00January 27th, 2021|Nursing, nursing research|1 Comment
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To Be or Not to Be: Choosing Between a Career in Art or Nursing

Art or Nursing, ink and watercolor, 2021 by Julianna Paradisi

The phrase ‘art of nursing’ describes how nurses bring personalized care to our patients. People with creative impulses are often as attracted to health science as to paint and canvas. My own combined career path of artist, writer, and nurse is an example. But although nursing and creative arts careers sometimes overlap, they require very different preparation and academic degrees .

Because of the path I’ve taken, I’m often approached by multitalented young people wanting advice when deciding between dedicating themselves to a career in the arts or taking a chance with building an art career while enjoying a relatively more dependable income in nursing.

A recent email from an artistically gifted high school senior distilled her concerns into these questions:

  • Do you find it rewarding to be a nurse?
  • Did nursing help your art career?
  • Do you have regrets about choosing nursing instead of another career more related to a career in art?
  • What advice would you give about this decision?

Yes, I have found nursing rewarding.

I have written in other blog posts that nursing was not my first choice for a career. I wanted to be a writer and make art, but I […]

2021-01-27T10:22:15-05:00January 25th, 2021|Nursing, nursing career|4 Comments
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AJN Off the Charts: Eight Enduring Blog Posts from 2020

In a 2020 largely defined since early March in the health care field by the all-consuming COVID-19 pandemic, we published many powerful and timely posts on this blog.

Some of them were very much of the moment as writers tried to sort through the unknowns and knowns about this unfamiliar virus, address the crisis faced by nurses thrown up against it with inadequate evidence or material support, and raise their voices in favor of sane policies to bring some order out of seeming chaos and mixed messaging.

The most striking and wrenching of these may have been the first one below, a powerful post from last April by a young ICU nurse working under frightening conditions during the first bewildering surge of the virus. Reading it may remind us of just how disorienting the early days and months of this pandemic were for everyone, especially ED and ICU nurses.

Other authors share historical contexts that help us understand our current situation or timeless wisdom that nurses can apply now to staying inwardly whole and sane during the pandemic and later when the going gets tough in other ways.

There are many many other posts that could have gone on this list. If any of these resonate for you, we hope you’ll share them. If you’re not already familiar with this blog and like what you read, we hope you’ll consider subscribing (see the right-hand sidebar) to receive each new post as an email in your inbox. We publish two to three times a week.

 

2021-02-23T17:06:29-05:00January 21st, 2021|Nursing, writing|0 Comments
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COVID-19 Vaccines Explained

As we in the U.S. struggle to set up systems for the rapid administration of SARS-CoV-2 vaccinations, what do nurses need to know about these vaccines?

Two vaccines have received emergency use authorization (EUA) in the U.S.—one manufactured by Pfizer/BioNTech, the other by Moderna. (A third, manufactured by AstraZeneca, is likely to receive EUA by April.) New, more efficient vaccine technologies along with a huge financial investment by the U.S. government have produced these products in a much shorter time frame than has been typical for other vaccines.

Currently available vaccines.

The two vaccines that are available now are messenger RNA, or mRNA, vaccines. This type of vaccine has been developed and studied for decades for possible use in preventing influenza, Zika, and other infectious diseases. Human mRNA is a strand of genetic material used for cell building and maintenance. For SARS-CoV-2 vaccines, mRNA based on part of the SARS-CoV-2 genome is synthesized and standardized in a lab.

When administered in a vaccine, this mRNA delivers to our cells the instructions  to replicate a “spike protein” found on the surface of the SARS-CoV-2 virus. (Important to know and tell patients: The mRNA never enters the nuclei of our cells, and can’t be incorporated into our own DNA.) After a cell follows these instructions and “posts” the spike protein replica on its surface, the immune system recognizes it as foreign […]

2021-01-19T11:08:24-05:00January 19th, 2021|infectious diseases, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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