What Would It Have Helped to Know as a New Nurse?

An incomplete record of starting out as a nurse. 

When I think back on my first year as a nurse, I always say two things to myself: “I wish I had written more,” and “I wish someone had given me a more realistic how-to manual.” I try to remember patients from back then. What would I have shared, had I written about each one?

I was never not writing about something (sometimes what I wrote was published on this blog), but over time, as I moved away from bedside care and into administration, I wrote differently: policies and program plans, research protocols and systematic reviews. Although I rarely worked directly with patients anymore, their positive outcomes continued to motivate my every word.

I like to think my writing has grown with me. I’ve learned the power of the active voice; the structure required for the APA Writing Manual. 7th edition; and the deepening of understanding that comes from reading and reflection. But I will always wish for more writing—of any kind—from that first year. Even a scribble to jog my memory. This nursing birth of mine, like any birth, began my nursing life in a very specific way. I was challenged and tested, understood and got lost, […]

2023-01-30T10:34:04-05:00October 22nd, 2020|new nurses, Nursing, nursing career|0 Comments

Emergency in the ED: Treating Hemorrhagic Shock

Emergency nursing isn’t all drama and adrenaline.

As any ED nurse knows, most of what a nurse sees in the ED is not what would classify as real emergencies—the kind of exciting, life-threatening situations that might have actually been the reason they chose emergency nursing. That’s how it was for me, and getting hired as a new grad to work at New York City’s Bellevue Hospital, one of the country’s premier emergency services, was a dream come true.

However, I quickly learned that most of the people who came through our doors did not have exciting, life-threatening emergencies but rather the more humdrum “urgencies” of life—gastroenteritis, a sudden high fever, a small laceration that needed a few sutures, sprains, and minor fractures. Minor, comparatively speaking, but certainly not minor to the patient, and all requiring attentive care. (For a vivid and poignant inside view of emergency nursing today, see the photo essay in the September issue; the essay is based on Carolyn Jones’s new film, In Case of Emergency, to be released this week for Emergency Nurses Week.)

When the ED doors slam open.

But then there were those sudden life-or-death emergencies that raised everyone’s adrenaline levels—a patient bleeding out was one of the more dramatic scenes. They usually arrived without […]

Bringing Escape Room Games to Nursing Education

The popularity of escape rooms has grown exponentially in the past decade, with these simulated group activities becoming an established part of gaming and pop culture. But the concept offers more than just a fun distraction or chance to work cooperatively with friends and family. Increasingly, these games are being incorporated into simulation-based clinical education.

An opportunity for collaboration.

In an escape room activity, a group of people work together to find clues, solve puzzles, and complete tasks within a set period of time. As they do so, they may progress through one room or several, but the goal is typically the same: for the group to “escape” from a simulated situation.

Step-by-step guide.

Educators have been exploring the use of this approach in nursing education to reinforce knowledge and engage students. As nurse educator Janice Hawkins and her colleagues at Old Dominion University School of Nursing in Virginia point out:

“By requiring a group of learners to solve a series of skills-related puzzles, educational escape rooms can help to build critical thinking, communication, and cooperative problem-solving skills.”

In “Behind the Scenes of an Educational Escape Room,” they provide a step-by-step guide to developing an effective educational escape room. Their advice stems from their yearlong experience developing, […]

Patient Input on Obstacles to Sleep Helps Focus One Unit’s Improvement Efforts

Do you know anyone who’s ever had a good night’s sleep in the hospital? As nurses, we hear the complaints; as patients ourselves, or as family members of patients, we’ve been there.

Differing views on the source of a unit’s sleep problem.

After their hospital’s 20-bed telemetry unit received a low HCAHPS survey score on a quiet-at-night question, nurse practitioner Christian Karl Antonio and his colleagues at a northern California community hospital took on the challenge of improving patients’ sleep experience on the unit.

Before designing an intervention, they spoke with patients as well as staff, and were surprised to learn that the two groups see the problem differently.

“Patients perceived being awakened for vital signs, blood draws, and medication administration as the most frequently occurring factors that contributed to noise at night. On the other hand, staff members perceived that noise at night came from staff conversations, equipment with alarms, announcements on the paging system, and delivery carts, among other sources.”

[…]

How Do Nurses Feel About Assessing for and Promoting Safe Gun Storage?

My grandfather and uncles were hunters, and they always looked forward to their forays into Michigan’s Upper Peninsula during deer hunting season. But while I was well aware of their activities, they never brought their guns into our house. So I never gave any thought to gun safety issues, even after I became a nurse—not even after caring for one memorable patient, a young man my own age who had been accidentally shot by a companion during a hunting trip.

What can nurses do?

“…a child finds an unlocked loaded gun and accidentally shoots themselves or someone nearby, a despondent teenager makes a rash decision to end their life with the family gun, a homeowner mistakes a family member for an intruder.”

It seems that we read about tragedies like these every day. Can nurses help prevent them? The American Academy of Nursing has recommended that health care professionals “assume a greater role in preventing firearm injuries by health screening.”

In “Nurses’ Knowledge and Comfort with Assessing Inpatients’ Firearm Access and Providing Education on Safe Gun Storage” in the September issue of AJN, Kimberly Smith Sheppard and colleagues report on their original research study, which examined nurses’ knowledge and comfort with assessing patients’ access to […]

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