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 […]

2020-10-15T10:16:25-04:00October 15th, 2020|Nursing|0 Comments
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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, […]

2020-10-13T12:50:15-04:00October 13th, 2020|Nursing, nursing students|2 Comments
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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.”

[…]

2020-10-08T10:01:55-04:00October 8th, 2020|family experience, Nursing, nursing research, Patients|0 Comments
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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 […]

2020-10-05T10:43:01-04:00October 5th, 2020|Nursing, nursing research, Public health|0 Comments
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Staying Away, Reaching Out: Offering Parents Support During the Pandemic

The ‘circuit breaker.’

Image by Wokandapix from Pixabay

I brace myself as I look over the names printed on my patient list. Our developmental pediatric unit has started an initiative to call our more vulnerable families during the COVID-19 pandemic.

Chan J. DOB: 12/10/2001. As I scan the electronic notes, I learn that mum is the main caregiver of not one but two boys with autism spectrum disorder who require a high level of support. They both usually attend special school, but the school is currently closed because of social distancing measures. We are in lockdown, or ‘circuit breaker’ as we call it in Singapore, and both children have been at home for the past three weeks. My heart sinks in anticipation as I punch in the numbers.

“Hello,” a voice hesitates at the other end.

“Good morning, Mrs. Chan,” I say, putting on a cheery tone. “My name is Jia Yi and I am a nurse from the child development unit. We are checking in with our families and I wonder if you have some time to speak with me?”

“What about?” This mother sounds tired.

“Oh, just checking in on how you are getting on and whether there is anything we can do to help.”

‘”It’s hard,” she says. I […]

2020-10-01T10:18:14-04:00October 1st, 2020|Nursing, nursing stories|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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