Addressing Harassment and Intimidation by Patients and Family Members

Since arriving at the skilled nursing facility after surgery for throat cancer, Ray had been attempting to touch female nurses inappropriately and had recently started making kissing motions at one of them whenever she entered and left the room.

Tacit acceptance of the unacceptable.

Though his behavior was recognized as unacceptable, most nurses had simply been redirecting him or telling him to stop, with no further consequences. Some explained the harassment away as the crude behavior of an old man who didn’t know any better. He’s from a different time; things were different back then. Some dismissed it as harmless. He thinks he’s being flirty. For others, his behavior was a mild though not particularly threatening irritation. He can’t even get out of his wheelchair—what’s there to worry about?

A symptom of cognitive decline, or plain old bullying?

The situation was complicated by the fact that Ray could not communicate verbally as a result of surgery, had short-term memory impairment, and difficulty concentrating. Although he appeared cognitively sound, there were just enough complications in communication and attention to cause some to speculate that he might be having neurocognitive decline that had disinhibited his self-restraint.

For others, Ray was a bully, maybe even a predator. He was taking advantage of access to female staff who were required […]

2019-11-14T10:28:12-05:00November 13th, 2019|career, Nursing, nursing career|0 Comments
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Remembering Veterans – All of Them

In the November 2010 issue of AJN, we published an editorial, “Families are Veterans, Too,” recognizing the stress and sacrifices of families of those who serve in the military. On this Veterans Day, we’re sharing an excerpt of that editorial below, and also offering free access to “Caring for Families with Deployment Stress,” the article mentioned in the editorial. This article was also published in the November 2010 issue and, unfortunately, is still very much pertinent, given that many families are still experiencing the stress of having a loved one deployed to a conflict zone. We honor and thank all those who have served.

As Erin Gabany and Teresa Shellenbarger explain in “Caring for Families with Deployment Stress,” that stress can be considerable. In families with children, deployment means that a two-parent household becomes in effect a single-parent one; when a single parent is deployed, grandparents, aunts, or uncles may find themselves filling that role. The deployment period may be especially difficult for families of soldiers in the National Guard or in reserve units—they’re less likely to be living on or near a military base or to have access to its resources and to other families going through the same experience. They’re also likely to have less income when the reservist’s civilian pay stops. Such stressors can play a role in a range of physical, emotional, and behavioral problems.

Nurses in all settings—not just those in clinics serving military families—may […]

2019-11-11T13:44:06-05:00November 11th, 2019|Nursing|0 Comments
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Managing Cardiovascular Complications of Pregnancy

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Over the past 30 years, the number of pregnancy-related deaths in the U.S. has more than doubled, from 7.2 women dying per 100,000 live births in 1987 to 16.9 women in 2016. By comparison, on average in high-income countries, 11 women die for every 100,000 live births.

CVD a leading cause of maternal mortality.

There are many reasons why more women die from pregnancy-related causes in the U.S. than in other developed countries; our dysfunctional health care system is, of course, a central problem. But is there more that nurses can do to ensure safe and healthy pregnancies?

“Cardiovascular diseases constitute a leading cause of maternal and fetal mortality in pregnant women… [In recent studies], inadequate peripartum follow-up—such as failure to evaluate new symptoms, reevaluate existing symptoms, or respond to changes without delay—was responsible for between one-quarter and two-thirds of deaths associated with pregnancy-specific cardiovascular diseases.”

That’s from “Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy:  A Clinical Review,” in the November issue of AJN. In this CE feature article, Maheu-Cadotte and colleagues at the Université de Montréal provide an update on the current management of gestational hypertension, preeclampsia, and peripartum cardiomyopathy.

Risks before, […]

2019-11-08T12:09:08-05:00November 8th, 2019|Nursing|0 Comments
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Caring for the Patient You Never Had a Chance to Get to Know

“For months, we simply knew him as this often agitated, sometimes unstable, generally nonverbal, nonpurposeful patient whose actual personhood seemed, if I’m honest, unrecoverable. We didn’t even know who we were trying to recover…”

This month’s Reflections essay in AJN is by Hui-wen Sato, a pediatric intensive care nurse in California. This piece is difficult to describe because it fits no clear category; this is also what makes it alive and engaging.

In “Beholding the Returning Light,” Sato explores the the experience of caring for a patient without ever having had a chance to get to know that person. What do you feel for that patient, and how much do you invest yourself in his or her possible future?

The ‘unthought known.’

Such questions and others may exist on a subconscious level throughout an ordinary work day for nurses in a number of settings. Sato, as she traces the sequence of events, her own emotions, and the role of the patient’s family, adroitly brings them to the surface. […]

2019-11-06T13:33:46-05:00November 6th, 2019|Nursing, nursing stories|0 Comments
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Supporting Systems to Address Clinician Burnout

National Academy of Medicine calls for action to address a crisis among clinicians.

As a nurse and researcher who has worked in the area of clinician burnout for many years, I was pleased to see attention to this issue by the National Academy of Medicine (NAM) in a recent consensus study report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

Burnout, a syndrome of “emotional exhaustion, depersonalization, and lack of personal accomplishment” (Maslach et al. 2001. Job Burnout. Annu Rev Psychol. 52: 397-422), has far-reaching and troubling consequences for health care clinicians. The problem has grown to crisis levels: estimates indicate that 35%-45% of the nearly 4 million nurses in the U.S. are experiencing symptoms of burnout, and up to 54% of our physician colleagues experience it as well.

A ‘chronic imbalance’ of job demands with available resources.

Prominent among the factors contributing to burnout are the systemic patterns that erode professional fulfillment and well-being, many of which are beyond the control of individual clinicians.  Burnout represents a chronic imbalance of job demands with resources needed to meet them.

The National Academies of Science, Engineering and Medicine (NASEM), of which NAM is a part, convened a committee to examine the scientific evidence towards understanding the scope and consequences of burnout on the […]

2019-11-04T09:34:15-05:00November 4th, 2019|Nursing|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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