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 […]

2019-11-04T09:34:15-05:00November 4th, 2019|Nursing|0 Comments
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Dia De Los Muertos: Thoughts On Life, Death, Nursing, and Time With Our Families

I discovered she died the way I typically learn a patient I’d navigated for died: the tiny abbreviation “dcsd” appeared next to her name on my computer’s patient list. Although her passing was not unexpected, I felt a deep sadness at the loss of her beautiful soul. From my desk, I sent a silent prayer of remembrance, and then another asking comfort for her family.

She was about the same age as my daughter, and like her, married to a devoted husband, the mother of young children. She was also an only child like my daughter, and feeling this connection, I grieved for her mother too. I wondered if there were things she would have done differently if she’d known their time together would be cut short.

Nursing doesn’t stop for the holidays.

Dia de Los Muertos. Illustration by Julianna Paradisi

We are entering the holiday season, and nurses begin scheduling their holidays off, and on. Not everyone will get what they desire. Perhaps it’s not coincidental that ringing in this season is the Latino celebration, Dia De Los Muertos (Day of the Dead, Oct. 31-Nov. 2), which is not […]

2019-10-30T09:58:35-04:00October 30th, 2019|Nursing, nursing career|0 Comments
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Informing Policy, Driving Change: No Longer Optional for Nurses

Nurses have the knowledge, skills, and obligation.

Rep. Lauren Underwood, left, with AAN president Karen Cox

The American Academy of Nursing (AAN) kicked off its annual policy conference last week by honoring Rep. Eddie Bernice Johnson, (D-TX), the first registered nurse elected to Congress, and hearing from the nurse most recently elected to the House, Rep. Lauren Underwood, (D-IL). Their presence underscored a viewpoint that is gaining traction in prominent circles, from the World Health Organization to the National Academy of Medicine: Nurses have the knowledge, skills, and obligation to inform policy and drive change.

During her talk, Underwood laid out her policy priorities and expressed her fervent belief that for nurses, “engaging in policy is not optional.”

Underwood serves on three House committees—Veterans’ Affairs, Homeland Security, and Education and Labor—and within those on subcommittees dealing with emergency preparedness, disability assistance, and other topics where she uses her health expertise to influence policy on a range of issues. These include gun violence prevention, black maternal health, infant mortality, drug pricing, and suicide among veterans.

A data-driven approach.

Underwood’s approach to policymaking is data driven. Prompted by research on medication adherence, she sponsored a bill to allow veterans to receive a full-year’s supply of contraceptives rather than having to refill their prescriptions every three months.

When […]

2019-10-29T15:50:34-04:00October 29th, 2019|Nursing, nursing perspective, nursing roles, Public health|0 Comments
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November Issue: Chronic Pain and Opioids, CVDs in Pregnancy, Preventing Patient Self-Harm, More

“[S]eeing this patient, his return, his presence, his enduring love, was a gift. Because some days in health care, you don’t really know what hope you are fighting for or for whom.”—Hui-Wen (Alina) Sato, author of the November Reflections column, “Beholding the Returning Light”

The November issue of AJN is now live. Here’s what’s new:

CE: Implementing Guidelines for Treating Chronic Pain with Prescription Opioids

An overview of five tools outlined in the CDC’s 2016 opioid safety guideline—prescription opioid treatment agreements, urine drug screening, prescription drug monitoring program databases, calculation of morphine milligram equivalents, and naloxone kits—and their relevance to primary care nurses.

CE: Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy: A Clinical Review

The authors discuss three of the most common pregnancy-specific cardiovascular diseases and their risk factors, prevention, assessment, and management.
[…]

2019-10-28T10:00:42-04:00October 28th, 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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