Dissonance and Harmony: Balancing Nursing and Home Life During the Holidays

Between worlds.

There is nothing quite like the holiday season in a culture obsessed with happiness at all costs to make me feel the complexity of navigating back and forth between work and home life as a pediatric ICU nurse.

Home life as a mother to two young children, wife, friend, and community citizen takes on an intense pace from just before Thanksgiving through the new year. I am coordinating celebrations with family and friends, keeping tabs on the kids’ school holiday programs, addressing Christmas cards, and deftly dodging BOGO promotional emails day and night. Life feels boundless with possibilities for activity and opportunity.

I arrive at work and enter the room of my patient, whose life has been brought to a screeching halt. She lies sedated, restrained by lines and tubes, barely oriented to day versus night. If not for the holiday decorations that we put up around the unit, there may be no indication of what season it is.

What is cheerful for me to anticipate at home during the holidays may be potentially disheartening for my patients and their families to consider. I can leave the hospital at will. They cannot. I am sensitive to this fact, and my demeanor when I talk about the holidays at work […]

2019-12-12T10:47:01-05:00December 11th, 2019|Nursing, nursing perspective, wellness|0 Comments
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Hematologic Childhood Cancers: An Issue for Kids and Adults

“A diagnosis of childhood cancer is a stressful event. It takes time for families to emotionally process the diagnosis before they can learn how to care for their child as therapy is initiated…”

Photo courtesy of the Children’s Hospital of Michigan.

Essential information for nurses.

In “Hematologic Childhood Cancers: An Evidence-Based Review” in this month’s AJN, author Jessica Lynne Spruit provides an overview of hematologic childhood cancers—among the most common types of cancer in kids—written for nurses who work with kids, teens, and adults. Spruit discusses symptoms, diagnosis, staging, treatment, and longer-term issues, as well as supportive care for both child and family.

The article focuses on acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), Hodgkin lymphoma, and non-Hodgkin lymphoma. A section on survivorship care, with an emphasis on the often-difficult transition from months of intensive treatment to less frequent primary care visits, reminds us to be sensitive to the life-changing nature of any cancer, but especially cancer in kids, for both child and family.

Problems among adult childhood cancer survivors.

We usually think of leukemias and lymphomas as pediatric territory. But today, more children are surviving childhood cancers, and problems related to the cancer itself, or to late treatment affects, can […]

2019-12-10T10:48:48-05:00December 10th, 2019|Nursing|0 Comments
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EHRs: Losing the Nuances of Nursing Care, and the Value

Image by mcmurryjulie from Pixabay

Our December issue is out, but before we move on from the November issue I want to highlight the Viewpoint, “Advocating for HIT That Captures Nursing Process.” It’s about something that greatly affects nurses’ work, seems to be the bane of all clinicians, and, I think, often prevents individualized patient-centered care.

I’m referring to the electronic health record (EHR), a system built to capture data important for billing and tracking aggregate patient outcomes—but arguably not designed for what clinicians deem as most important for understanding and documenting patient care.

Dylan Stein and colleagues Jasmine Travers and Jacqueline Merrill write what most nurses know about EHRs:

“The nuances of our care get lost in task-oriented, quantitative drop-down menus and checkboxes, while the qualitative value of our interventions and impressions are not encoded in a useful way.”

Nursing notes devalued.

In the old days BC (before computers), clinicians used some checklists for charting but also relied heavily on narrative notes to describe the patient’s individual story. While there are areas one can add notes in an EHR, nurses tell me that it’s not very easy to do so and that no one really reads them because they’re […]

2019-12-05T12:03:16-05:00December 5th, 2019|digital health, Technology|2 Comments
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A Nursing Way with Meaning

“I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.”

Despite our seriously malfunctioning health care system, sometimes we are lucky enough to be reminded of the richness of our practice. Most of us experience a bright spot or two on most days—a patient’s condition finally improves, and we know we had a hand in that; we are able to spend some “quality time” to help a patient cope with her illness; a discharged patient returns for a happy visit.

Thriving, not just surviving.

A few of us, though, are lucky enough to have nursing work in which we can thrive, and not merely survive, every day. In this month’s Reflections column, “The Way of Johnson Tower,” nurse practitioner Mark Darby describes his work in an unlikely setting: a medical clinic located in a public housing high-rise. Resources may leave something to be desired—occasional leaks from the laundry above seem to target the clinic’s centrifuge—but his practice is rich and fulfilling.

“All these people, despite their circumstances, teach me more about generosity, perseverance, and hope than I could learn anywhere else.”

[…]

2019-12-02T12:57:58-05:00December 2nd, 2019|Nursing, nursing roles, nursing stories, Public health|1 Comment
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December Issue: Diabetes Burnout, Hematologic Childhood Cancers, Malnutrition Readmission Prevention, More

“Now more than ever, nursing is in a position of influence.”—editor-in-chief Shawn Kennedy in her editorial, “Anticipating a Banner Year for Nursing”

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

CE: Original Research: Experiences of Diabetes Burnout: A Qualitative Study Among People with Type 1 Diabetes

Diabetes burnout has been described as feelings of exhaustion and frustration related to the demands of managing the illness, resulting in inconsistent self-care behaviors. The authors of this study conducted in-depth interviews with adults who have type 1 diabetes and current or previous experiences of diabetes burnout, revealing more about the nature of burnout and its contributing factors.

CE: Hematologic Childhood Cancers: An Evidence-Based Review

This article provides an overview of the approaches used to treat hematologic childhood cancers, explains which treatments are indicated for the various types of leukemia and lymphoma, and discusses nursing care of the child and family.
[…]

2019-11-25T09:41:53-05:00November 25th, 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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