The Hospital as Foreign Country

Capture“A Foreign Place,” the February Reflections essay by Barbara Sosman, delves into one patient’s experience of the sometimes inscrutable, sometimes terrifying, sometimes humorous events and encounters in one small corner of a hospital.

Below are the first two paragraphs, but as always, it’s worth clicking through and reading the entire essay (the PDF version is best). This one would be particularly hard to summarize; it takes us to unexpected places.—Jacob Molyneux, senior editor

The flow of life and death in a hospital is mysterious, like the sound of a foreign language, and the mysteries that bring us here are profound. Stretched out in an unfamiliar hospital bed, I suppress realities, aware that tomorrow a scalpel will remove an enlarged node for a biopsy. The biopsy will show what I sense, a cellular chaos that threatens my life. Soon my disease will be presented like an offering. What will I do with it?

A room can become a universe and time there an infinity. This room is inhabited by women, of whom I am the youngest by decades  . . .

As always, comments are welcome.

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2016-11-21T13:05:27-05:00February 7th, 2014|nursing perspective, patient engagement, patient experience|0 Comments
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It’s Starting Again

Some Notes on Pink Ribbons and the Primacy of Breast Cancer Advocacy

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Breast cancer awareness giveaways/Wikipedia Commons Breast cancer awareness cornucopia/Wikipedia Commons

It’s starting again. October is less than a week away and already they’re everywhere. But then again, they never really go away. Those darn pink ribbons.

Breast cancer is a terrible disease. My family has experienced its share and I know the anxious—it’s going to be fine, oh my god what will happen to my kids if I die—feeling of waiting for a path report after a lumpectomy.

But there are other terrible things that happen to women—and happen more frequently. And we don’t pay anywhere near the same attention to them. Take heart disease, for example. Heart disease is the number one killer of women. In 1999, according to the CDC, 24% of deaths in women were from heart disease, while 22% were from ALL types of cancer combined. Or consider domestic violence, experienced by one in four women during their lifetime while one in eight women will experience breast cancer.

So why is it that breast cancer garners so much of the public’s attention, and along with that, a disproportionate amount of its resources? It collects more funding than any other type of cancer. For example, […]

2017-04-21T22:20:27-04:00September 25th, 2013|nursing perspective|6 Comments
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‘The Nurse Who Changed My Treatment’

By Annalisa Ochoa, for AJN. All rights reserved. By Annalisa Ochoa, for AJN. All rights reserved.

Two years ago, when I was diagnosed with advanced lung cancer in the ED of a large urban hospital, I asked a nurse if I could borrow her cell phone. Without hesitation, she handed me her Blackberry—this simple gesture was a first indication of the solidarity I’d come to feel with the nurses whose kindnesses have helped me heal.

We think it’s important to sometimes include a patient perspective in our monthly Reflections essay. “The Nurse Who Changed My Treatment,” the June Reflections essay, is by Nila Webster, who writes about the gestures by nurses, the little kindnesses and words of wisdom and encouragement, that helped her during her treatment for lung cancer and made her feel seen and understood. The essay is free, and short, so please click the link and give it a read.—JM, senior editor

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2016-11-21T13:07:27-05:00May 29th, 2013|Nursing, patient experience|1 Comment
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Shared Decision Making and PSA Screening

PSA article screenshot“Should men get PSA tests to screen for prostate cancer?”

The Wall Street Journal posed the question in an informal, online poll last September. An accompanying article featured a debate between Richard Ablin, who’d discovered the prostate-specific antigen (PSA) in 1970, and an oncologist, Oliver Sartor. Ablin argued that the PSA test should be used only to screen men with a family history or active symptoms. For all other men, he said, a coin toss would be as effective. Sartor countered that the test finds cancers that can be treated early, acknowledging that for most men surveillance instead of active treatment is appropriate. Ablin retorted, “If we really could determine which cancers need treatment and which don’t, we wouldn’t be having this debate.”

The passage above is from this month’s AJN Reports by Joy Jacobson, “Navigating the PSA Screening Dilemma.”

The article gives a great overview of one of the big screening debates of the moment. Many of these debates are driven by changes in guidelines along with a dawning awareness in the medical community that certain tests we’ve assumed to be wholly beneficial, wholly necessary for most patients, may in fact be more harmful than not for many patients, leading to unnecessary treatment, anxiety, and waste of valuable resources.

The article also incorporates a discussion of the role being envisioned for “shared decision making” in helping patients make informed choices that are right for them. Let us know […]

2016-11-21T13:08:30-05:00January 23rd, 2013|Nursing|0 Comments
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The ‘Inexhaustible Well’: Notes from a Trauma Nurse on Mortality

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” will be published in the May issue of AJN.

Years ago, long before I was a nurse, I read The Sheltering Sky, by Paul Bowles. He speaks of the tendency of people to take life for granted, and says that in the unpredictability of death there lies a presumption that everything is limitless:

“Because we don’t know when we will die, we get to think of life as an inexhaustible well. Yet everything happens only a certain number of times, and a very small number really. How many more times will you remember a certain afternoon of your childhood, an afternoon that is so deeply a part of your being that you can’t even conceive of your life without it? Perhaps four, five times more, perhaps not even that. How many more times will you watch the full moon rise? Perhaps 20. And yet it all seems limitless.” 

Lately, especially at work, that quote has edged forward and lingered with me. The ICU I work in is primarily devoted to trauma, but there’s been a recent shift in patient demographics. Last week I took care of only one trauma patient—an athlete who’d […]

2016-11-21T13:10:16-05:00April 19th, 2012|Nursing, Patients|7 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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