Well On His Way: A Nursing Professor’s Humbling Experience

Holding On / D'Arcy Norman, via Flickr Holding On / D’Arcy Norman, via Flickr

By Martina Harris, EdD, RN, a UC Foundation assistant professor at the University of Tennessee at Chattanooga School of Nursing

It was 6 am and I was on my way to make patient assignments for my first semester nursing students. Inside the long term-care facility, the hallways were quiet, the majority of patients still in bed. I made my way to the second floor to begin identifying and assigning patients for my fundamental nursing students. Standing at the nurse’s station, my focus was on finding patients who would provide students varied opportunities to reinforce the basic skills they’d been learning at campus lab.

The charge nurse approached me and asked if I would be willing to assign a student to Mr. Hugh, an 84-year-old who was proving to be very “complicated.” Assuming that “complicated” meant that his care required lots of psychomotor tasks, I agreed to her request. She then explained that this patient had been using his call light frequently, but that each time the staff responded, he only wanted someone to sit and visit with him. Though this didn’t seem an ideal opportunity for a student to practice basic nursing skills, I felt the gracious thing to do was to take the assignment.

In the hallway, my group of fundamental nursing students huddled together, dressed in their white uniforms and nervously awaiting the start of their first clinical […]

Nursing Handoffs: Do We Know What Constitutes Best Practice?

By Sylvia Foley, AJN senior editor

A systematic literature review on nursing handoffs, written by nurse researcher Lee Ann Riesenberg and colleagues and featured as a CE article this month, might just shock you. The researchers found that although there is  “abundant evidence that poor communication and variable procedures result in inadequate handoffs,” surprisingly little is known about what makes nursing handoffs effective. Which is kind of incredible, given how crucial handoffs are to providing safe and effective patient care.

Of the 95 English-language articles that met the researchers’ inclusion criteria, just 20 reported on research on nursing handoffs, and only 3 were found to be of reasonably good quality (scoring above 10 on a 16-point scale). The researchers concluded that although “the Joint Commission is calling for structured handoffs . . . we found very little evidence to support the use of any specific structure, protocol, or method.”

Barriers and Strategies
But the researchers were able to identify, categorize, and list numerous barriers to and strategies for handoffs that were mentioned in the literature. […]

In Medicine as in Aviation, Communication Breakdown Leads to Fatal Errors

By Christine Moffa, MS, RN, AJN clinical editor

Lately I’ve had communication on my brain. I’m always amazed that we get anything done in this world at the rate that messages can get lost in translation. For instance, I recently had a phone call from a mother of two girls who was upset about a medication error involving her 12-year-old daughter. While the mother was at work, the child came home from school with cold symptoms and a temperature of 102.5. The daughter called her mother and was told to take two tablets of Sudafed, which she did. About an hour later, the babysitter picked up the younger child, age nine, from school. Concerned that her sister was sleeping unusually soundly, the nine-year-old called her mother at work. Realizing that just giving her older daughter Sudafed hadn’t addressed her fever, she told her younger daughter to wake up her sister and have her take “two Advils.” 

A few hours later the mother came home from work. As she was about to give her daughter another dose of medication before bedtime, she remarked to the children that she wished she had a combination drug containing both Sudafed and Advil so that the girl wouldn’t have to swallow four separate pills. The nin- year-old informed her that they did in fact […]

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