Decreasing ED-Acquired Pressure Injuries

Perfect candidates for developing pressure injuries.

The photos of EDs crowded with patients waiting for admission at the height of the COVID-19 surges brought back many memories of clinical days in Bellevue’s ED. But even on our worst evenings, it was never like what I saw in those photos in the news media. And in some places, the ED hallways still have lines of stretchers with patients waiting to be sent to units.

In busy hospitals, patients can wait hours, sometimes a full day, on stretchers in the ED, waiting to be sent to a patient care unit. And we know that if they are being admitted for inpatient care, they usually have complex medical needs—many of these patients may be unable to ask for help, be incontinent, or unable to move themselves. These patients are perfect candidates for developing pressure injuries (PIs).

PIs can develop in a matter of hours.

As an article in the February issue of AJN notes, pressure injuries can develop in a relatively short time (the authors cite studies that found hospital-acquired PIs can “occur in as little as two hours of unrelieved pressure”).

The article, “Pressure Injury Prevention in Patients with Prolonged ED Stays Prior to Admission,” details how a nurse-led evidence-based practice (EBP) team sought to decrease hospital-acquired […]

2021-02-16T14:23:23-05:00February 16th, 2021|Nursing|0 Comments
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Emergency in the ED: Treating Hemorrhagic Shock

Emergency nursing isn’t all drama and adrenaline.

As any ED nurse knows, most of what a nurse sees in the ED is not what would classify as real emergencies—the kind of exciting, life-threatening situations that might have actually been the reason they chose emergency nursing. That’s how it was for me, and getting hired as a new grad to work at New York City’s Bellevue Hospital, one of the country’s premier emergency services, was a dream come true.

However, I quickly learned that most of the people who came through our doors did not have exciting, life-threatening emergencies but rather the more humdrum “urgencies” of life—gastroenteritis, a sudden high fever, a small laceration that needed a few sutures, sprains, and minor fractures. Minor, comparatively speaking, but certainly not minor to the patient, and all requiring attentive care. (For a vivid and poignant inside view of emergency nursing today, see the photo essay in the September issue; the essay is based on Carolyn Jones’s new film, In Case of Emergency, to be released this week for Emergency Nurses Week.)

When the ED doors slam open.

But then there were those sudden life-or-death emergencies that raised everyone’s adrenaline levels—a patient bleeding out was one of the more dramatic scenes. They usually arrived […]

2020-10-15T10:16:25-04:00October 15th, 2020|Nursing|0 Comments
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Documentary Filmmaker: The ED Reflects Everything Going on in Our Country

A new documentary profiles emergency nurses.

If you think the photo on the cover of the September issue is dramatic, it’s because it was taken during the emergency treatment of a young man with a gunshot wound. (See On the Cover for details.)

The photo is from the new film by filmmaking team Carolyn Jones and Lisa Frank, In Case of Emergency, which was made in concert with the Emergency Nurses Association to mark its 50th anniversary.

Michelle Lyon, RN, an ED nurse at the University of Kentucky Albert B. Chandler Hospital, Lexington.

The film’s release is scheduled for October 14th, the beginning of Emergency Nurses Week, and we highlight the film in a photo-essay in the September issue. (The article is free until the end of the month, and best viewed as a pdf.)

The film follows the work of ED nurses in several parts of the country. As a former ED nurse, I was struck by the ability of these filmmakers to accurately capture the work.

Scenes […]

2020-09-10T14:18:29-04:00September 10th, 2020|narratives, Nursing|0 Comments
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Emergency Nursing 2019: Interactive Learning and Today’s Health Crises

The medical transport helicopter was at the ready. Meanwhile, the trauma team was in the midst of resuscitating a man. The crowd of onlookers remarked on the extreme pallor of the patient and were ready to jump in to help as needed. Fortunately, this was not a real life trauma but a scene in the exhibit hall of the sold-out Emergency Nurses Association (ENA) meeting in Austin, Texas, last week.

Four thousand ED nurses spent four days at Emergency Nursing 2019 attending educational sessions, skills labs (including a mock ED and a cadaver lab), and CE classes; viewing exhibit hall products; and relaxing in ‘Awesome Austin,’ celebrating themselves and the important work they do.

Documentary film producer Carolyn Jones (The American Nurse; Defining Hope) opened the meeting by presenting previews from her current documentary on emergency nurses, In Case of Emergency, a project in collaboration with the ENA for its 50th anniversary, to be released in May 2020. Jones and her film team traveled to seven EDs around the country, from an urban ED to rural farm country, to document ER nurses at work. […]

2019-10-07T10:13:54-04:00October 7th, 2019|Conference reports, Nursing|1 Comment
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Nursing Perspective: Why I Work in Corrections

By Megen Duffy, BA, BSN, RN. Her blog is Not Nurse Ratched.

Michael Coghlan/Flickr Michael Coghlan/Flickr

When I go to work, I go through a metal detector (did you know Danskos contain metal?), and all my belongings are scanned or gone through. I check out keys and a radio, and then I go through a series of sally ports to get to the medical area. I count every needle and pair of scissors I use. I never see patients without an armed guard nearby, and a good portion of my patients are cuffed and shackled. I’m on camera from the second I get out of my car.

Welcome to prison, nursing style!

“Why?” people ask me. “Couldn’t you get another job? Aren’t you scared? Didn’t you like the ER?” I worked in critical care/emergency nursing for a long time, and yes, I did like it. I brought those skills with me to corrections, where they are a lock-and-key fit. A surprising number of corrections nurses are ex-ER nurses. The same personality types work well in both settings.

Corrections nursing involves phenomenal nursing autonomy and uses many of the skills I honed in the ER:

  • quick triage
  • multitasking
  • sorting out who is lying from who is sick
  • knowing which assessments are the most important for each situation

The atmosphere tends to be quirky to chaotic and requires imagination, flexibility, and an ability to […]

2016-11-21T13:03:08-05:00January 23rd, 2015|career, Nursing, nursing perspective|21 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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