What Ever Happened to a Good History?

ky olsen/via Flickr ky olsen/via Flickr

By Karen Roush, MS, RN, FNP, clinical managing editor

What ever happened to a good history? We were taught as NP students that the history portion of the exam was as important as the physical. In fact, in most cases it’s what you learn in the history—from asking the right questions and really listening to the patient’s answers—that gives you the information you need to figure out what is going on. The physical findings either support what you’re thinking or lead you to ask more specific questions.

A good history isn’t just listening to the patient’s answers to your questions; it’s listening to all the information they offer. Take for example, the middle-aged construction worker who takes his lunch hour to come in to the clinic complaining of a cold. He lists the usual symptoms, cough, fatigue, a little shortness of breath, and then as you’re starting the exam he casually mentions that he hasn’t been to a doctor in 15 years.

Someone who’s managed to stay out of a doctor’s office for 15 years and now shows up, on his lunch hour, because of a simple cold? So, you ask some more questions and learn about some chest pressure he attributes to the coughing he’s been doing and about […]

2016-11-21T13:05:39-05:00January 10th, 2014|nursing perspective, Patients|4 Comments
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NP Develops Innovative Runaway Intervention Program in Minnesota

Ten years ago, NP Laurel Edinburgh began to see a number of sexually exploited girls in her practice at the Midwest Children’s Resource Center, a child abuse clinic within Children’s Hospitals and Clinics of Minnesota in St. Paul. The girls, who were runaways, were quickly slipping through the cracks. Half were no longer in school, many hadn’t been reported missing by their parents, and many were staying with gang members. Some had been gang-raped; others had had sex with men in exchange for money or drugs.

Via U.S. Dept. of Health and Human Services Web site Via U.S. Dept. of Health and Human Services Web site

That’s the start of a profile (“Nurse Develops Runaway Intervention Program”) by editor Amy Collins in the November issue of AJN. It’s about a nurse practitioner in Minnesota who, in the course of her daily practice, noticed a population in need and did something about it, finding ways to establish contact with runaway girls and help them rebuild their lives. The article will be free until December 6. The nurse who started the program, Laurel Edinburgh, RN, CNP, hopes her approach will catch on in other states—so please give it a read.—Jacob Molyneux, senior editor

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2016-11-21T13:05:59-05:00November 22nd, 2013|nursing perspective|0 Comments
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A Focus on Meaning and Attitude: This Week’s Nursing Blog Post Suggestions

By Jacob Molyneux, AJN senior editor

'Autumn Washed Away,' Diane Hammond/ via Flickr ‘Autumn Washed Away,’ Diane Hammond/ via Flickr

Here are a few recent posts by nurses that you might find of interest. As I put this together, a theme emerged, so it seemed fair to just go with it. Maybe the approach of these bloggers has to do with the time of year, the shorter days and colder weather as we approach the winter holidays . . .

At the intriguingly titled Nursing Notes of Discord blog, there’s a short reminder post with a fairly straightforward descriptive title: “Anyone Can Make a Positive Difference.” And, the author points out, you “don’t even have to be a nurse” to do so.

At Digital Doorway, Nurse Keith has a recent post that also focuses on positivity, this time about one’s profession: “For Nurses, ‘Just’ Is a Four-Letter Word.”

At HospiceDiary.org, in the lovely post “Leaves, Geese and Other Ramblings”—as the below quote may suggest—we find another angle on this theme of being present and focusing on the good in the midst of sometimes constant, poignant awareness of change, loss, dying, and rebirth:

2016-11-21T13:06:05-05:00November 13th, 2013|career, healthcare social media, nursing perspective|0 Comments
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Tightly Scripted: One NP’s Experience with Retail Clinics

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

Retail health clinics (walk-in clinics that are in a retail setting such as a drugstore or discount department store)KarenRoush have become an effective mode of providing increased access to care for many people and a growing source of employment for nurse practitioners (NPs). Their place in the health care arena may take on even more significance as the Affordable Care Act (ACA) increases access to care for previously uninsured people.

I worked as an NP in a retail clinic for about six months while working on my PhD. I left because of concerns I had about the model of practice. It didn’t have to do with the fact that I had to mop the floor at closing time or collect the fees and cash out the “drawer” every night. Nor because I spent eight hours alone in a small windowless room tucked away in the back of a drugstore. Those aspects were not great, but they weren’t deal breakers.

What was a deal breaker was the rigid programming of my practice. The computer was in control. From the moment the patient checked in at the kiosk outside my door, every action was determined by the computer.

The organization I worked for prided itself on following […]

2016-11-21T13:06:09-05:00November 1st, 2013|career, nursing perspective|2 Comments
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Old Friends Among the Devastation: A Red Cross Volunteer in the Oklahoma Tornado Zone

In 2011, after devastating tornadoes struck Alabama, we ran a series of blog posts, “Dispatches from the Alabama Tornado Zone,” by Susan Hassmiller, the senior adviser for nursing at the Robert Wood Johnson Foundation. Hassmiller went to Alabama as a Red Cross volunteer, and reported back to us with a number of moving and inspiring posts and photos. The recent tornadoes in Oklahoma are the occasion for a new series we are initiating today.


Eleanor Guzik, NP, RN, a volunteer disaster health services manager with the Red Cross, describes herself as a 74-year-old wife, mother, grandmother, great-grandmother, traveler, serial volunteer, and a late-in-life RN who worked in critical care for 10 years, was an NP for 10, and retired in 1995. This piece by Eleanor Guzik describes her deployment and arrival in Oklahoma; subsequent posts by Guzik and other Red Cross volunteer nurses will give us glimpses of the day to day work of volunteers in Oklahoma and the people and situations they encounter.

Deployment and Arrival

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2016-11-21T13:07:16-05:00June 19th, 2013|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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