‘Didn’t You Used to Be a Nurse?’: Finding the Nurse Within

The author of the Reflections essay in AJN‘s September issue, Kathleen Resnick, confronts a question many nurses must confront at some point: what is it to be a nurse?

And a related question: what is the essence of nursing work? If you can no longer work as a nurse because of physical constraints or for another reason, are you still a nurse?

Writes Resnick in “A Different Kind of Nurse“:

My nursing career was spent in hospitals, working mostly in critical care as a bedside nurse, then in management. I worked hard and my work was a large part of my sense of self-worth. I loved patient care and the satisfaction of making a difference. As a manager, I felt my  primary mission was to enable those I served to do their best work. . . . I was somebody. Now what am I? An acquaintance asked me, “Didn’t you used to be a nurse?”

[…]

2020-09-15T16:23:15-04:00September 15th, 2020|career, narratives, Nursing, nursing stories|2 Comments
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Bringing Redemptive Voices from Greek Tragedy to COVID’s Frontline Clinicians

Bearing witness.

I enter my patient’s room and hear the sucking click as the door slides shut behind me. Vacuumed silence, negative pressure—but all the pressure in the world seems to settle onto my shoulders, my head, and down through my back, filling my feet like wet cement.

I need to move. His oxygen saturation is dropping again. He’s grimacing. Is he in pain? I wonder as I step closer to the bed. My pulse quickens as I take in the scene before me: glassy eyes inset upon a sunken, sallow complexion; bleeding mouth; the imperceptible rise and fall of chest to the biddings of the ventilator; swollen limbs. A lock of hair falls into my eyes, but my PAPR hood prevents me from pushing it aside. His heart rate and respiratory rate are higher now. Maybe he needs more sedation. If only he could speak. I take in a measured breath of filtered air as I suction his breathing tube. Breathe.

The doctor appears and is talking to me, but her voice is barely audible above the steady stream of air rushing past my ears. We’re practically shouting. The plan, a combination of trial and error, science, and visceral, pit-of-the-stomach intuition, is shaky at best.

As she moves away toward the door, I want to call out to her, to beg her to stay, to look upon the suffering and feel its weight, but I am silent and she disappears into a sea of blue scrubs. I am alone in this sealed room […]

2020-08-27T09:45:26-04:00August 27th, 2020|Nursing|1 Comment
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Every Frontline has a Backline: What Nursing Can Learn from Rugby

Photo credit: KJ Feury

Have you ever had a day at work that could only be fixed by an ice cream from your favorite creamery or by a hug from your best friend? Every shift during the height of the COVID-19 pandemic felt like this.

Unfortunately, because I work as an RN in a pediatric ICU at a large hospital in northern New Jersey, social restrictions that coincide with COVID-19 forestalled my usual comfort measures. After the start of the COVID-19 pandemic and during my reassignment in the COVID-19 ICU, I could no longer truly “leave” work. Work came home and walked with me throughout my day.

Dozens of IV pumps lining hallways, countless boxes of gowns, gloves, masks, and rubber shoes scattering the unit; ventilator alarms sounding; coworkers with surgical caps and masks, only identifiable by their eyes. The once medical–surgical unit transformed into a critical care unit equipped to care for COVID-19 patients.

After donning and doffing personal protective equipment (PPE), giving medication, adjusting ventilators, and updating families, you leave your 12+ hour shift wondering if you did your best. In the chaos of an unfamiliar unit, caring for patients with an unfamiliar virus, did I do everything to create the best outcome for my patients?

Missing […]

2020-07-22T10:18:03-04:00July 22nd, 2020|COVID-19, infectious diseases, Nursing, nursing perspective, nursing stories, Public health|3 Comments
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Serious Mental Health Issues: No Room for System Errors

I knew that my patients were once without mental illness, just like my little sister Doris had been before her diagnosis 10 years before, and I always tried to picture them like that, each their own best version of themselves.

A sister’s preventable death.

In this month’s Reflections column, “No Room for Error: Reflections on My Sister,” family nurse practitioner Kelly Vaez shares the story of the unexpected death of her sister, who had been diagnosed with schizophrenia ten years earlier. It’s particularly heart-wrenching to be able to see clearly, in retrospect, the ways in which our rushed, fragmented, and mental-health-unfriendly health care system contributed to what was probably an easily preventable death.

A dentist prescribed an unusually long course of antibiotics after a routine tooth extraction. The primary care team seemed unaware of the antibiotic therapy. No one made the connection between Doris’ diarrhea and this antibiotic, a frequent cause of C.diff infection.

And finally, loperamide—a drug that should never, ever be given for diarrhea that might be caused by C. diff—was prescribed with what seems to have been minimal assessment for the cause of the diarrhea. Was this last because the patient was a young adult with schizophrenia, and often […]

2020-02-10T10:13:29-05:00February 10th, 2020|mental illness, Nursing|1 Comment
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Supporting Systems to Address Clinician Burnout

National Academy of Medicine calls for action to address a crisis among clinicians.

As a nurse and researcher who has worked in the area of clinician burnout for many years, I was pleased to see attention to this issue by the National Academy of Medicine (NAM) in a recent consensus study report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

Burnout, a syndrome of “emotional exhaustion, depersonalization, and lack of personal accomplishment” (Maslach et al. 2001. Job Burnout. Annu Rev Psychol. 52: 397-422), has far-reaching and troubling consequences for health care clinicians. The problem has grown to crisis levels: estimates indicate that 35%-45% of the nearly 4 million nurses in the U.S. are experiencing symptoms of burnout, and up to 54% of our physician colleagues experience it as well.

A ‘chronic imbalance’ of job demands with available resources.

Prominent among the factors contributing to burnout are the systemic patterns that erode professional fulfillment and well-being, many of which are beyond the control of individual clinicians.  Burnout represents a chronic imbalance of job demands with resources needed to meet them.

The National Academies of Science, Engineering and Medicine (NASEM), of which NAM is a part, convened a committee to examine the scientific evidence towards understanding the scope and consequences of burnout on the health […]

2019-11-04T09:34:15-05:00November 4th, 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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