Designing Nurses: Make Your Ideas Reality

“At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher…”

Earlier this month, the New York Times published an article, “Design Thinking for Doctors and Nurses.” In it, the author describes a simple solution designed by a nurse to identify who was in charge of a resuscitation team: whoever was wearing the orange vest was the leader.

As a former ED nurse who participated in many codes and trauma emergencies, I could easily picture the chaotic scene that led to this innovative solution. In a large urban teaching hospital, cardiac arrests and trauma calls draw many physicians and medical students, respiratory therapists, and of course, at least two to three nurses. It wasn’t unusual to have conflicting orders shouted out by physicians, residents chiming in with questions and suggestions, and the medication nurse making the decision as to which order she/he would process. At one hospital I worked, nurses used masking tape to outline a box on the floor around the resuscitation stretcher—only the physician in charge and resuscitation team were allowed inside the box. All other onlookers (mostly medical students and residents) had to stay outside the box and be silent. It did wonders for instilling a quiet, organized atmosphere into a highly charged event.

Left out […]

2017-08-16T09:22:11+00:00 August 16th, 2017|Nursing, nursing perspective|0 Comments

When Brokenness Transforms Nursing

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” appeared in AJN‘s August issue.

photo by Karen Roush/all rights reserved

I’ve had opportunities to sit in peer interview panels for new grad nurses looking to start their career in our unit, an experience which prompted me to consider what it takes to be a good nurse.

The obvious qualities were, well, obvious: critical thinking skills, strong communication, compassion, teachable, team player. But I’ve had a sense for a while that we nurses have been missing something when we consider what it takes to be a good nurse. While this something is strongly tied to empathy, it’s still a bit different. I tend to think of it as the nurse’s recognition and embrace of his/her own brokenness, even as the nurse looks to take care of others who are in some manner broken.

By brokenness, if the term is unfamiliar, I simply mean the awareness that we all know what it is to suffer, to struggle, to feel lost or wounded or weak. So in speaking of brokenness, I don’t mean it as a condescending lens through which we view everyone as objects to be fixed. I […]

2017-08-10T16:30:09+00:00 August 9th, 2017|Nursing, nursing perspective|3 Comments

Antibiotic Stewardship: Inherent to Good Nursing Practice

neutrophil interacting with two pink-colored multidrug-resistant Klebsiella pneumoniae bacteria

Although most nurses are aware of the urgent problem of antibiotic overuse in hospitals, some may be unfamiliar with terms like “antibiotic stewardship.” This is partly because few nurses besides those working as infection control preventionists have had a formal role in stewardship programs, explain authors Rita D. Olans, Richard N. Olans, and David J. Witt in “Good Nursing Is Good Antibiotic Stewardship,” which appears in this month’s issue as a Special Feature. In the article, the authors detail how bedside nurses are vital to the success of these efforts.

What Is Antibiotic Stewardship?

Antibiotic stewardship programs offer a formal approach to addressing the current crisis, in which an increasing number of organisms are developing resistance to antimicrobial medications. In the absence of new drugs, stewardship programs have been established to improve the way currently available antibiotics are used in hospitals. These programs aim to:

  • optimize antibiotic therapy.
  • shorten the duration of use of broad-spectrum antibiotics.
  • reduce the number of adverse events.

According to the authors, “because nurses are not typically prescribers of antibiotics, they often don’t see themselves as participants in antimicrobial stewardship programs.” Yet, even though they may not know it, “staff nurses are already performing many critical antimicrobial stewardship functions.” For example, nursing practices directly relevant to antibiotic stewardship […]

2017-08-02T11:36:27+00:00 August 2nd, 2017|Nursing, Public health|1 Comment

Connecting Emotional Intelligence, Team Communication, and Patient Safety

An Early-Career Nursing Memory

Photo by Barry Diomede/Albany Stock Photo.

Many years ago, fresh out of nursing school, I was in charge one night, with no other RNs on the unit. We had an “active GI bleeder” who needed hourly boluses of either ice water or iced milk through an NG tube. (Yes, the standard treatment at that time was gruesomely uncomfortable for the patient, and in later years determined to be counterproductive.) I had more than a dozen other patients to care for, but everyone got their meds and, miraculously, the bleeding man made it through the night.

When my supervisor made rounds at the end of the shift, I reported that all was well and that my critical patient had survived. Her only response: “Mrs. Todd! There is blood on your shoes!”

This senior nurse, standing there in her starched whites and impeccable shoes, didn’t recognize that I had feared I would be inadequate to the task, or even acknowledge my pride as a brand-new nurse in actually saving someone’s life. In retrospect, I can’t help wondering if her choice to focus on a superficial fact, irrelevant to the crisis, could be interpreted as an indication that she lacked a certain acuteness of emotional […]

2017-07-17T16:49:20+00:00 July 17th, 2017|Nursing, patient safety|1 Comment

Nursing as an International Profession

For much of my nursing career, I functioned as a 100% American-minded nurse.

Even though the Ebola epidemic had trickled right into my city, before I attended a global health day at the United Nations (UN) during Nurses Week in 2015, I’d neglected to really consider nursing at the international level.

Until I listened to non-governmental organization (NGO) subject matter experts’ briefings and toured the restricted areas at the UN where global decisions were made, my view of nursing had been largely consumed with understanding things in my own backyard: my day-to-day struggles as a new nursing leader at work, the evolving Affordable Care Act (ACA), and finding ways to apply the IOM Report on the Future of Nursing to my own clinical and academic practice.

My mono-continental nursing mind began to open that day.

The briefings, and most importantly, the subsequent friendships I kindled with nurses involved in international policy work through NGOs like Sigma Theta Tau International (STTI) and the Nightingale Initiative for Global Health, began to help me realize how interdependently we all practice together on a global stage and how attainable international involvement actually is.

Earlier this winter, a new nursing friend, Holly Shaw, PhD, RN, chair of the UN Advisory Council for STTI, asked me if I was attending the

2017-06-07T11:48:26+00:00 May 23rd, 2017|Nursing|0 Comments