Viewpoint: Some Arguments for More Autopsies

Detail from Rembrandt's 'The Anatomy Lecture of Dr. Nicolaes Tulp' Detail from Rembrandt’s ‘The Anatomy Lecture of Dr. Nicolaes Tulp’

When families ask whether they should get an autopsy, what will you tell them?

When I was a nursing student at the University of Michigan, we learned anatomy by working on human cadavers. The experience left me with a deep appreciation for the beauty of the human body (even when ravaged by disease) and fundamentally shaped my view of a nurse’s role in health and healing.

The Viewpoint essay in the August issue of AJN,When Families Ask About an Autopsy,” reemphasizes the role of the human body as a teaching tool. Author Billie Holladay Skelley points out that autopsies can also

  • provide definitive answers about the cause of death (offering reassurance to family members).
  • reveal undiagnosed genetic conditions.
  • improve our understanding of diseases and disease trends.
  • and foster advances in treatment.

Virtual or minimally invasive autopsies may be more acceptable to some families while still offering some of the benefits of a full autopsy. […]

August 19th, 2016|Nursing|0 Comments

Nurses Take Action on Moral Distress (Updated Post)

(Editor’s note: We have updated the photo caption in this post, which contained one inaccuracy. And to our blog’s subscribers: we had a technical issue and this resulted in duplicate email notifications for some old blog posts. We are working on this today and promise not to keep filling your inboxes!)

Nurses gather at the Johns Hopkins School of Nursing to address this growing problem.

A nurse struggles to reconcile repeated surgeries and transfusions for a premature infant with the child’s slight chance of survival. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she is not giving needed care to patients because of inadequate staffing.

From left, Katherine Brown-Saltzman, Kathryn Trotochaud, Lisa Lehmann, Heidi Holtz From left, Katherine Brown-Saltzman,
Paula Goodman-Crews, Lisa Lehmann, Heidi Holtz

Situations like these are not rare for nurses and often give rise to moral distress—that is, when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

Moral distress in nursing has risen to unprecedented levels, contributing to burnout and staff shortages and imperiling safe, quality health care.

Seeking solutions.

Nursing researchers, clinicians, organization representatives, and other stakeholders convened in Baltimore on August 11-12 for an intense invitational workshop called State of the Science Symposium: Transforming Moral Distress to Moral Resiliency in Nursing. The meeting focused on how to best address moral distress.

The 46 participants heard from experts on what’s known from research and what’s still being debated, potential avenues for study, and what, despite the dearth of hard data, appear to be promising practices for dealing with moral distress. (For more on the intersection of moral distress and moral resiliency, see “Moral Distress: A Catalyst for Building Moral Resilience” in the July issue of AJN.)

After identifying what seem to be the essential elements of helpful initiatives and models, participants worked in groups to brainstorm strategies for developing resilience and creating healthy work environments that will promote safe, quality care for patients and their families. […]

August 16th, 2016|Nursing, nursing perspective|0 Comments

Summertime: Time to Write

karindalziel/ via Flickr Creative Commons karindalziel/ via Flickr Creative Commons

July 4th has come and gone and summer still stretches out before us. For many, summer is a time to relax and take things a bit slower. Working moms and dads don’t have to deal with school projects; faculty have no or at least fewer classes to teach. It’s the perfect time to write—or at least start—that article you’ve had on your “To Do” list for the last year (or two or three).

Many budding authors tell me that the hardest part about writing is getting started, so here are suggestions from a pair of editors and writers who teach writing workshops (included, along with several other writing tips, in my 2014 editorial on the topic):

  • Set a consistent time to write, even if it’s only 15 minutes a day. Make an appointment with yourself and honor it as you would an appointment with someone else. Make yourself sit down and write—and write anything to begin; you don’t need to start at the beginning or do an outline. Once you get rolling, you can always write for a longer time.
  • “Start anywhere, but start. And keep your hand moving, whether you’re using a pen or a keyboard. Whether it’s because of muscle memory or the mind–body connection, this works. Random thoughts will morph into coherent sentences, which you’ll later organize into paragraphs; before you know it, you’ll have 500 words and a good start to a short essay or an article.”


July 11th, 2016|career, narratives, Nursing|1 Comment

A Strong Case for the Professional Introduction in Nursing

nametagDo you always introduce yourself by name to your patients? Or do you simply say, “Hi, I’ll be your nurse today?”

In their Viewpoint essay in the June issue of AJN, Raeann LeBlanc and two colleagues at the University of Massachusetts Amherst College of Nursing make a strong case for the professional introduction, in which “a nurse states her or his full name and role in the patient’s care.”

The authors argue that professional introductions are “a powerful way to make clear the centrality of the nurse’s role in the care of the patient.” When nurses use professional introductions, we make our knowledge and expertise more visible and help patients better understand just what it is that nurses do.

The authors also address potential safety concerns nurses may have about disclosing their full name to a patient, and they offer some reasons why the importance of professional introductions may not be taught in nursing school.


When Patients Ask About Palliative Chemotherapy

Photo © Associated Press. Photo © Associated Press.

Nurses repeatedly witness the suffering of people with advanced, metastasized cancer who are undergoing chemotherapy. These drugs often seem to diminish rather than enhance the quality of the remaining weeks of their lives.

In the first article in a new AJN series on palliative care, author Marianne Matzo points to research indicating that chemotherapy in end-stage cancer does more harm than good. So what should we do when patients ask (as in this article), “Is the chemotherapy going to help me? And if it’s not, why are they offering it?”  […]