Defending Against Moral Distress

A collaborative initiative offers recommendations to build moral resilience.

All nurses have at some point been faced with situations that challenge their values. Whether dealing with families or patients or the actions of colleagues, we may be faced with acting (or not acting) in accordance with our professional or personal values. I can easily recall several situations (which I detail in my February editorial) that involved unnecessary invasive procedures and surgery or removing life support.

Such situations take a toll on the individual and the care team and ultimately have a negative effect on patient care quality. Moral distress is not something that can be entirely eliminated—there will always be situations that provoke angst. But individuals can build moral resilience if they learn to recognize it when it occurs and if their organizations support them in finding ways to manage ethically challenging situations. […]

February 3rd, 2017|Ethics, Nursing|0 Comments

A Public Health Nurse at the Intersection of Birth and Death

by Lisa Dietrich for AJN/ all rights reserved

The January Reflections essay in AJN is called “Touching Death, Touching Life.” The author, Yaffa Vinikoor, is a public health nurse who describes a patient she refers to as Sidney. Over time, she’s come to know the worn furniture of Sidney’s small apartment and the details of his life, such as Arnold, his paid caretaker, and Sidney’s younger wife, who lives separately. Sid has dementia and several other conditions and is in decline. “Sid,” she writes “usually lay slanted, like he’d been haphazardly dropped onto the enormous mattress, hair askew and face contorted.”

The essay explores what it’s like to be pregnant while doing such work. Vinikoor’s situation that summer puts her in relation to two very different currents:

I continued to do my work in the city as a public health nurse with the chronically ill homebound up until the day I went into labor. . . . I continued to walk miles per day, the nursing supplies in my backpack bowing my back and the baby in my belly guiding me forward . . . . As I cared for those whose lives were in steady decline, I thought about what giving birth to new life would be like.

[…]

January 27th, 2017|Nursing, nursing stories, Public health|2 Comments

Top Nursing, Policy, Clinical Stories of 2016

Crowd members hold candles during a vigil for the victims of a mass shooting at the Pulse nightclub in Orlando, Florida. Photo © Associated Press

Late last year, we asked our editorial board members and contributing editors to tell us what they thought were the most important health news stories of 2016. In our January article “The Year in Review 2016,” we take a closer look at three of their most-mentioned topics: the Affordable Care Act (ACA), opioid misuse, and Zika virus.

What other issues stood out last year in specific areas of health care? We compiled top news story roundups for several categories—here’s an overview (click the links below to read the full articles):

Health Care Policy

  • Gun violence
  • Access to care: LGBT health, migrants, mental health care, medication costs, rural health care

Nursing

  • Workplace stress: 12-hour shifts, EHRs, evidence-based practice, staffing
  • Nursing education: increased access, faculty shortage, expanded simulation, improved employment prospects
  • Care delivery barriers: care for veterans, nurses’ practice authority

Clinical News

  • Sepsis awareness
  • Maternal mortality
  • Patient engagement
  • Population health trends

Finally, see “Stories to Watch in 2017” for a discussion of a few health topics, aside from the fate of the ACA, that we expect to hear more about this year.

January 23rd, 2017|Nursing, Public health|0 Comments

2016: An ‘Unbelievable’ Year

“When I think about 2016, one word that keeps coming to mind is ‘unbelievable.’ It’s a word I’ve found myself using many times over the past year, often while shaking my head in disbelief.”

That’s the opening of AJN editor-in-chief Shawn Kennedy’s January editorial. In it, she lists serious public health challenges facing this country and the ways political considerations get in the way of acting in the public’s best interest—whether in relation to gun violence, funding to fight infectious disease threats, the ever-increasing cost of essential medications, or health care reform. Too often lies and distortions are now treated by people who know better as the equals of truth and fact.

But you probably have your own list of ‘unbelievable’ things that happened in 2016, perhaps some of them hopeful. Click the above link to read the article, which is free.

January 6th, 2017|Public health|0 Comments

2016 Nurse Faculty Scholars/AJN Mentored Writing Award Winner

AJN0916.Cover.OnlineAnd the Winner Is….

We’re pleased to announce that the winner of the 2016 Nurse Faculty Scholars/AJN Mentored Writing Award is Denise M. Eckerlin, BSN, RN, a predoctoral fellow at the University of Washington School of Nursing in Seattle. She won for her CE feature article published in the September issue of AJN,Military Sexual Trauma in Male Service Members.”

Eckerlin coauthored the article with her mentor, Andrea Kovalesky, PhD, RN, an associate professor in the School of Nursing and Health Studies at the University of Washington Bothell, and Matthew Jakupcak, PhD, a clinical psychologist and researcher at the Northwest Mental Illness Research, Education, and Clinical Center in the VA Puget Sound Health Care System, Seattle. She will receive an award certificate and $500. […]

November 21st, 2016|Nursing, nursing students|1 Comment