COVID-19: On and On

A note from AJN’s editor-in-chief Shawn Kennedy.

Published: March 30. As I write this, the United States has over 140,000 COVID-19 cases and over 2,400 deaths, and we’re told those numbers have yet to peak. The US Navy hospital ship Comfort is on it’s way to New York City, bringing its 1,000 beds to be used as a supplemental hospital. Its sister ship Mercy is on its way to Los Angeles. Bedside nurses and CNOs alike talk about the “war zone” that their hospitals have become. And they’re exhausted: many ICU nurses are working five days of 12-hour shifts as they await help from nurses who are getting crash courses in ventilator management.

Perspectives for and by nurses, from many angles.

Our goals during this pandemic are to serve as a reliable and up-to-date source of information and advocacy for those on the front line, to bear witness and give nurses and other health workers a voice during these uncertain times.

We’ve been using this blog to bring you evidence-based information about the COVID-19 pandemic, mostly via posts by our clinical editor Betsy Todd, whose expertise is in public health and infectious disease. She has done a yeoman’s job, researching the latest information and ensuring what we publish on PPE and COVID-19 is in in accord with the most current state of knowledge at the time—even contacting study researchers to verify facts and […]

2020-03-30T15:03:14-04:00March 30th, 2020|healthcare social media, infectious diseases, Nursing, nursing perspective, Public health|0 Comments
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Is Your Facility’s Computer System a Patient Safety Risk?

Discussed in this post: “How Often Do EHRs Result in Patient Harm?” (AJN, News, March).

When we first had computers in the hospital—that is, while we still charted on paper but had quick online access to lab, radiology, and pathology results and could easily look up a patient’s prior admission history—it was wonderful. No more little lab slips floating all over the nurses’ station. No more unit-to-unit searches trying to figure out who last had custody of the patient’s X-ray films. (How could objects so large be so easily lost?)

A rocky transition to EHRs.

electronic health recordsThe transition to almost fully digital charting, on the other hand, has been pretty much a nightmare from the beginning. Nursing was rarely included in initial needs assessments. Many rollouts were chaotic, without additional staffing for the inevitable glitches that are bound to occur. Training of frontline clinical staff has been routinely minimal; we seem to be expected to pick up the many fine points of new software by some kind of digital osmosis.

That elusive clinician friendly EHR.

It’s very clear at this point that electronic health records (EHRs) were designed primarily for data collection and billing purposes. I have yet to see a system that could in any way be […]

2020-03-12T08:02:22-04:00March 12th, 2020|digital health, Nursing, Technology|2 Comments
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Defining Death

My first encounter with brain death was back in the early 1970s. I was a new RN in a shock-trauma unit. We admitted a 17-year-old young woman who had attempted suicide by jumping out of a fifth-floor window. If it wasn’t awful enough, I remember it was Thanksgiving weekend and she had been home from college.

Angiograms of normal blood flow in an active brain (at left) and lack of blood flow indicating
brain death. Photos © Fusionspark Media Inc.

As one might imagine, she sustained massive injuries, including severe head trauma. She had been intubated at the scene and was on a mechanical ventilator. Her pupils were fixed and dilated, and she had no spontaneous respirations and virtually no brain activity, according to electroencephalography (EEG) studies.

A gradual refinement of criteria.

I recall that there had to be three consecutive EEGs done before we could remove the ventilator. There was no ethics committee or formal meetings with hospital attorneys or administrators—just the physician, the family, and the pastor. And then the patient’s siblings and grandparents came to say goodbye. It was heart-wrenching.

Things have gotten more defined and […]

2020-03-05T08:21:37-05:00March 5th, 2020|Nursing|0 Comments
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COVID-19 for Nurses: Skip the Rumors and Stick to the Basics

(Published: February 28. Editor’s note: much information in this post is now dated and the post should be read only as a response to a particular moment in time. COVID-19 is now officially a pandemic and has rapidly spread worldwide. While rumors and misinformation were, sadly, already very much in play when this was written, and the overall tone of this post was neutral and descriptive according to our knowledge at that current moment, the post only remains live for archiving purposes. Our most recent posts on the crisis can be found here.)

In the U.S. at the time of this writing, the major risk presented by the current novel coronavirus (COVID-19) is not from the disease itself but from misinformation. Rumors, misinterpretations, and conspiracy theories are being transmitted at a rate far greater than that of the coronavirus itself. While the situation is evolving rapidly and things can change quickly, our understanding of the illness has also grown in a remarkably  short period of time.

So, is this a pandemic?

In an NPR interview this week, WHO director-general Tedros Adhanom Ghebreyesus said the term is used to suggest that the spread of a new infection is out of control and doing significant damage worldwide. We are not quite there yet. COVID-19 transmission in China appears to have plateaued, and, while the virus has been detected in numerous other countries this week, several countries have also been successful in controlling the spread of COVID-19 within […]

2020-03-19T14:34:33-04:00February 28th, 2020|infectious diseases, Public health|13 Comments
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The Sound of Silence: Racism in Nursing

“In the end, we will remember not the words of our enemies, but the silence of our friends.”   -Dr. Martin Luther King

One of the conundrums I face when writing stories from my nursing career is the question “whose story is it?” For instance, does observing an act of racism give the observer the right to tell the story of what happened to another person? Does telling the story with the intent of exposing the ugliness of racism make it okay?

by julianna paradisi

It’s February, Black History Month. How can a white woman, a registered nurse, discuss race issues in a profession in which only 7.8% of the workforce is black without sounding ignorant, or worse, racist herself? Once or twice in the past I’ve made well-intended comments that revealed my own blind spots when talking about race. Fortunately, these were brought to my attention by friends who understood my good intentions, however misguided. I’m grateful for their support, and compassion. Like learning a new language, using the right words when talking about race requires commitment, practice, and a little bit of courage.

‘Here’s the chart. Answer the man’s questions.’

Years ago, I encountered a surgeon I’d never met before who repeatedly asked me for updates […]

2020-02-26T09:39:39-05:00February 26th, 2020|Nursing|3 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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