Thoughts on Preventing Delirium During an ICU Stay

It’s well known that an ICU stay presents several risks to patients, whatever their reason for needing critical care.

  • Various infections are more likely to develop than in other care units.
  • Intense drug therapy can result in adverse drug interactions.
  • The excess stimulation and (often) windowless rooms increase the risk for delirium and its consequences.

Would you do anything to protect your own health if you knew that after surgery you would be spending time in an ICU?

In this month’s Viewpoint column, author Patricia Gavin describes how she coped with her own ICU stay, which she knew in advance would be part of her post-op care:

“…when I realized I would be there for a few days, I decided to create
my own ‘care plan’ to stave off delirium and its adverse outcomes.”

Does it help if the patient knows her own risk factors?

She goes on to explain what she knew about her own risk factors for delirium, and the things she could do to stave off the complication during this stressful time.

And she notes how one nurse made a particular difference in helping her to get through her stay without cognitive complications. Gavin reminds us of the practical strategies that nurses can employ, beginning with, “Extend […]

2019-09-26T10:31:05-04:00September 26th, 2019|Nursing, patient safety|0 Comments
Read More

Milk and Molasses Enemas – A Tradition to Keep

By Maureen Shawn Kennedy, AJN editor-in-chief

I recall giving an “M&M” enema when I worked as a nurse’s aide in high school. The small community hospital medication room had a jar of molasses in the cabinet, and I watched the nurse mix ½ a cup of the thick syrup with ½ cup of milk and put it in an enema bag. She then handed it to me and said, “C’mon, it’s easy, I’ll show you how.” And it was, and it worked pretty quickly. Older nurses and physicians swore by it.

By the time I was out of nursing school and working in clinical practice, commercial preparations seemed to be the standard. But as the song goes, “everything that’s old is new again.” This month in AJN, Jackline Wangui-Verry and colleagues’ paper, “Are Milk and Molasses Enemas Safe for Hospitalized Adults? A Retrospective Electronic Health Record Review,” describes their investigation of this long-time and oft-used intervention for constipation.

Examining the safety of a long-established, ‘last resort’ practice.

The authors “wanted to learn whether this approach is actually safe and effective or more of a ‘sacred cow’ . . . .”

This study focused on safety and a follow-up study will include efficacy. They evaluated the hospital records of 196 hospitalized adults who received an M&M enema after laxatives or stool softeners failed to produce a bowel movement. No serious complications—“allergic reactions, bacteremia, bowel […]

2019-09-11T10:41:01-04:00September 11th, 2019|Nursing, nursing research|3 Comments
Read More

Addressing Health Care Worker Trauma with an Off-Site, Overnight Workshop

Everyone experiences loss and other personal trauma, but those of us who work in health care are obliged to cope with our own personal grief and stress as well as witness the suffering and pain of our patients. Do these words ever describe you at the end of a shift at work?

” . . . angry . . . anxious . . . hopeless . . . stressed . . . depleted . . . depressed . . . frazzled . . . “

One health system gets serious.

There’s a lot of talk these days about addressing clinicians’ burnout, and in some workplaces staff now are offered a meditation room, or aromatherapy or massage.

But since 2013, Montefiore Health System in Bronx, New York, has seriously invested in their staff’s mental and emotional health by offering a two-day, off-site experiential and educational workshop twice a year. And by paying for the program, retreat center, and meals for all participants so that staff can attend for free.

In “Helping Care Providers and Staff Process Grief Through a Hospital-Based Program” in the July issue of AJN, Ronit Fallek and colleagues share their experiences in developing this program along with their analysis of feedback about its effectiveness. They offer enough detail to confirm […]

2019-07-25T11:18:15-04:00July 25th, 2019|Nursing, nursing career, wellness|0 Comments
Read More

Duty to the Patient: A Crucial Element in any Malpractice Case

It’s frightening to be named in a malpractice lawsuit, or even simply to be asked to provide a deposition in a case in which you personally have not been charged. When things go wrong at work, the possibility of legal action adds to the upset a nurse may already feel about a patient’s injury or death.

A primer on the basics of malpractice.

In “The Elements of a Nursing Malpractice Case: Duty” in this month’s AJN, nurse and attorney Edie Brous provides readers with the first of a four-part “primer” that delves into the basics of malpractice.

What exactly is duty to a patient?

In every malpractice case, the plaintiff is required to prove four “elements” in order to win:

  • that the nurse or physician named in the suit had a duty to the patient;
  • that this duty was breached (that is, not fulfilled);
  • that the patient was actually harmed in some way;
  • and that the breach of duty was the direct cause of harm to the patient.

[…]

2019-07-22T09:36:11-04:00July 22nd, 2019|career, Nursing|0 Comments
Read More

A Detailed Look for New Nurses at What Happens During a Code

Photo by Ashley Gilbertson / The New York Times / Redux.

There’s an article in the July issue that I highly recommend to all new graduate RNs—or to anyone who is returning to acute care. The article, one of the offerings in our Transition to Practice column, which is geared to new nurses, is “Surviving Your First Code.” It offers a detailed look at what happens during a code and the various responsibilities of the resuscitation team.

You never forget your first code.

I clearly remember my first code—and I bet every nurse does as well. I had seen cardiac arrests before, but that was when I was a nurse’s aide and my job during a code was essentially to get out of the way. It’s very different when you are a nurse and play a role.

It was my fourth day as a new graduate nurse working in the ED. We heard the sirens coming from a long way off. When the ambulance arrived, the stretcher came crashing through the ED doors with the paramedics yelling that the patient had just arrested as they arrived.

My role that day was to be the crash cart nurse, so I put myself in front of […]

2019-07-18T07:54:28-04:00July 18th, 2019|new nurses, Nursing|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top