Recommended Reading from the August Issue of AJN

The August issue of AJN is now live.

“Nursing Care for Patients After Ostomy Surgery,” a CE feature, details the basics of pre- and postoperative care and patient education for colostomy and ileostomy—two of the most common types of ostomy surgery.

This month’s Original Research article is on nurses’ self-reported QI engagement and competence. Also see “Cultivating Quality: Reducing Tubing and Device Connections” to learn about a nurse-led QI project that explored misconnection prevention strategies.

“Fostering Race-Based Conversations in Nursing,” our latest Focus on DEI column, discusses ways to address racism and promote cultural competence.

AJN Reports examines the unintended consequences of online health care portals, noting that:

Although patient portals are designed to help with the management of personal health information, their proliferation may also be creating barriers to care for some people.

See also the extensive health care news sections, the Journal Watch and Drug Watch sections, a new installment in our series on palliative nursing, and a Reflections essay on how a school nurse compassionately cared for the author when she became pregnant at age 15—and whose kindness inspired the author to eventually become a […]

2023-07-27T10:05:09-04:00July 27th, 2023|Nursing|0 Comments
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The Face of Burnout in Nursing: My Personal Story and Lessons Learned

Woman looking at ocean at sunset Photo by Artem Kovalev on Unsplash

Two-and-a-half years ago, I experienced severe burnout in my role as a night shift charge nurse in a cardiovascular ICU. This blog post shares my personal story, highlighting the common ingredients of burnout and the challenges I faced. Through this experience, I learned valuable lessons that can benefit both nurses and the health care industry as a whole.

Where it All Began

Transitioning from a clinical nurse educator to a night shift charge nurse in a new cardiovascular ICU was an exciting opportunity for me. However, it soon became overwhelming due to various factors. These included a surgeon I didn’t see eye-to-eye with, moral and ethical dilemmas in patient care, staffing challenges, and a hostile work environment created by lateral violence from coworkers.

Strained to the Breaking Point

As my anxiety grew, I struggled to meet expectations each night. While prioritizing patient care and my night shift team, I feared for our patients’ well-being. Frequently, we were overloaded with acute post-cardiothoracic surgery patients. Despite my efforts to manage admissions responsibly, I faced constant pressure. Doubts crept in, and I lost trust in myself and my ability to provide safe care.

The emotional toll affected […]

2026-05-07T12:04:37-04:00July 13th, 2023|career, Nursing, nursing career, nursing stories, patient safety|5 Comments
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Preventable and Aggressive Care for Cancer Patients: To the Bitter End

There have been a couple of recent studies that confirm what I have observed as a palliative care nurse practitioner (NP) in an academic medical center: that there’s still a tendency to pursue very aggressive care with older people with cancer. While every situation is different, the evidence shows that people with cancer could also benefit from palliative care and advance care planning to make sure they’re getting the best and right care for them.

Palliative care could prevent many ED visits.

The first study to catch my eye as a former ED nurse was Trends and Characteristics of Potentially Preventable Emergency Department (ED) Visits Among Patients With Cancer in the US. This study reviewed data on almost a billion (854,911,106) ED visits, of which 4.2% were made by patients with cancer. The mean age of those patients, not surprisingly, was 66. The study found that more than half of ED visits among patients with cancer, 51.6%, were identified as potentially preventable, with the absolute number of potentially preventable ED visits increasing substantially between 2012 and 2019.

The authors concluded that this highlights “the need for cancer care programs to implement evidence-based interventions to better manage cancer treatment complications, such as uncontrolled pain, in outpatient and ambulatory settings.”

This sounds […]

2023-04-07T09:34:11-04:00April 7th, 2023|end of life, Nursing, palliative care, patient experience, Patients|2 Comments
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Every Patient Needs an IV, or Do They?

(This post is by an author of AJN‘s January CE feature, “Evidence-Based Practice for Peripheral Intravenous Catheter Management.”)

Questioning the status quo.

As a former critical care nurse and now a vascular access nurse researcher, I’ve had the good fortune to travel widely and work with nurses from around the globe on multiple projects. As a researcher, part of my role is to question clinical practices we often take for granted and to ask, “Is this the best way? Could there be a better way?” Identifying practice that may not always be evidence-based is how research often begins.

Prior to the Covid-19 pandemic, I undertook a two-month fellowship in the US and visited several hospitals where, time and again, I noticed the majority of hospital patients had a peripheral intravenous catheter (PIVC) in place, but many were not in use. When I asked the nursing and medical staff why patients had a PIVC that was not in use, I was repeatedly told, “Every patient needs an IV, just in case.” When I pointed out that some patients had two or three PIVCs not in use, or a central venous access device as well, it became obvious that this is a common problem.

An ‘idle’ catheter is a PIVC that has not been […]

2023-01-11T11:41:34-05:00January 11th, 2023|Nursing, patient safety|0 Comments
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One Hospital and Community’s Rock Garden of Hope

In March 2020, Mount Sinai Queens, like many other hospitals, was overrun with patients with COVID-19. Despite layers of PPE, plus anxiety, exhaustion, and communication overload, the will to not only survive but thrive sustained the breath behind every mask. Heroes of all types were saving and soothing lives, and still are.

Outside the big front door of our hospital is a bustling ED ramp. To the left were two 18-wheel refrigeration trucks, the sight of which could take your breath away. To the far right were two 30-foot inflatable enclosed tents propped up to help the ED off-load abundant overcrowding inside. These were constant reminders that we were living through a once-in-100-year-pandemic.

An ER nurse’s creative response to a grim time.

The health care workers at the hospital weren’t the only ones subjected to these grim sights; so were our Astoria neighbors, who lived on the same block facing the ED ramp. We’ve always prided ourselves on the collaborative work we do for and with this community, including health fairs, screenings, and partnering with them on community boards. So one of us, an ED nurse named Fionnuala Quiqley (Nuala), decided to do something about it.

Nuala is a skilled and passionate ED nurse with more than 14 years of experience. She is also […]

2022-12-08T10:19:25-05:00December 8th, 2022|COVID-19, Nursing|1 Comment
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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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