When There’s a Disconnect Between Good Nursing Practice and Reality

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

shawnkennedyThis is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

‘Patient Activation’: Real Paradigm Shift or Updated Jargon?

By Jacob Molyneux, AJN senior editor

I attended a Health Affairs briefing yesterday in Washington, DC. Based on the February issue of the journal, it was called “A New Era of Patient Engagement.” A lot of research money appears to have been flowing to this area in recent years.

Our January article on "Navigating the PSA Screening Dilemma" includes a discussion of 'shared decision making' Our January article on “Navigating the PSA Screening Dilemma” includes a discussion of ‘shared decision making’

The basic idea isn’t entirely new to anyone who’s been hearing the term “patient-centered care” for a long time: as Susan Dentzer writes in “Rx for the ‘Blockbuster Drug’ of Patient Engagement,” a useful article summarizing the main ideas raised in the Health Affairs issue: “Wherever engagement takes place, the emerging evidence is that patients who are actively involved in their health and health care achieve better health outcomes, and have lower health costs, than those who aren’t.”

One might add to these projected benefits: better experiences as patients.

Something’s got to change, so why not this? If many nurses feel they’ve heard all this before, the sense of a […]