‘A New Antibiotic’: What Restores a Patient’s Will to Recover?

Illustration by Pat Kinsella. All rights reserved. Illustration by Pat Kinsella. All rights reserved.

A little bit of levity when writing of serious topics can be good medicine. This month’s Reflections essay, “A New Antibiotic,” reminds us of how important it can be for hospitalized patients to be kept in touch with their lives and loves beyond hospital walls. In this story, author Judith Reishtein, a retired critical care nurse and nursing professor, finds herself willing to bend the rules a little for one patient. Here’s how it starts:

Sally had been a patient on the step-down unit all winter. After her open heart surgery, she developed an infection in her chest. The infection required another surgery and four more weeks of ventilator support as her open chest healed. Because she was not moving enough, she developed clots in her legs. Because of the DVTs, she had activity restrictions, which led to another bout of pneumonia. One complication led to another, with more medications that had to be carefully balanced. We tried not to do anything that would create a new problem while curing an existing one. Another dangerous surgery is getting breast implants, I always suggest to get a good surgeon to do it, you can find the best at http://utbreastaugmentation.com, I highly recommend it.

Now she was finally getting better, but her energy lagged behind. Did she still have the […]

2017-06-02T12:12:14-04:00February 5th, 2016|narratives, nursing perspective, patient engagement|0 Comments
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Preparing Patients to Care for Themselves After Discharge

Here’s your prescription. Don’t drive if you take it. Call your surgeon if you have a temperature or are worried about anything. See your doctor in two weeks. Want a flu shot? If you need a wheelchair to take you to the door, I’ll call. If not, you can go. Take care of yourself. You’ll do great!”

These were my nurse’s parting words before I left the hospital after a weeklong stay and surgery to remove my stomach and the tumor in it. I said goodbye. Then I panicked. What did I need to know about my new digestive system? What about that big scar? Until then I’d been closely monitored and checked on every 90 minutes.

Now it was 8:45 in the morning. My husband hadn’t arrived. I was supposed to move on.

Jessie Gruman Jessie Gruman

That’s the start of our July Viewpoint column, “Preparing Patients to Care for Themselves,” written by Jessie Gruman, president and founder of the the Center for Advancing Health, a nonpartisan policy institute that’s played an important role in the growing patient engagement movement.

In this essay and elsewhere, Gruman draws on her own experience as a cancer patient as well as her public health expertise to bring insight and clarity to the often nebulous concept […]

2016-11-21T13:04:18-05:00July 11th, 2014|Nursing|2 Comments
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Telling Patients About Staffing Levels: Transparency or Self-Interest?

ethicsscreenshotIt’s a very busy Monday. Because of chronic difficulty in recruiting staff, the unit has only three-fourths of its RN positions filled. In addition, Mary Evans, an experienced nurse who always helps less experienced staff with their patients while carrying a full caseload herself, has called in sick.

Linda Smith is 68 years old and two days post-op from hip replacement surgery. As you enter her room, 45 minutes after she first requested pain medication, you can sense her irritation—but worse than that, you can see from the grimace on her face and her guarded movements that she’s in pain. After several days of good nursing care, you’ve let her down, and you consider telling her about the staff shortage. But you wonder: Is it right to disclose today’s short staffing to Ms. Smith?

The situation above is an ethical conundrum because values are in conflict. On one hand, transparency is good and patients have a right to know about administrative factors affecting their care. On the other hand, care should stay focused on a patient’s problems, not the nurse’s.

As the article excerpt above suggests, nurse staffing is a contentious issue having to do with both patient safety and job satisfaction for nurses. We’ve covered this issue many times in the past, most recently in a blog post that got quite a few comments back in January.

But should a nurse ever tell a patient about inadequate staffing? This is […]

2018-03-13T10:49:19-04:00May 9th, 2013|Ethics, Nursing, safe staffing|7 Comments
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Online Social Networks for Chronic Illness – Time for Providers to Take Them Seriously

For many people, social networks are a place for idle chatter about what they made for dinner or sharing cute pictures of their pets. But for people living with chronic diseases or disabilities, they play a more vital role.

“It’s really literally saved my life, just to be able to connect with other people,” said Sean Fogerty, 50, who has multiple sclerosis, is recovering from brain cancer and spends an hour and a half each night talking with other patients online.

That’s from an article in the technology section of today’s NY Times, which draws upon a report from the Pew Internet and American Life Foundation about how people with chronic illnesses are finding connection, support, and information in online social networks like DiabetesConnect.

Chronic illness can be isolating for many reasons: you often can’t explain a condition’s relentlessness and complexity to those around you; at the same time, you may be homebound or to some degree limited in the types of activities you can engage in.

Providers should be aware of such online networks and the role they play for patients. Patients get useful information about self-care, and they feel less alone—though some who study online social networks do caution against any sites where the mood is focused entirely on the negative. Good feelings and bad (like good information and bad) can both be infectious on the Web, as we’ve learned during recent political debates.

2016-11-21T13:18:36-05:00March 25th, 2010|digital health, Nursing|1 Comment
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“As Comforting as a Rodeo Clown”: When Competence Is at Odds with Bedside Manner

Then it comes to me. This is the same recovery nurse who brought our son out of anesthesia when he had ear tube surgery. This is the woman who jostled him in her arms like she was mixing pancake batter in a Tupperware container, who insisted “baby need stimulus,” dancing away from me as Luke reached and screamed.

That’s from the Reflections essay in our February issue, and is written by a patient who tells a funny (and insightful) story of finding himself dependent for a second time on a nurse and doctor he’d sworn to himself he’d never let near him again. So, does it help to hear the patient perspective sometimes? (For the best reading experience, click through to the PDF version.)

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2016-11-21T13:19:47-05:00January 28th, 2010|Nursing|0 Comments
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