Adapting to the Emotional Toll of Nursing

take2refectionsillustrationsept2016New nurses may find themselves confronted with great human suffering, enormous technical challenges, and the norms and pressures of the nursing profession and the individual workplace.

Most eventually learn the skills and knowledge they need to succeed in the profession. But some may struggle more than others with the emotional intensity of the work. A question that seems to come up a lot when nurses write about their work goes something like this: How do you keep caring as a nurse and not get burned out? How do you develop a resilient professional persona?

This month’s Reflections essay, How I Built a Suit of Armor (and Stayed Human),” by Jonathan Peter Robb, enumerates the challenges faced by a sensitive new nurse and the ways he found to protect himself over time. Here Robb, a district nurse for the National Health Service in London, England, describes one kind of challenge he faced:

The weight of being responsible for a person’s health wasn’t one I had prepared for. Sitting in lectures doesn’t train you for the moment when you’re standing at the end of a bed looking at a patient who is struggling to breathe, semiconscious (but who just last week was sitting up and talking), and thinking: Did I miss something? Is this my fault?

As Robb writes, “caring hurts.” […]

A Strong Case for the Professional Introduction in Nursing

nametagDo you always introduce yourself by name to your patients? Or do you simply say, “Hi, I’ll be your nurse today?”

In their Viewpoint essay in the June issue of AJN, Raeann LeBlanc and two colleagues at the University of Massachusetts Amherst College of Nursing make a strong case for the professional introduction, in which “a nurse states her or his full name and role in the patient’s care.”

The authors argue that professional introductions are “a powerful way to make clear the centrality of the nurse’s role in the care of the patient.” When nurses use professional introductions, we make our knowledge and expertise more visible and help patients better understand just what it is that nurses do.

The authors also address potential safety concerns nurses may have about disclosing their full name to a patient, and they offer some reasons why the importance of professional introductions may not be taught in nursing school.

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Why I Like Nurses Week

Safety Plan Safety Plan/Plougmann/via Flickr

By Shawn Kennedy, AJN editor-in-chief

Here’s why I like Nurses Week. I’m sure some folks groan over the idea that for only one week out of the year, health care administrators actually think about all that nurses do and show their appreciation. My perspective is that at least we have one solid week with the spotlight on nursing, when we can toot our horns and make sure that people know the critical role of nursing in health care.

Sure, there are some people who will never “get” what nurses do beyond the old stereotype that nurses are doctors’ helpers. I’m always flabbergasted, though, when physicians—after so much time working alongside nurses as medical students, interns, and residents—still don’t have a more nuanced view of nursing.

In this month’s editorial, I address the American Nurses Association Nurses Week theme, “Culture of Safety: It Starts with You.” How many times, in the dead of night, have nurses called physicians to alert them to a critical change—or questioned an inappropriately ordered medication that, if given as ordered, could have had dire consequences? I also addressed this issue in a 2014 blog post about Arnold Relman, now deceased but […]

Ethical Practice with Patients in Pain

Photo @ AJ Photo / Hop Americain / Science Photo Library Photo @ AJ Photo / Hop Americain / Science Photo Library

Pain is difficult to define and hard to convey. The way both patients and clinicians respond to it can be influenced by a multitude of possible biases. This month’s Ethical Issues column in AJN is by Doug Olsen, PhD, RN, an associate professor at Michigan State University College of Nursing. In “Ethical Practice with Patients in Pain,” Olsen summarizes the challenge nurses and other clinicians face in treating patients’ pain:

Responding to a patient’s pain is a fundamental ethical obligation in nursing. However, nurses caring for patients in pain can run into ethical conflicts from both over- and undertreatment of pain. Undertreatment of pain represents a failure to fulfill the core nursing obligation to alleviate suffering—but overtreatment may ultimately harm the patient, contradicting a core nursing value, nonmaleficence. The complex nature of pain complicates efforts to provide treatment that is ‘just right.’ Nurses must understand that complexity if they are to make ethical decisions in the care of patients who experience pain.

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Medical Marijuana: A Nurse’s Primer

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Illustration by J Paradisi. Illustration by J Paradisi.

Since I wrote “Marijuana Legalization and Potential Workplace Pitfalls for Nurses Who Partake” in July 2014, a few things have changed. For one, Measure 91 passed in Oregon, making it the third state to legalize recreational marijuana. Medical marijuana, however, has been legal since 1998 in Oregon, currently one of 23 states nationwide.

Also, when I wrote the earlier post, I was an infusion nurse—now, as an oncology nurse navigator, I’m asked about medical marijuana often, and I need to know the answers, as do all nurses practicing in states with legalized medical marijuana. Nurses working in oncology, emergency departments, pain management, infusion clinics, and pediatrics have high exposure to patients with medical marijuana cards.

By ‘knowledge,’ I don’t mean knowing everything, but knowing where to find what you need to know. In Oregon, for example, information about medical marijuana is found at the Oregon Medical Marijuana Program (OMMP). The Web site includes qualifying diagnoses, a downloadable handbook, an application packet with instructions, and a list of approved dispensaries. While retail issues surrounding recreational marijuana are still being sorted out, medical dispensaries in Oregon sell recreational marijuana to clients aged 21 and older.

Patients using medical marijuana are as […]

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