Counting Your Blessings

By Maureen Shawn Kennedy, AJN editor-in-chief

A perhaps idealized past: 'Home for Thanksgiving,' Currier and Ives lithograph/Wikimedia Commons A perhaps idealized past: ‘Home for Thanksgiving,’ Currier and Ives lithograph/Wikimedia Commons

At the Thanksgiving holiday in the U.S., it’s customary to take some time to reflect on our good fortune—to give thanks for what we have. For many of us, it means being thankful for family and good health. But what about all the other people who may make a difference in how we live our lives, who make the world in which we live better or in some indirect way have had an impact on what we do, how we do it, how we feel about life or our work?

Here are some folks I’d like to thank:

Compelled by Professionalism

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

ParadisiThanksIllustration“Ah, Julianna.”

This greeting from a physician marked my arrival at work. I assumed he was about to give me information or an order about one of our patients. I prepared myself for the forthcoming shift—”Ready or not, here it comes.”

Instead, he did something completely unexpected. Quickly retreating to his office, he reappeared, extending towards me a bright blue envelope with my name neatly written on the back.

It contained a greeting card. Not the generic kind hospitals provide managers in bulk for staff recognition. Not the “You’ve Been Caught Doing Something Fabulous!” quarter page–sized certificates available in the staff lounge for coworkers to fill out in recognition of their peers. This was a genuine, bona fide greeting card, the kind you have to go to a store and select from a rack and purchase. Inside, he’d addressed it to me again, with a personal note in handwriting, shattering the long-held belief that physicians cannot write legibly in cursive.

Being thanked by a physician for an act of nursing I had provided for his patient isn’t what caught me off guard. During my years of practice, many physicians have verbally expressed appreciation for my nursing skills. A half-dozen have even apologized for disagreeing with an assessment of mine (only to find out […]

Three Nurses and a Doctor Go Sailing – Some Notes on Communication Style

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Untitled from the series, Pareidolia. Charcoal and graphite on paper, 12" x 9," by julianna paradisi Untitled from the series, Pareidolia. Charcoal and graphite on paper,
12″ x 9,” by julianna paradisi

There’s an old joke about the personality differences among nurses of different specialties. It goes like this:

A medical–surgical nurse, an ICU nurse, an ER nurse, and a doctor go sailing. The doctor stands at the bow of the boat and shouts to the nurses, “Trim the sail!”

The med–surg nurse asks, “How do you want it?”

The ICU nurse replies, “I’ll trim, okay. But I’m doing it my way.”

The ER nurse shouts back at the doctor, “Trim the sail yourself!”

ICU style. The joke is a generalization, of course. However, I was a pediatric intensive care nurse once upon a time, and I have to admit that the ICU nurse characterization resonates with my own experience. Like the nurse in the joke, I always have an opinion, and rarely mind sharing it. In the ICU, if another nurse, a physician, a pharmacist, or respiratory therapist didn’t agree, conversation ensued. My colleague, equally opinionated, would state her or his position. Data was consulted, […]

A Physician Finally Gets Nursing

RelmanArticleCaptureBy Shawn Kennedy, editor-in-chief

Earlier this month, the New York Review of Books published an article by a patient who described his hospital stay following a life-threatening accident. This was no ordinary patient—the author, Arnold Relman, is a noted physician, emeritus professor of medicine at Harvard, a former editor of the New England Journal of Medicine, and along with his wife Marcia Angell, well known as a critic of the “medical–industrial complex.” His account is very detailed and gives a good example of how it can look when the system works (and when one has access to it).

His understanding of his condition and treatment, his knowledge of the system, and also his relative prominence as an individual, all undoubtedly helped him avoid some pitfalls and make a remarkable full recovery. However, as a number of others have pointed out recently, one comment in his account was surprising.

In reflecting on his hospitalization and recovery, he wrote, “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.” After all his years in medicine, he only realized the value of nursing as a 90-year-old trauma patient.

This week, Lawrence Altman, another physician and author, wrote an excellent […]

Voice of Dissension: When Nurse Teamwork and Patient Safety Diverge

ParadisiIllustrationDissension Dissension (from the series Pareidolia), charcoal & graphite on paper, 12″ x 9,”
2012 by Julianna Paradisi

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.

The term “voice” gets thrown around a lot these days, usually in reference to creative content. Visual artists, writers, musicians, and actors rise to their unique place in the art world on the originality of their voice, not merely for mastery and talent.

In nursing, voice is important too. Hospitals spend a small fortune in paid staff hours for team-building meetings or retreats for nurses to smooth the rough edges of staff members, reducing friction among unit nurses with the ultimate goals of nurse retention and improved patient care. While these are admirable goals, I’m beginning to wonder if too much emphasis on team building may also diminish a nurse’s unique voice, thereby inadvertently interfering with patient safety? A team is only as strong as its individual members. […]

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