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Insights Blog

When you hear your peers tell their own nursing stories, you gain insight into how you may want to handle your professional growth, patient care, self-care, patient advocacy, and more. You may also want to share your own stories by submitting a blog for possible publication.

February 16, 2018

By: Fidelindo Lim, DNP, CCRN

There is a ritual in medical schools to hold a memorial service to honor those who have donated their bodies or body parts to advance medical education and research. In spite of advances in instructional technologies, the dissection of human cadavers remains a staple teaching strategy in gross anatomy in medical schools. There is no doubt, dissecting cadavers teaches more than just muscle insertions and blood vessels. It invites the future physician to contemplate on our collective humanity, to acknowledge the inescapable reality of disease and death, and to ponder upon the virtue of gratitude.

It’s proper and good to eulogize the people who donated their bodies to medical education. To give thanks to those who continue to give, post-mortem, is a moral obligation. Organ donors, both live and cadaver, evoke similar heartfelt thanksgiving. A donated organ can save a life, but a donated body paves the path to save many more. The gift of the dead, both physical and spiritual, will continue to manifest in the lives restored under the care of a learned and skillful physician.

Nurses don’t dissect cadavers to learn their craft. And the dead do not endure. Before the advent of high . . .

February 10, 2018

By: Chris Hirschler, PhD, MCHES

Trained as a licensed practical nurse in 1948, after being a nurse’s aide in Rochester, New York during World War II, Rita Hirschler has cared for the sick and dying throughout much of her century-long life. She has provided end-of-life care for multiple family members, including her mother, two husbands, a daughter, my mother, and many patients. I might not be alive to write this story had my grandmother not been by my bedside 33 years earlier in the hospital’s intensive care unit and noticed I was bleeding internally.

On January 8, 2018, Rita turned 101. She has spent the last 840 days in this nursing home, enduring a tiny, shared space separated by a thin curtain and the maddening blare of strangers’ television selections. When I visited her two days before Christmas 2017, I asked her how she was doing. A single tear formed, desperate, as if tortured, her voice quivered, “I can’t sleep!” Meanwhile, her roommate screamed gibberish. The woman’s daughter, cognizant of the disturbance, reassured my cousin, “She won’t be here long.” Making light of the mortal implication, my cousin quipped, “They’ll do a Dateline special on my . . .

January 29, 2018

By:

Having been a registered nurse for almost 10 years, I’ve been fortunate to have only been a patient for the happy occasions of welcoming my children into the world. During those visits at our local hospital, all with surgical births, I was thankful for the kindness, compassion, and understanding of the nursing staff as I asked many questions and stubbornly insisted on doing many of my own care activities. My first two deliveries, both daughters, are nearly a blur in my memory now. The care was excellent, evidence based, and respectful of my preferences and needs. My husband and I received patient centered discharge instructions that were personal and thorough. We felt confident leaving the hospital, and we truly gave all the credit to our amazing nurses.

Only the stay with my son sticks with me now as different than the first two. Like the deliveries before, we’d had a great OR experience, with excellent and evidence-based care. We’d kept our son in our room for the entirety of the stay, and were treated with respect and dignity. We had chosen to keep our son intact, to not circumcise, and had been supported in our choices . . .

January 22, 2018

By: Lynne M. Hutchison, DNP, FNP-BC

Have you thought about what to do in your retirement? Are you sad about giving up the nursing skills you developed over your years of practice? Have you ever thought of using some of your skills and knowledge to work as a volunteer nurse? There is a need for volunteer nurses in both the United States and abroad. Many nurses are volunteering their time to help those in need after going through a traditional retirement from nursing. Many of the activities nurses performed in their regular fulltime careers translate well to a volunteer setting. Here are some common questions about volunteering in retirement.

What’s in it for me?

Working as a volunteer is rewarding all on its own. The feeling of serving other people is something that makes most of us have a sense of self-worth and one of the reasons we entered the nursing profession. In addition, you are providing care in the most urgent need areas, gaining new skills, and making lifelong friendships. When I go to my volunteer job, everyone is happy to be there. If I miss a week, everyone asks where I was and say they missed me. When was the last time . . .

January 12, 2018

By: Roric P. Hawkins RN, MBA, BSN

As we ended 2017, I reflected on some of the feedback I’ve received from the blogs that I wrote during the year. Most people’s comments have been very positive and supportive, but some have raised questions or concerns. As we start the new year, I thought this would be a good opportunity to address some of those questions here.

Why does nursing seem to be the primary focus of all your blogs?

Most hospital organizational missions are written as a commitment for what patients should expect when choosing to receive care within their hospital facility. It would be next to impossible to accomplish these missions without the direct involvement and unwavering support provided by nursing staff. In hospital settings, nurses are the most central figures to patient care, responsible for not only the delivery of consummate quality, but also acting as coordinators of care both within and often outside of hospital settings. Nurses represent the direct link between the patient’s health, physicians, support services, and associated family members and friends.

As it relates to implementing safe patient handling programs, it must be understood that most patient handling injuries in hospital settings are incurred by the nursing staff . . .

January 5, 2018

By: Jon Templeman, BSN, RN

 

 After a long, arduous winter of work, you have saved up your PTO and fly out to your dream destination for a much-needed vacation. You are miles away from the cacophony of call lights, alarms and demands of your job, and with each passing mile, you feel the stresses shed away and the beckoning call of the ocean strengthen. The plane is cruising along at an altitude of 40,000 feet as you watch a movie and daydream about the coming days, thinking about how you are going to spend them relaxing on the beach.

In an instant, your moment of tranquility is disrupted by a loud banging noise and the intense pressure of frigid air rushing into the cabin. You fumble with the oxygen mask that has dropped down in front of you, trying to put it on, now remembering the words of the flight attendant instructing you to put your own mask on before you help those you are with. You don’t know this, but you have the next 15 to 20 seconds to properly don the oxygen mask before you lose consciousness.

Thankfully this scenario is something that happens very infrequently; however, the necessity . . .

December 30, 2017

By: Tracey Long PhD, RN, MS, CDE, CNE, CCRN

Angels are generally thought of as having wings and appear quietly, but on October 1, 2017, hundreds of angels descended on Las Vegas wearing scrubs amidst noisy chaos. After a mass shooting at the Mandalay Bay hotel upon 22,000 country music lovers at the Route 91 concert, angels without wings, known as nurses, went into full action.

The two busy trauma centers of Las Vegas include Sunrise Hospital and UMC Hospital and generally receive and treat approximately 20 traumas each day. After “shots fired” was announced, however, both centers received and treated over 250 patients, hundreds with gunshot wounds and more with surgical needs. The total was 527 wounded and 58 fatalities. That Sunday evening, both hospitals had called in all of their off-duty surgeons, anesthesiologists, and nursing surgical teams and activated all their training and creative thinking to deal with the sheer volume of people flooding into their emergency departments. More than 100 physicians and nurses came in, like angels swooping down into chaos to bring help and healing.

“We get patients like this all the time, but maybe two at a time at most,” said Rhonda Davis, Las Vegas Sunrise trauma nurse. “You do all these . . .

December 22, 2017

By: Mary Ellen Wurzbach, PhD, RN

Suffering is an ephemeral state. Not physical pain exclusively but also the mental state that accompanies pain of all degrees. Pain is what the person says it is and so is suffering.

Pain and suffering, although co-mingled, are very different aspects of the same phenomenon. Pain is one part of suffering but not the whole. Suffering entails many characteristics not found in pain alone. Suffering involves many psychological mechanisms encompassing some attributes common to all and some specific to the individual. Suffering includes the physical aspects of pain for some but not others.

Sometimes there is an existential threat. The person worries about his or her own demise, or possibly not death but dying or disability. There may be a loss of social value for the person because of the suffering. Maybe the person has lost a long-held belief or faith in another person or entity. Suffering may be short lived or long standing and it may be continuous or intermittent. Suffering may become permanent as in PTSD, a prolonged illness, or a painful experience. Suffering takes so many forms that it would be difficult to describe all of them. Every individual experiences suffering in his or her . . .

December 15, 2017

By: Jon Templeman, BSN, RN

It’s likely that every nurse who has accumulated a few years of clinical experience can look back on interactions with various medical providers where he or she has gleaned some nuggets of wisdom while working for, or side by side, these providers. I occasionally collected these nuggets the best I could as I busily performed my duties as a new night shift nurse on a med/surg unit, and after two and half years of this, made the transition to home health care. The home health care environment made interactions with providers infrequent and thus, my gold nuggets were few and far between.

A year and a half later, I once again was ready for a change, and became a hospice nurse. Little did I know that I was not just going to get some nuggets, but was going to be entering the gold mine, in the name of Dr. Benjamin Ranck. Dr. Ranck was in the twilight of his career as a hospice physician, but he was clearly committed and passionate about educating staff, patients, and families alike while providing excellent care. I had the distinct honor of working alongside this wonderful man and learning from him for . . .

December 8, 2017

By: Roric P. Hawkins MBA, BSN, RN

In today’s nursing practice, varying opinions about how to best implement safe patient handling (SPH) programs exist. Some nurses offer suggestions based on personal experiences, which is both common and to be expected. Others are passionate and steadfast regarding the successful strategies they may have created.

Although these contributions are important as we move this injury prevention initiative forward, we must be cautious about our personal successes making us rigid in our thinking so that we begin to believe that our way of doing things is absolute. Nor should we allow our strong opinions to lead us to believe that all SPH processes should be standardized to be successful. Instead, we need to understand that others need the option to choose from our strategies and apply those that best fit with their practice situation. This approach also helps inexperienced SPH coordinators to develop decision-making skills related to implementing SPH programs: The more confident coordinators become, the more they learn to trust their abilities to make sound implementation decisions.

Stay flexible

Though it’s true that SPH programs are built on a foundation of evidence-based research that identifies how to reduce clinical staff injuries related to manually lifting . . .

December 1, 2017

By: Jon Templeman, BSN, RN

Unless you’re from Salem, Oregon or have read USA Today lately, you likely have not heard the story about what happened 75 years ago at Oregon State Hospital. In the midst of World War II, this psychiatric hospital experienced a tragic November night when 47 of its patients died horrific deaths due to a botched ingredient in the scrambled eggs.

The assistant-cook needed powdered milk to add to the egg yolks, so he sent one of the patients who was assisting him down to the basement to fetch it. The patient went to the wrong storeroom in the basement and came up with sodium fluoride, a powerful roach poison. The assistant-cook then unknowingly added this poison to the eggs and served a lethal dinner to the hospital residents. Within minutes, the first sign that something terrible was taking place was observed as patients began vomiting blood and having respiratory paralysis. Within a few hours, dozens of patients were dead, and by the time it was all over, 47 were dead and hundreds more were ill.

The subsequent investigation revealed that the assistant-cook had broken a rule by handing the basement keys to the patient who was . . .

November 24, 2017

By: Jon Templeman, BSN, RN

I have been a hospice nurse for 5 years. I have been treading water in an ocean of grief that is compiled of the collective tears of my community. In my relatively short time as a hospice nurse, I feel like I have seen enough suffering, pain, and sadness to put to shame any fictional work that has ever come out of Hollywood or been written by the greatest of authors. If art imitates life, it’s failing miserably and can’t hold a candle to what I have seen play out, from the most complex to the beautifully mundane.

I’m now at a point where my identity as a hospice nurse has overshadowed my previous identity as a U.S. Marine. With each patient that I connect with and work towards getting comfortable, there is a change that occurs within me. It draws my heart closer into this field, even as my mind tells me sometimes that I can’t take much more of this.

One thing that I retain from my military days is a fighting mentality, and that I believe is of absolute necessity. I was never deployed to a combat zone, so I won’t . . .

November 17, 2017

By: Leon Chen, DNP, AGACNP-BC, CCRN, CEN

In 1885, a young nursing student at Cambridge Hospital in Massachusetts was going through her studies; her brightness and positive attitude quickly earned her the nickname “Jolly Jane.” While there were some concerns with her occasional propensity to tell fibs and her seemingly bizarre interest in patient autopsies, by all accounts Jane was well liked by her colleagues, competent in her skills, and adored by her patients. Her patients thought she showed extraordinary compassion and was eager to help them beyond the call of her duty.

Because of her popularity with patients, after Jane was terminated from her position at Cambridge Hospital for being reckless with opiate administration she was able to quickly obtain a new position at the prestigious Massachusetts General Hospital. She later lost her position because of her liberal dispensing of morphine to her patients. Yet because she was so well liked by her patients, a physician recommended her for a position as a private duty nurse to take care of his wealthy patients. Jane became financially well off as a private duty nurse, until she was discovered to have murdered dozens of patients, associates, and even family members over about 10 years.

Jane Toppan was one . . .

October 13, 2017

By: Roric P. Hawkins, MBA, BSN, RN

Safe patient handling (SPH) is a much-needed solution to address widespread injuries occurring among nurses performing patient care. Injuries that result from manually lifting human beings often happen because of many factors, but nevertheless remain an existing problem in need of a committed focus. Though there are a variety of injury prevention programs in patient-care settings intended to address the safety of those who function within these spaces, it has become ever-more important to remember that the foundation, processes, and incorporation of patient-lift technology were developed to target specifically the safety of healthcare workers.

In defining SPH as a program, it’s important to ensure that the intent remains committed to minimizing injuries in healthcare staff related to manually lifting and moving patients first. Combining these programs with other hospital injury prevention initiatives run the risk of assuming SPH to be an “extension” or an “addition to” resource, opposed to an evidenced-based program created to address a specific objective.

 Safe patient handling is assistance

When considering an injury prevention program such as SPH, it’s reasonable to attribute some positive patient care outcomes to processes that include use of patient-lift technology. For instance, equipment . . .

October 6, 2017

By: Mary Robinson Prody, RN

Yearly, millions of women and men in the United States return home from the hospital, with one or more drains inserted in the surgical site. The drains are placed during certain surgeries to carry fluids away from the surgical site, a process that helps with healing. A drain may need to stay in place for several days to several weeks. Unfortunately, traditional ways to secure these drains, such as use of safety pins, have significant drawbacks, such as tube punctures, which can frustrate patients.

After years of working with patients, and witnessing their frustration, discomfort, and anxieties with post-surgical drains, as well as the clinical complications that occurred related to not having a universal way to secure drainage bulbs, I decided it was time to find a safer, easier to use, alternative. Despite an extensive search, I could not find one, so I developed a belt-like surgical drainage bulb holder. Patients can wear the holder under clothing, while sleeping, and in the shower.

The Surgical Drainage Bulb Holder (SDBH), patented in 2003, meets the clinical criteria for maximizing drain function and preventing complications, and is used in 155 nationally recognized hospitals.

Filling a need

Traditionally, most drainage bulbs . . .

September 28, 2017

By: Mary Janette Sendin, MSN, CNS, CCNS, PCCN

This patient could be us, our family, or other people we love. Vulnerable, scared, helpless. Do we listen to our patients? How can we support them and their families while they are under our care? The bottom line answer is patient advocacy.

According to the Merriam-Webster dictionary, advocate used as noun is defined as one who pleads the cause of another, one who defends or maintains a cause or proposal, one who supports or promotes the interests of a cause or group. Advocacy used as a verb is defined as the act or process of supporting a cause or proposal.

All nurses are patient advocates but the clinical nurse specialist (CNS) advocates at an advanced practice level. According to the American Association of Critical-Care Nurses (AACN) Scope and Standards for Acute Care Clinical Nurse Specialist (CNS) Practice, CNSs are influential in enabling an organizational culture of caring. They work with patients and families to establish an environment where caring is supreme. They also work to create an environment for patients and families where patient advocacy is one of the groundwork in achieving optimal outcomes for patients, families, and the organization.

Here is an example of patient advocacy by . . .

September 22, 2017

By: Jennifer Gentry, MSN, RN, NEA-BC

Jennifer Gentry, MSN, RN, NEA-BC, is the chief nursing officer at CHRISTUS Spohn Hospitals Corpus Christi–Shoreline & Memorial in Corpus Christi, Texas. She’s also a member of the American Nurse Today editorial advisory board.

Jennifer spoke with American Nurse Today about her experiences during Hurricane Harvey, noting the teamwork and sacrifice of her nursing colleagues and other healthcare team members.

American Nurse Today: What did you and your family do to prepare for Hurricane Harvey?

Jennifer Gentry: My husband, 17-year-old son, and I live just east of Corpus Christi in Portland, TX. As soon as it was predicted that the storm had advanced to a potential Category 2 at landfall, we sent our son to Victoria, TX, to stay with his grandmother. My husband stayed in our home because he didn’t want leave me behind to evacuate.

On Tuesday evening I knew that, depending on the storm’s progression through the night, the hospital would begin aggressive preparations the next day. On Wednesday morning, I packed my hurricane go bag, said goodbye to my family, and headed to work.

ANT: Before Wednesday, how did you and the rest of the CHRISTUS Spohn Shoreline &amp . . .

September 14, 2017

By: Lisa Blumer BSN, RN, CHPN

I am afraid…..Every time I read a new hospice referral.

I am afraid…..Every time I walk into a dying patient’s room.

I am afraid…..Every time I start a conversation about hospice care.

I am afraid…..Every time I assess a dying patient.

I am afraid…..Am I missing something?

I am afraid…..Am I going to meet the patient’s needs?

I am afraid…..Am I going to say the wrong thing?

I am afraid…..How are they going to react?

I am afraid…..Every time I hold a patient’s hand

I am afraid…..Am I going to cry?

I am afraid…..Will I be confident enough?

I am afraid…..Will someone know I am afraid?

I do it anyway because someone needs to go into the room.

I do it anyway because someone needs to talk about the hard things.

I do it anyway because they need to know someone cares.

I do it anyway because patients need to know they are not alone and they can still get care.

I do it anyway because it makes me a better nurse.

I do it anyway because it makes my assessment better.

I do it . . .

August 26, 2017

By: Roric P. Hawkins MBA, BSN, RN

Achieving the values associated with an injury prevention program such as safe patient handling (SPH) is rooted within the confines of its ability to gain end-users’ commitment to use patient-lift equipment. Commitment is at the core of what it takes to accomplish the program’s evidenced based outcomes, which include reductions in employee injuries, lost production work days, and restricted or light duty work days.

The very premise of what makes an SPH program successful is the willingness of the end-user to use patient-lift technology in everyday clinical practice. It’s up to the facility coordinator to implement program processes and methodologies in such a way that end-users understand that this innovative technology is capable of producing quality outcomes equivalent to or even better than traditional practice processes—and safer and without the physical risks for injuries.

Implementation is challenging

The success for which program outcomes are achieved depends on the program coordinator’s ability to effectively transition the injury prevention’s program design into existing clinical practices and processes. Coordinators must be able to overcome the challenges that are presented, because those same existing practices and processes are firmly established as professional nursing practice . . .

July 28, 2017

By: Roric P. Hawkins MBA, BSN, RN

Many hospitals strive to achieve Magnet® designation to highlight the clinical accomplishments achieved within their organizations. One evidenced-based practice that can be used to demonstrate what Magnet considers Exemplary Professional Practice (EP) is a comprehensive safe patient handling (SPH) program.

In the 2014 Magnet Application Manual under EP18EO: Workplace safety for nurses is evaluated and improved, facilities are asked to provide two examples with supporting evidence of improved workplace safety for nurses resulting from the safety strategy of the organization. The structural components of a comprehensive SPH program are made up of many of those necessary strategies, which at my facility, we were able to include as examples of our Sources of Evidence.

Should a SPH program be implemented and followed as recommended, it’s likely to systematically generate the staff empowerment required to produce the kind of quality outcomes, which can help in making the case for Magnet designation.

Starting the process 

At the inception of the decision made to create an SPH program, employee injuries related to moving and handling patients are identified, validating the need to implement mechanical patient-lift devices into clinical practice. In choosing a patient-lift vendor, deciding the types and quantities of . . .

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The views and opinions expressed herein are those of the contributors, authors and/or advertisers on this website and do not necessarily reflect the opinions or recommendations of the ANA the Editorial Advisory Board members, or the publisher, editors, and staff of American Nurse Today.

American Nurse Today attempts to select contributors who are knowledgeable in their fields.  However, it does not warrant the expertise of any contributor, nor is it responsible for any statements made by any contributor.  Nurses should not use any procedures, medications, or other courses of diagnosis or treatment discussed or suggested by contributors without evaluating the patient’s conditions and possible contraindications or dangers in use, reviewing any applicable manufacturer’s prescribing or usage information and comparing these with recommendations of other authorities.

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