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A forum for discussion of the latest news and ideas in nursing management and healthcare.

Wednesday, June 12, 2019

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As we continue to celebrate our 50th volume in 2019, here's ​another look back through our print archives. This time, we're going back to 1983. 

In the April 1983 issue of Nursing Management, former editor-in-chief Leah Curtin published an in-depth piece on the prospective payment system (PPS) established by the Centers for Medicare and Medicaid Services that year to control hospital expenses.

The article can be found in PDF format here!

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Check back with our blog or on social media as we celebrate our 50th volume by highlighting entire issues or specific content from our archives throughout 2019.  

Thursday, June 6, 2019

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Guy Vandenberg, RN, MSW, speaks glowingly of his time practicing on the world's first special care unit dedicated to caring for patients with HIV/AIDS. The ward opened in San Francisco General Hospital's Ward 5B in 1983 and had moved to a larger ward, 5A, by the time Vandenberg arrived in the 1990s as a per diem nurse. At that time, people were still dying fighting a disease that had no cure.

"It was a combination of trying to cure what we could cure and providing palliative care to patients who couldn't be cured," Vandenberg said in a recent interview.

Vandenberg and other nurses and caregivers who played a role in creating and nurturing the ward in the 1980s and 1990s tell their powerful stories in a new documentary, 5B. Made by filmmakers Paul Haggis and Dan Krauss, the film was acquired by Verizon Media and is slated for an exclusive screnening during the opening festivities at LA Pride Weekend in West Hollywood on Friday, June 9. It will then hit select theaters nationwide on June 14. The documentary will give a portion of its proceeds to The Global Fund.  

For Vandenberg, working on the ward was a freeing, rewarding experience. Then in 1999, his husband, Steve Williams, was diagnosed with HIV and was soon hospitalized in the ward.

"I had been working in HIV [care] for a number of years at that time, and I had this idea that somehow people close to me should be exempted," Vandenberg said. "Of course, it doesn't work that way."

While his husband was ill, Vandenberg would work on the opposite side of the ward to where Williams was staying.

"It's not a good situation when you work in the same place where they're taking care of your loved ones," Vandenberg said. "The nurses were very supportive and kept me updated and involved, but obviously I couldn't take direct care of him."

Vandenberg's husband was comatose in the ward for 2 months and almost died, but he survived over the course of several months of treatment, which had become more advanced. 

On days when his husband was very sick or anxious, the nurses would prepare a cot for Vandenberg next to his husband's bed. In Ward 5B, family members and loved ones could stay overnight, and the ward recognized same-sex visiting rights, he said.

"We did things differently," he said. "We redefined what was family. People who weren't biologically related or married would be turned away [in other hospitals]. The administration and management left nurses to figure that out and gave us the freedom to create that space where nurses and social workers on staff could make it work."

The documentary shares the stories of those who created and worked on the unit and the patients who lived and died there. Cliff Morrison, a program director at the hospital, had become frustrated at the lack of care and humanity that patients with HIV/AIDS were receiving in the early 1980s. He spearheaded the effort to create Ward 5B. Alison Moed, one of the original 12 nurses who launched the unit, later became the ward's nurse manager. LGBTQ activist Rita Rockett first visited the ward to visit a close friend and soon started the ward's longtime tradition of hosting weekly brunches and entertainment for its patients.

The ward's caregivers did what they could to make their patients feel comfortable. They threw parties for patients and allowed pets to visit. They carried out a caring model that would later be studied and modeled in hospitals around the globe.

Then there were patients like George Kelly and Williams, whose health rapidly deteriorated before improved medical treatments would save their lives. The film also shares the perspective of Harry Breaux, who watched as his dying friends and loved ones were treated with acceptance, compassion, and love in 5B.

At the same time, the ward's caregivers had to put their prejudices aside, Vandenberg said.

"It wasn't just about gay men," Vandenberg said. "We had a lot of injection drug users, homeless folks, people coming out of prison. Once you do confront own hang-ups, it is so freeing. It's incredibly rewarding to help somebody in a difficult time, to help somebody restore their dignity.

"Ideally, you want to restore their health. But if that's not possible, be there," he added. "Touch people. Alleviate what you can."

The ward eventually closed as continued advancements in HIV treatment lessened the need for an inpatient HIV/AIDs ward. The hospital, now named Zuckerberg San Francisco General Hospital and Trauma Center, now runs an outpatient HIV clinic, where Vandenberg works as an HIV clinical specialist. There, he coordinates care, provides triage and urgent care, conducts a monthly Reproductive Health Clinic for those affected by HIV, and facilitates the clinic's Opiate Prescribing and Pain Management Committee.

Although the documentary tells the story of a ward that opened four decades ago, Vandenberg stresses that 5B gives its viewers a lesson on the present day.

"This isn't a story about the past," Vandenberg said. "This is about now. Many patients either don't know that they're living with HIV or aren't accessing care. We need to reach them so they know that lifesaving care is there. We have a lot of work to do."

You can watch the official trailer for the film here, and check local theaters to see if it's playing in your area.

Monday, April 8, 2019

​Did you know Nursing Management once went by a different name? Starting with our first issue in 1970, we published our journal under the name Supervisor Nurse for about a decade until the journal's staff, led at the time by Editor Leah Curtin, decided to make a change. 

Here is a look back to our September 1981 issue (Volume 12, Issue 9), the first issue published under our current name. 

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In an editorial on the decision, Curtin said readers had repeatedly requested the change due to changes in nursing management that were taking place at that time.

"Yesterday's nurses had 'bosses,' and those bosses were nursing supervisors," Curtin wrote. "Today's nurses are more educated and independent. They know, better than anyone else, how to perform their functions. They don't want or need bosses, but they do want and need the support, guidance and direction that results from good management practice."

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The full issue is available online to our subscribers here.

Check back with our blog or on social media as we celebrate our 50th volume by highlighting entire issues or specific content from our archives throughout 2019.  

Volume 12 Issue 9

Monday, December 17, 2018

While the winter holiday season tends to be associated with joy, it can also trigger heightened levels of stress, anxiety, and depression for some.

In our latest Pathway to Excellence® column, titled "An Investment in Staff Well-Being," author Leigh Hume, MN, RN, shines a light on the importance of investing in strategies to help nurses cope with high levels of work-related stress and optimize their well-being, which can, in turn, have a positive effect on patient safety. Keeping work stress in check and fostering overall well-being can help contain or prevent the "holiday blues" in some cases. If you haven't yet, be sure to check out this article—the latest in our series of columns in collaboration with the American Nurses Credentialing Center's Pathway to Excellence Program.

Further, consider these 10 holiday health and safety tips from the Centers of Disease Control and Prevention for yourself, your team, and your patients. This guide covers the basics, such as practicing proper hand hygiene, avoiding smoking, handling and preparing food safely, keeping an extra watchful eye on the kids, and being as active as possible. See the CDC's guide for more details.

Nursing Management wishes our readers a happy, healthy holiday season. Need to catch up on 2018 articles before the end of the year? You can read our latest published content here. Also keep an eye out for our Best of 2018 collection, coming soon!

Tuesday, November 13, 2018

For nurse leaders in search of current research and perspectives on a wide range of patient care considerations, look no further than Nursing Management’s new Safety Solutions special. As part of our November issue, the annual Safety Solutions guide features the latest on topics ranging from mental health and informatics to medication administration and staffing. Here’s a quick look at this year’s coverage.

Mental health was the focus of the continuing-education feature “Suicide risk assessment and prevention.” This article discusses the importance of ensuring that your nursing team is adequately trained in patient suicide risk assessment and appropriate follow-up prevention, and offers concrete steps you and your staff members can take to reduce the risk of patient suicide attempts.  

Our Informatics article, written by Nursing Management Editorial Board member Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN, explores clinical decision support tools that can help clinicians by taking over routine tasks, warning of potential problems, or providing suggestions for the clinical team and patient to consider. We highlight infection control with “Changing practice, saving lives,” which describes one neurosurgical ICU unit’s project to achieve a sustained decrease in catheter-associated urinary tract infections. Medicine administration takes center stage in “Blame: What does it looks like?” This article uses a medication error case study to distinguish between blame and accountability.
Infusion and monitoring topics are also included. “Vascular access: HD patients’ perceived knowledge and practices” reports on a study evaluating patients’ awareness of complications linked with tunneled central venous catheters and their interrelated practices. “Factors associated with falls among hospital inpatients” presents a mixed-methods study, which concluded that most impatient falls can be eliminated or significantly reduced if nursing staff members adhere to high-reliability organization principles.

“Cultural considerations for hepatitis B vaccination compliance” focuses on communication by recounting one hospital’s initiative to increase hepatitis B vaccine administration rates within its Orthodox Jewish patient population. The topic of staffing rounds out the issue in “Hospital staffing technology: Hazard and opportunity risks,” which considers the risks and mitigation strategies associated with deploying a web-based staffing application across an integrated multi-hospital system.

The full issue can be viewed online here.