The art of questioning

A physician once saved my life with a question, or more precisely,with two questions. I had been short of breath for several months. Because I hadhad some cardiac problems in the past—an episode of pericarditisseven years previously—I called my cardiologist. He thoughtit sounded like a slight worsening of my generally mild asthma,and reassured me. As the weeks passed, I had good days and baddays, and sometimes I worried more and sometimes less. At somepoint I organized a chest X-ray and an ECG for     

Touching the dead: Autoethnographical reflections about the researcher’s body in the field of death,dying, and bereavement

This essay presents an account of the influence of the researcher‘s body within qualitative death research. It suggests that appropriate reflection on the researcher‘s subjectivity should consider his or her own bodily performances and experiences. At the beginning I offer some introductory thoughts in this regard, referring to Plessner‘s distinction between ‘being a body‘ (Körper-haben) and ‘having a body‘ (Leib-sein). Here, I highlight the importance of autoethnographic approaches for the understanding of bodily experiences, such as sensations, perceptions and their aesthetics. To demonstrate the importance of considering the researcher‘s body within the research process, I then draw on my own autoethnographic material, discussing how I experienced in my body frightening and disturbing feelings while dealing with the dead. This material was collected during a six-month internship from April to September 2016 at a small funeral home in Thuringia, Germany. I explain how I was socialised regarding my bodily behaviour towards the dead years ago and how I acquired the knowledge that touching a corpse is often taboo; describe my bodily reactions when I saw a dead body for the first time during my internship and how these reactions influenced my fieldwork; relate how my senses and perceptions when first touching a corpse led to extreme responses that drew most of my attention to the haptic and sensual dimension, making me unable to notice other information in the field; and show how these bodily experiences crossed borders and influenced my life beyond my field research.     

Health hazards of air travel

Three years ago, while travelling on an aeroplane, I developed a deep vein thrombosis. I was admitted to hospital in Singapore for five days and the rest of my holiday was cancelled. I tell my story in the hope that people will read and understand my experience and reflect on the topics and questions raised. I have also included some preventative education to help people avoid circulatory problems while travelling and a brief literature review.     

From the tower into the trenches: a nurse educator's reflections on the knowledge of experience

I have been in the tower for a long time. I have been teaching nursing for more than 20 years, and only now, after spending 6 months in the trenches as a staff nurse, have I begun to realize how far removed I had become from the real world of nursing. In this article, I will first discuss the experiences that motivated me to take a leave of absence from my teaching position in Canada for a staff nurse position in an acute care hospital in Florida. Then I will share my early reflections about what I learned as a staff nurse in Florida and how I interpreted this experience in the context of my own teaching practice and in the context of nursing education.     

The importance of spiritual assessment: one clinician's journey

Assessing spiritual values of a patient causes the nurse to assess and or re-examine his or her own beliefs. Self- reflection makes one aware of how spirituality affects the individual's life and nursing practice. Those who find themselves uncomfortable with spiritual issues may have difficulty in delivering spiritual care to others. Nonetheless, the ability to seek appropriate assistance should be possible, but in-depth conversation regarding spirituality may need delivery by another caregiver.[8]Before assessing spirituality, examine your own beliefs to provide compassionate care related to meeting the patient's spiritual needs. Today, I regularly ask if the elder has a religious or faith-based belief he or she follows. If so, I probe further to determine how this belief system helps them with their health care concerns. I watch for symbols such as a Bible, inspirational readings, or religious items in the home or health care setting. A practice choice I have made is to offer prayers together with my patients and families. This is an individualized involvement that some believe crosses the boundaries of professionalism and political correctness. However, this level of involvement provides a positive opportunity to provide fulfillment in my nursing practice for my patient and myself. I will continue this added dimension of care.Spiritual assessment involves the evaluation of spiritual needs and the relationship to health care issues, whereas spiritual care involves compassion, presence, listening, and the encouragement of hope. It may or may not involve God or religion. To best serve the elderly patient, nurses should examine their own spirituality and how this may affect their own unique ability to assess or deliver spiritual care.     

Registering the History of Nursing

As a school of nursing librarian, I received increasing numbers of inquiries about historical records from researchers in this country and abroad. Nursing schools and leaders were being honored with exhibits and films, biographies of American nurses appeared in the literature in greater numbers, and occasions, such as National Nurses'Day, were observed with historical displays. This lively interest in the history of nursing stimulated my curiosity about our own past and about the many apparently unrecorded documents and memorabilia that I kept finding in my attempts to answer some of these questions.     

The nurse practitioner in industry.

To summarize my feelings of my original goals and how I presently feel about an Industrial Nurse Practitioner: What it has made me is a better nurse, definitely more valuable to my employer, and I am serving my patient/employees at a more skilled level. I have much greater job satisfaction in my expanded role. Progress is slow and painful, and in representing the new expanded role of nursing, I am still involved in the routine everyday problems. Success is not always realized at the time it is most needed or wanted and there have been days when the load seemed almost too heavy to bear; however, I have experienced some of the triumphs of when a goal is realized, and it is knowledge of this that makes it all worthwhile.     

Gaining strength and focus from hardship

Three members of my family have been diagnosed with cancer in the past five years. During the fall of my freshman year of high school, my older brother was diagnosed with acute lymphocytic leukemia. His health began to deteriorate in August 2006. My mother would take him to the hospital weekly, insisting that the doctors run every test on her ill-ridden son. Chris's diagnosis in November 2006 accounted for his rapidly failing health and provided treatment options that would hopefully restore his once lively appearance and attitude. Now, five years after his diagnosis and less than a year from completion of treatment, I am able to call Chris's cancer a blessing. During his intensive and long protocol, my focus was on how unfair this diagnosis was. It was as if my eyes were shielded from anything positive and all I could see was darkness. Why my family? Why my brother? Why me? Is he going to die? These thoughts constantly pounded my brain, drawing me deeper into self-wallowing and pity. And, with each obstacle, whether it was a grand mal seizure, a near-deadly rash, or some other allergic reaction, I would dive deeper into this darker state. It took me a year to finally be able to say my brother has cancer without bursting into tears. And, within two years, I was beginning to feel alive again as I watched my brother gain strength with each new day.     

Documenting quality: One case at a time

Many physiotherapeutic models of management are widely accepted on the basis of empirical observations. General principles of treatment are then incorporated into therapists′ personal models. In order to encourage physiotherapists to re-evaluate their individual approach, I have critically analysed my individual approach to the treatment of hearing-impaired infants who present with gross motor delays. The analysis includes an examination of the theoretical basis as well as assumptions underlying treatment. The new management model that evolved as a result of this analysis is then presented.     

‘A pacemaker in my heart’– classification of questions asked by pacemaker patients as a basis for intervention

Aims. The research aimed to identify the information patients find necessary, following pacemaker implantation. Background. Although pacemaker devices do not have an adverse impact on lifestyle, they evoke anxiety related to the patient’s activities and lifestyle. Design. Survey. Methods. A convenience sample of participants was taken from the entire population of patients who attended the cardiology clinic between January–June 2007; 274 individual meetings were held with 123 pacemaker patients in three periods, reflecting different stages of recovery. In the meeting, patients were invoked to ask any question they may have regarding pacemaker implantation. The questions were collected from the patients and categorised chronologically, in accordance with their frequency in three periods, reflecting different stages of recovery. Results. Eight categories, representing common issues and content were raised: motion and effort, environmental influences, personal hygiene, knowledge concerning the pacemaker operation, medical treatment, eating and drinking, clothing and general questions. Findings show that the common factor for most of the questions was the loss of confidence in the various aspects of life. The largest relative question proportion was in the motion and effort (27%) (e.g. may I swim? how many kg may I lift?) and environmental influences (26%) (e.g. may I use a cellular phone? may I use a shaving machine?). Conclusions. A coherent, continuous pattern was found, characterising the different points of measurement where, at the first point, questions were characterised as more existential, related to daily routine activities and as time passed and patients were exposed to non‐daily activities and conditions, other questions were raised. Relevance to clinical practice. Pacemaker implant guidance should be based upon experimental evidence, arranged according to each category’s relative weight and take into account the patient’s point of view.     

About the lecture by a physician

As I had been lectured to by a physician about the dangers of morphine use in my child, I agonized over allowing its administration, which only prolonged my son's suffering. It is one of my biggest regrets upon looking back on Austin's time here on earth. A lack of education on the positive benefits of morphine actually increased the time of his suffering. It's still hard to digest. When Austin received morphine he did not stop breathing, die, or lose his personality as I had feared. Instead, he was able to regain some of the weight he had lost during his bouts with dystonia and spasticity and could enjoy life within reason. He could even smile again, something that I had not seen in a full month of his suffering in the hospital. He died at age 14, but not before enduring other periods of time dealing with horrific spasms. Austin's pain became unmanageable in February 2005 and I had to make the painful decision to withdraw nutrition and hydration in order to end his horrible suffering, as there was no cure for the disease he had and no end in sight for the pain.     

Balancing life—in heels and a suit

“We need to hear the voice of nurse leaders talk about balance,” said my esteemed colleague. I agreed and set to task by reviewing the literature, exploring definitions, and reflecting on my past experiences. To write an article on balance between personal life and professional life appeared to be something I could accomplish with minimal to moderate effort. After all, I am the chief nursing officer (CNO) of a large major academic organization. My family life is busy with a husband and 2 children, one of those a preteen and the other in those glorious teenage years. I manage to do my fair share of carpooling, attend required school events, and even coach softball in the summer. Included on my weekly to-do list are exercise, church, and household chores.     

How I learned what I thought I already knew.

Recently, I experienced cancer from the other side: I have had the privilege of sharing the cancer experience with an intimate other. It was while I lived through this experience, this hand-in-hand, heart-to-heart and soul-by-soul walk with my husband that I really learned what I thought I already knew about how oncology nurses alleviate suffering, help heal and lessen the burden of the cancer illness. The purpose of this paper is to provide the oncology nurse with a portal into a lived experience of a person dying of cancer and to confirm what we do know, describe what we do not know and to lovingly challenge some of our assumptions so that we may become better students of our real teachers: our patients.     

A hitch-hiker's guide to the past

We all romanticize the past. But in some ways at least, I’mcertain that life is less safe and spontaneous for my two youngchildren nowadays than it was for me. When I was their age (there,I’ve said it!) I used to disappear with friends for hoursto the local park, kicking a ball around, fishing for sticklebacksin the stream, and playing hide and seek in the bushes. I wouldnever dream of letting my own children do this unaccompanied.Nor do I ever see kids under ten roaming freely around northLondon     

A suitable case for treatment

In August 1982, I finished a six-month stint as a senior houseofficer in obstetrics, and brought my career as a hospital doctorto an end. Since then, I have worked mainly in general practiceand as an educator. I have only had the typical contacts thatyou would expect a GP to have with the world of hospital medicine.However, a few months ago I was asked to design some trainingfor hospital consultants in how to carry out clinical supervisioneffectively. Since then, I have been visiting acute hospitals     

Becoming a doctor of nursing practice: my story

There has been a great deal of curiosity about the new Doctor of Nursing Practice (DNP). I have been asked by my colleagues to share my story. “What is a DNP? What prompted you to seek a DNP? Why not a PhD? How will this degree help you in your career? Where will you practice?” Approached with so many questions and general curiosity, I decided to share my story.     

2001 Torald Sollmann Award lecture. Looking toward the future, using lessons from the past

It is a privilege and honor to be selected by the American Society of Pharmacology and Experimental Therapeutics for the Torald Sollmann Award. I wish to take this opportunity to comment on my experiences over the last 40 plus years as both a student and a faculty member. I was trained in pharmacology as well as medicine with the goal of entering an academic career that would permit me to engage in teaching and research. The subject of my presentation focuses on the events that helped to shape my career. Attention is given to those who made it possible for me to advance in my learning, teaching, and research. In addition to having been taught by excellent instructors, I have benefitted from having many outstanding undergraduate and graduate students, as well as postdoctoral fellows, without whom much of what I feel I have accomplished would not have been possible. Being surrounded by a supportive environment and accompanied by bright and eager young students gives me reason to look toward the future with enthusiasm. I chose to take the time and space allotted to me to present a brief overview of where I have been and how many individuals played important roles in helping to achieve my goals. In essence, this composition is a tribute to my family, professional associates, and current and former students.     

It happened to an ICU nurse : an experience on the receiving end of intensive care.

After working in intensive care for thirteen years, I believed I understood some of the experiences of our patients and their families. However, my own experience on the receiving end of intensive care has demonstrated how little I knew and has changed not only my own views and perceptions, but has stimulated changes to practice in one icu.     

Seeing the psychiatrist: an autoethnographic account

Autoethnography is a fairly recent approach to ethnography and one in which the writer becomes the 'subject' of the study. It remains an approach under question until more has been done in the field. In this account, I describe attending an interview with a psychiatrist, as a patient. I map out the process I encountered and offer, alongside the map, various critical and reflective comments. I offer a summary of my 'findings' and close with a critical evaluation both of the method and of the paper. Findings included: a comfortable and comforting 'setting up' of the interview; a sense of moving into the 'patient role'; a clear indication of how the interview would proceed; and empathic manner on the part of the psychiatrist and a sound process of follow-through with my general practitioner. In the critique section, I try to answer the question as to whether or not authoethnography is self-indulgent and the degree to which it can or cannot help others in understanding mental health issues. I remain uncertain about both the method and its value. In the end, it is probably for the reader to answer these questions.