Creating and sustaining a culture of excellence

Our hospital system, in which two facilities received Magnet Recognition® and one Pathway to Excellence® designation in 2023, implemented a series of initiatives to create and sustain a culture of excellence across the organization. The Nurse Excellence department includes three campus-based Nurse Excellence Coordinators and a system-wide Nurse Excellence Director. This team’s multifaceted approach enhances the nursing work environment, instills collaboration among all levels of nursing, and engages commitment to excellence.

Spontaneous pneumothorax

A 19-year-old man with no significant medical history, develops sudden, sharp, left-sided chest pain while playing basketball. After 8 hours, his pain doesn’t improve with over-the-counter acetaminophen, prompting a visit to the emergency department. During auscultation of the patients lungs, the triage nurse notes diminished breath sounds on the left.

Spontaneous pneumothorax

A 19-year-old man with no significant medical history, develops sudden, sharp, left-sided chest pain while playing basketball. After 8 hours, his pain doesn’t improve…

Creating and sustaining a culture of excellence

Our hospital system, in which two facilities received Magnet Recognition® and one Pathway to Excellence® designation in 2023, implemented a series of initiatives to…

Nurse-driven frailty screening

Home-based primary care (HBPC) involves routine and urgent primary care provided by an interprofessional team to frail vulnerable adults who would otherwise lack access due to homebound status. Despite its demonstrated success, access to HBPC remains limited. This project fostered…

Oral care and hospital-acquired pneumonia

Many consider oral care an element of grooming, not an infection control measure. However, an association exists between poor oral care and systemic disease. For example, aspiration of oropharyngeal pathogens into the lungs can lead to pneumonia. Immobile or confined…

Nursing-led M&M conferences

The implementation of nursing-led morbidity and mortality conferences (NMMCs) in our neonatal intensive care unit emerged after experiencing several adverse patient outcomes and identifying nursing knowledge gaps related to certain diagnoses. With the goal of improving the quality of nursing…

Eat, Sleep, Console

When people experience opioid use disorder in pregnancy, the fetus has prolonged exposure to the opioid. At birth, abrupt cessation of this exposure may lead to infant withdrawal symptoms, traditionally known as neonatal abstinence syndrome. However, neonatal opioid withdrawal syndrome…

How is Your Nursing Team Making a Difference?

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From Shortages to Solutions: Supporting Nurses and Strengthening Teams

Who handles the handling?

Gastrointestinal Whole-Patient Care

Collaboration in Patient-Centered Care Planning: Navigating Oncology

Simulation: Preparing for workplace violence

Current Journal

Mental health and well-being in nursing: An inside view

Reflect, renew, and reconnect

Fostering a workplace where nurses can flourish

Vanishing voices

The hidden cost of 2025 federal funding cuts on nursing and midwifery leadership When we showed up for work on January 20,…

Alleviating nurse fatigue

Today's nursing workforce spans multiple generations, each with distinct needs, strengths, and challenges. Addressing generational differences as healthcare evolves remains essential for…

Reflect, renew, and reconnect

With the start of the new year, we’d like to offer nurses a timely, supportive reset message for 2026, grounded in current…

Creating and sustaining a culture of excellence

Our hospital system, in which two facilities received Magnet Recognition® and one Pathway to Excellence® designation in 2023, implemented a series of…

Continuing Education

Oral care and hospital-acquired pneumonia

Dress for success: Wound dressing basics

Some nurses find wound dressing selection intimidating and frustrating. Businesswire estimates that more than 5,000 wound care products exist in the United States, in a myriad of shapes and sizes, each designed to address different wound characteristics and stages of…

Comprehensive nursing approach to hepatitis B and C

HBV and HCV pose significant health risks. In their chronic form, years after initial infection, both viruses can result in severe health issues, including…

ESCAPE from delirium

Falls in hospitals frequently coincide with delirium, a common yet sometimes unrecognized comorbidity among geriatric patients. Delirium is characterized by sudden, rapid cognitive impairment…

Naloxone education for nursing staff

In 2021, 4 years after the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency, the Centers for…

STIs: Antibiotic resistance and treatment challenges

Since the discovery of multidrug-resistant infections, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci, concern has grown regarding antibiotic resistance among sexually transmitted infections…

Oral care and hospital-acquired pneumonia

Many consider oral care an element of grooming, not an infection control measure. However, an association exists between poor oral care and…

Dress for success: Wound dressing basics

Some nurses find wound dressing selection intimidating and frustrating. Businesswire estimates that more than 5,000 wound care products exist in the United…

Comprehensive nursing approach to hepatitis B and C

HBV and HCV pose significant health risks. In their chronic form, years after initial infection, both viruses can result in severe health…

ESCAPE from delirium

Falls in hospitals frequently coincide with delirium, a common yet sometimes unrecognized comorbidity among geriatric patients. Delirium is characterized by sudden, rapid…

Education and Career Guide

Education can be the key to professional success. Whether you’re a new or experienced nurse, returning to school to get your BSN or another advanced degree can make the difference between thriving and stagnating in your career. Tap into the articles presented in this year’s education guide for tips and thoughtful advice on nursing education. The American Nurse Education and Career Guide, provides you with facts, figures, other nurses’ experiences, and tons of other resources to help you in your journey.

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Rapid Response

Spontaneous pneumothorax

Crohn’s disease and GI perforation

JUSTIN REYNOLDS*, a 22-year-old man, arrives at the medical–surgical unit for a diagnostic workup after reporting abdominal pain, diarrhea, vomiting, and weight loss for 3 days. Justin doesn’t drink alcohol or use tobacco products. He reports a history of Crohn’s…

Serotonin syndrome

A 54-year-old woman arrives at the ED with flu-like symptoms, including fatigue, muscle aches, and a mild fever. Her medical history includes depression, which…

Alpha-gal syndrome

A 67-year-old woman arrives at the ED in distress. She tells the ED triage nurse that about 3 hours after eating beef nachos, she…

Pericarditis

Pericarditis, an inflammation of the pericardial sac, typically occurs as a result of a viral infection. It’s most common in men between 20 and…

Malignancy-induced hypercalcemia

A 69-year-old man arrives in the ED with reports of persistent fatigue, nausea, vomiting, anorexia, excessive thirst, increased urination, and back pain for 3…

Spontaneous pneumothorax

A 19-year-old man with no significant medical history, develops sudden, sharp, left-sided chest pain while playing basketball. After 8 hours, his pain…

Crohn’s disease and GI perforation

JUSTIN REYNOLDS*, a 22-year-old man, arrives at the medical–surgical unit for a diagnostic workup after reporting abdominal pain, diarrhea, vomiting, and weight…

Serotonin syndrome

A 54-year-old woman arrives at the ED with flu-like symptoms, including fatigue, muscle aches, and a mild fever. Her medical history includes…

Alpha-gal syndrome

A 67-year-old woman arrives at the ED in distress. She tells the ED triage nurse that about 3 hours after eating beef…

Practice Matters

Alleviating nurse fatigue

Today's nursing workforce spans multiple generations, each with distinct needs, strengths, and challenges. Addressing generational differences as healthcare evolves remains essential for mitigating nurse fatigue and ensuring a resilient, sustainable workforce, according to a study by Sanches and colleagues.

This article is available to American Nurses Association members and ANJ subscribers only.

Already a member? Log in here

Mental Health access

A culture shift from stigma to support Being a nurse is one of the most meaningful professions. Each day offers the opportunity to heal,…

Have you ever served?

Although change is inevitable, experiencing several changes simultaneously can lead to significant stress. Each year, according to the Government Accountability Office, approximately 200,000 U.S.…

Breast cancer: Personalized prevention for women

Through evidence-based education and shared decision-making, nurses play a vital role in closing knowledge gaps and empowering all patients at risk for breast cancer.…

We want you! Professional writing in nursing

Professional writing plays a vital role in nursing. By sharing clinical expertise, innovative strategies, and critical perspectives, nurse authors make meaningful contributions to both…

Geriatric urosepsis: Prevention and detection

Despite extensive research and updates to practice guidelines, urinary tract infections (UTIs) remain a common occurrence within long-term care (LTC) facilities. The…

Vital conversations

Nurses’ key role in engaging patients about vaccine safety, effectiveness VACCINATION is one of the most impactful public health interventions worldwide. The…

Ethics of disclosure in pediatric end-of-life care

A 17-year-old girl with a terminal diagnosis has an estimated 3 weeks to live. Both parents, who understand the situation, are religious…

From the Ethics Inbox

Fostering a workplace where nurses can flourish

I’m the Nurse Manager for a 34-bed medical–surgical unit and pursuing my DNP in nursing leadership. My school has a strong focus on ethics, and I want to incorporate the Code of Ethics for Nurses (Code) into my schoolwork and…

Everyday ethics: Interconnected care in a changing world

It seems like the revised Code of Ethics for Nurses, with the addition of Provision 10, is taking us beyond the bedside and our healthcare facilities and into the wider world. Why do we need an additional provision to the…

Balancing life and death transitions

I’m an ICU Nurse at a hospital that frequently procures organs from patients who’ve given consent to donate on their driver’s licenses. In some…

Everyday ethics: Addressing gun violence

As an RN working in the labor, delivery, and post-partum unit, I’ve witnessed the impact of gun violence on patients and families, both through…

Everyday Ethics: Supporting cultural values and health equity

I work in the obstetrics department of a community hospital. Our patients include immigrants and refugees who don’t speak English and have cultural practices…

Everyday ethics: Hear something, say something

Recently, I witnessed something that made me uncomfortable. I was surprised when one of my more senior nurse colleagues referred to a newly graduated…

Fostering a workplace where nurses can flourish

I’m the Nurse Manager for a 34-bed medical–surgical unit and pursuing my DNP in nursing leadership. My school has a strong focus…

Everyday ethics: Interconnected care in a changing world

It seems like the revised Code of Ethics for Nurses, with the addition of Provision 10, is taking us beyond the bedside…

Balancing life and death transitions

I’m an ICU Nurse at a hospital that frequently procures organs from patients who’ve given consent to donate on their driver’s licenses.…

Everyday ethics: Addressing gun violence

As an RN working in the labor, delivery, and post-partum unit, I’ve witnessed the impact of gun violence on patients and families,…

Perspectives

Beyond the metrics: The human work of leading from the middle

Where leadership meets the work: Lessons from my first year as a nurse leader

The silent epidemic: Social isolation is harming our seniors

Limiting access to graduate nursing education: A policy shift that threatens workforce stability and public health

Beyond the metrics: The human work of leading from the middle

Middle leaders, especially nurse managers, live at the intersection of strategy and lived experience. We’re close enough to feel every shift in…

Where leadership meets the work: Lessons from my first year as a nurse leader

When I stepped into my first nursing leadership role, I thought I understood what leadership meant—to coordinate, organize, and support. Yet within…

The silent epidemic: Social isolation is harming our seniors

The last time Mrs. Gates spoke to another person was 5 weeks ago. At 70, she’s lived alone since her husband died…

Limiting access to graduate nursing education: A policy shift that threatens workforce stability and public health

The pathway into nursing is rarely straightforward. I grew up in a working-class family, and college felt out of reach, but with…

Community

Transitions as literary signposts: Powerful guides for the reader’s journey

Classifying AI use in writing for publication

Strengthen health systems worldwide: Invest in nursing professional development

Healthcare workers are the bedrock of an effective healthcare system and nurses comprise nearly 60% of the global healthcare workforce. Despite this…

Remembering Eloise Richardson

During World War II, countless women answered the call to serve, stepping into roles that reshaped history and helped turn the tide…

News

ANA “deeply disturbed” by Minnesota shooting death of ICU nurse Alex Pretti

New federal loan limits will worsen America’s nursing shortage and leave patients waiting longer for care

Excluding nursing from professions list limits graduate loan eligibility

Proposed regulations before the U.S. Department of Education would exclude nursing from the list of graduate programs eligible for up to $200,000…

Once a Patient’s in Custody, ICE Can Be at Hospital Bedsides — But Detainees Have Rights

In July, federal immigration agents took Milagro Solis-Portillo to Glendale Memorial Hospital just outside Los Angeles after she suffered a medical emergency…

My Nurse Influencer

What honors code taught me about teaching

Until recently at my institution, each student signs a paper honor code at the start of an exam. The back of that sheet doubles as scratch paper. While proctoring, I began to notice something curious. Some students who finished early…

Transitions as literary signposts: Powerful guides for the reader’s journey

Even with GPS, drivers still need signposts to know where they’re going on their travels. Similarly, readers need signposts to guide them on their reading journey. Transitions are essentially “literary signposts” that make it easier for readers to move from…

The Gifts We Do Not See

The holidays may be behind us, but this blog by Fidelindo Lim, DNP, CCRN, FAAN, offers some critical insights into the enduring humanism of…

Gratitude and meaning can keep nurses going

Research continues to affirm what many of us intuitively know: gratitude is good and good for our health. A study has shown that people…

You’re wearing that to work?

Few undergraduate programs pay as much attention to attire as nursing. At every clinical orientation, dress code policies are reiterated with the familiar warning:…

What’s new in the 2025 hypertension guideline?

The American Heart Association released its latest hypertension guideline in August 2025, establishing best practices for diagnosing and managing a disease that remains the…

What honors code taught me about teaching

Until recently at my institution, each student signs a paper honor code at the start of an exam. The back of that…

Transitions as literary signposts: Powerful guides for the reader’s journey

Even with GPS, drivers still need signposts to know where they’re going on their travels. Similarly, readers need signposts to guide them…

The Gifts We Do Not See

The holidays may be behind us, but this blog by Fidelindo Lim, DNP, CCRN, FAAN, offers some critical insights into the enduring…

Gratitude and meaning can keep nurses going

Research continues to affirm what many of us intuitively know: gratitude is good and good for our health. A study has shown…

Mental Health

Choosing the right restraint

Nurses at the bedside are experts in driving the safest, most effective patient care. In some cases, nursing assessment and clinical judgment…

Not just “eating our young”: Workplace bullying strikes experienced nurses, too

Even though nursing is a profession of caring and compassion, bullying exists in many forms in it. Bullying threatens teamwork, morale, communication,…

Critical Care

Promoting safe use of parenteral anticoagulants

Parenteral anticoagulants—unfractionated and low-molecular-weight heparin—primarily are used to prevent and treat VTE (deep vein thrombosis [DVT] and pulmonary embolism [PE]) associated with…

Neuroleptic malignant syndrome

Neuroleptic malignant syndrome, a life-threatening neurologic emergency, frequently occurs with dopamine antagonists (antipsychotics and antiemetics).

Pediatrics

Take Note – Sept/Oct 2009

Patients lose when nurse staffing is insufficient Heavy workloads and insufficient staffing affect patient care, according to about 2,000 nurses surveyed worldwide…

I’m just going to say it: It feels like we’re playing Russian roulette with our kids and our staff

Apoorva Mandavilli, a journalist from the New York Times, graciously interviewed me about what reopening of schools looks like in the midst of…

Cardiology

Transesophageal echocardiography: Getting a clearer view

This minimally invasive approach provides an unobstructed view of nearly all cardiac structures.

Take Note – March 2007

Previous hospital-room occupants may spread MRSA and VRE The risk of acquiring methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) infections increases…

American Nurse TV

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HealthCom Media, the publishers of American Nurse Journal, the American Nurses Association and Al Roker Productions collaborated to bring a few shining examples of the exemplary work being done by nurses in today’s very challenging healthcare environment to the American public.

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