Archive for September, 2009
September 30, 2009
By Diana J. Mason, RN, PhD, editor-in-chief emeritus
Yesterday, nurses and other health care workers from New York State went to the state capitol in Albany to protest a regulation issued by the New York State Department of Health mandating that all health care workers get vaccinated for both the seasonal flu and for the pandemic H1N1 2009 influenza by November 30th or lose their jobs. Deborah Gerhardt, RN, who was interviewed by USA Today, says she may have to lose her job because she doesn’t have confidence in the safety of the new H1N1 vaccine: “Just because the FDA approved the H1N1 vaccine ‘doesn’t mean it’s safe in my book.’”
New York State Commissioner of Health Richard Daines, MD, disagrees, and followed up an open letter to health care workers released on September 24th with a press conference to defend the new policy. The New York State Nurses Association, which urges nurses to get vaccinated but is against mandatory vaccinations, wrote their own open letter in response.
Citing one study of health care workers during a mild flu season that showed that 23% of the workers showed evidence of having had the flu that season but that 59% of these said they didn’t have the flu that year, Daines said that his concern is that workers are carrying the virus and exposing at-risk patients without realizing it. When challenged on whether family members and other visitors represent an equally great threat to patient safety, Daines noted that some hospitals would close their doors to visitors if an infectious disease were spreading.
Should we have a choice? Does our health and safety come before that of our patients?
For more on the ethics and safety of getting vaccinated, see these recent blog posts as well:
Nurses Express Safety Concerns About H1N1 Vaccine
Is It Ethical for a Nurse to Decline the H1N1 Vaccine?
Posted in ethical issues, H1N1 virus (swine flu), legal issues, nursing perspective | Tagged flu pandemic, flu pandemic preparedness, influenza vaccine, mandated vaccinations, New York State, patient safety, regulation, swine flu vaccine, vaccination policy, vaccine safety | 8 Comments »
September 29, 2009
By Shawn Kennedy, MA, RN, AJN editorial director & interim editor-in-chief
'Nuff Said by ElektraCute / Elektra Noelani Fisher, via Flickr.
While many people (including nurses) remain relatively unworried about the coming flu season, others, it seems, are on high alert. I do wonder about the millions of dollars being spent (and being made) in the name of H1N1 (swine flu). I’ve heard of several seminars touting “must-know” facts and bearing titles that might make hospital administrators feel negligent if they don’t send staff (at hefty registration fees). Many companies, including mine, are distributing bottles of hand sanitizer to employees. And I can’t even imagine how many N95 respirators have sold since the Institute of Medicine (IOM) recently recommended their use by health care workers caring for patients with pandemic (H1N1) 2009 influenza.
Take it seriously. Still, as a former emergency nurse, I’m all for being prepared for disasters. This influenza should be taken seriously. As of September 20, the World Health Organization reports there have been 3,917 deaths and more than 300,000 confirmed cases worldwide, although the actual number of cases is probably much higher. The latest surveillance report from the Centers for Disease Control and Prevention indicates widespread flu activity throughout much of the United States already this year.
Mandated vaccinations for health care workers. The unusually high number of U.S. cases last spring—not typically flu season in the northern hemisphere—have some asking whether we’re in for a more severe and more deadly flu season, which officially begins on October 4. Read the rest of this entry ?
Posted in H1N1 virus (swine flu), nursing perspective, Shawn Kennedy, AJN editor-in-chief | Tagged controversial, disaster care, ER closed, H1N1, mandated vaccinations, N95 respirators, preparedness, swine flu | Leave a Comment »
September 28, 2009
By Alison Bulman, AJN senior editorial coordinator
the school bus routine by woodley wonderworks, via Flickr.
On Friday the New York Times reported that a shortage of school nurses is making students more vulnerable to the pandemic (H1N1) 2009 virus, stating that “[m]any districts have few or no nurses to prevent or respond to outbreaks, leaving students more vulnerable to a virus that spreads easily in classrooms and takes a heavier toll on children and young adults.”
The article acknowledges the key role played by school nurse Mary Pappas, who we interviewed for this blog shortly after she’d helped identify the first U.S. cases of H1N1 at a school in Queens. As AJN reported in June, school nurses have been and will continue to be on the front lines of efforts to prevent or manage outbreaks. But the school nursing shortage is acute, with just one nurse for every 1,155 students nationally, a ratio that the American Federation of Teachers has called “dangerous.” With a new school year underway, the Times reports, school districts are relying more heavily on non–health care personnel to identify and isolate sick kids and monitor absences.
For more on issues related to school nurses and nursing, see these recent posts:
Can School Nurses Help Prevent Heat Stroke Fatalities in High School Football?
Nurse Organizations Oppose Move to Allow Non-Licensed Personnel to Give Insulin to Students
Posted in children's health, H1N1 virus (swine flu), nursing shortage, school nurses | Tagged H1N1, Mary Pappas, nursing shortage, school nurses, swine flu | 1 Comment »
September 25, 2009
By Peggy McDaniel, BSN, RN
As a long-time fan of ER and Grey’s Anatomy, I looked forward to watching the first episode of Mercy, an NBC drama that focuses on three nurses instead of using doctors as the primary characters (click the image to visit the show’s Website, where you can check out the first episode). At the same time, while I’ve often laughed aloud at the tasks doctors are seen doing on Grey’s Anatomy, such as putting patients through a CT scan, it’s the characters that make the show compelling—and as a clinician, I choose to enjoy them and ignore that you rarely see a nurse at the bedside.
ER, unlike Grey’s Anatomy, featured what I would consider “real” nurses doing “real” nursing tasks backed by intelligence, education, and intuition. Maybe it made a difference that it was originally created by Michael Crichton, a doctor who obviously knew something about what happens in a clinical setting. ER skillfully blended clinical action and personal stories of strong, engaging characters. As a clinician, I loved the accuracy and drama.
I have mixed feelings about Mercy. The first episode introduced the characters, who appeared to be at least interesting, if not scintillating. Veronica, the primary character, suffers from PTSD after her return from service in Iraq. While she showed a slightly softer side in the end, I couldn’t get past her rude comments and actions to both coworkers and patients. I understood that she was sharp and competent, but her stressed-out, edgy manner distracted more than engaged me, and I yearned for a more positive portrayal of competent nursing. Read the rest of this entry ?
Posted in media depictions of nursing, nursing perspective, professional identity | Tagged combat nurse, ER, Gray's Anatomy, Mercy, NBC, PTSD, TV | 3 Comments »
September 24, 2009
Kaiman's "Self-Portrait," September cover
Charles Kaiman, a clinical nurse specialist in psychiatric mental health nursing at the New Mexico Veterans Affairs facility in Albuquerque, is also an acclaimed artist. This month we feature his work both on our cover and in Art of Nursing. In On the Cover, Kaiman offers thoughts on his painting technique, which he calls “a form of visual meditation,” and describes how it clears the mind. If you’re in the New York City area in early October, come check out his show at the Blue Mountain Gallery at 530 West 25 Street in Manhattan, October 6 through 31. For more information, visit the artist’s Web site.
Sylvia Foley, AJN senior editor
Posted in art and nursing, healing/holistic, male nurses | Tagged Charles Kaiman, clinical nurse specialist, meditation, nurse artist, painting technique | Leave a Comment »
September 23, 2009
By Barbara Glickstein, MPH, MS, RN. Glickstein is an independent broadcast journalist in NYC and a member of AJN‘s editorial board.
I’m a feminist, public health nurse, and journalist. I know how powerful the mass media is, and I keep an eye on how it represents women—as well as on how it represents and reports about nurses and nursing.
Last week was Fashion Week in New York City and the top designers, after-parties, gossip, and trends were analyzed and criticized. Even so, I was pretty surprised last Saturday when I found two separate NY Times articles on Fashion Week referring to nurses. One by Cathy Horyn, “Even Walking Away, They Still Look Good,” had this line describing a dress by a designer: “One of Ms. Scott’s signature headmistress dresses, in pink wool, had a candy-striper pink collar. It didn’t exactly say ’nurse.’”
The second article, by Guy Trebay, quoted fashion designer Cynthia Rowley, who described a waitress “moving with gymnastic ease” through the crowd while adorned in an elegant dress at a new hot spot in Manhattan: “When you come in and see her, at first she’s like a beautiful nurse in white, bringing you your cocktail.” When once she’s dispensed her curative potions, Ms. Rowley added, the nurse–waitress magically “becomes an angel.” And, after a certain amount of time on the job at the Boom Boom Room, the nurse–angel–waitress, Ms. Rowley suggested, “may well ’become a bride’ to one of the monied denizens of this very world.”
Here’s the recap on the images: nurse as candy striper (usually a volunteer, unpaid and often of high school age) or this one: nurse → angel → bride (to very rich man). Here we are in the heat of a national debate on health care reform—there are two sexist images of nurses in the fashion section and not one story about our critical role in health care reform. Why aren’t we on the front page and out of the fashion section in the 21st century?
Posted in media depictions of nursing, professional identity | Tagged Boom Boom Room, candy striper, cliches, fashion, feminism, nurses, NY Times, sexist | 3 Comments »
September 22, 2009
A few weeks ago I came across an article in a Virginia newspaper in which reporter Mike Owens wrote about the arrest of James Wright, who was indicted on four counts of aggravated sexual battery against different patients in a nursing home where he worked as a nurse’s aide from 2000 until 2007. The nursing facility, NHC HealthCare – Bristol, is one of 76 facilities owned by National HealthCare Corporation. According to the story, staff members—from peers to administrators—had known about Wright’s abuse of patients for years, but nothing was done to stop it until Patty Davenport, another nurse’s aide, frustrated and appalled that no action was being taken, lodged a complaint with the Office of the Attorney General of Virginia.
To me, Davenport is a hero. But why did this take so long to come to light? A more recent article by Owens reports that several staff have accused the then director of nursing, Anne Franklin, of “trashing” their written complaints about Wright.
Through her attorney, Franklin denies this. I hope it’s not true. I’d like to think that any nurse who learned of such egregious acts would immediately take action to protect patients and blow the whistle long and hard. Read the rest of this entry ?
Posted in ethical issues, human rights, legal issues, media depictions of nursing, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged National HealthCare Corporation, nurse's aide, nursing home, responsibility to report, sexual abuse | Leave a Comment »
September 21, 2009
By Diana Mason, editor-in-chief emeritus
Ann Keen
First, the necessary throat-clearing about who and where: I recently attended a public session held by the Institute of Medicine Initiative on the Future of Nursing. Chaired by University of Miami president and former secretary of Health and Human Services Donna Shalala and chief nurse for Cedar Sinai Medical Center Linda Burnes Bolton, the session began with presentations by two nurses involved in the Prime Minister’s Commission on the Future of Nursing and Midwifery in England: Ann Keen, Member of Parliament and Parliamentary Undersecretary for Health Services, who chairs the British commission; and Jane Salvage, the lead secretariat for the commission and a former contributing editor for AJN.
Now the point: During the formal session, Keen noted that various countries in the UK each have a chief nurse officer (CNO) who is responsible for developing a national nursing strategy. Afterwards, I interviewed Keen and Salvage, who both said they didn’t understand why American nurses were not supporting the call for a CNO for the United States, one who would be charged with developing and overseeing a national nursing strategy for this nation. In their eyes, a CNO who is on par with the surgeon general could help the nation to develop approaches to ensure an adequate nursing workforce, identify barriers to their full utilization, identify new models of care to better promote the health of the public, and develop strategies for removing the barriers that impede forward movement.
Opposition from nursing groups. In the U.S., organized nursing has largely opposed the efforts of a group of grassroots nurses who are calling for the establishment of an Office of the National Nurse. Read the rest of this entry ?
Posted in Diana Mason, editor-in-chief emeritus, health care reform, international nursing, nursing perspective, nursing shortage, professional identity | Tagged CNO, Donna Shalala, IOM, national nurse | 21 Comments »
September 18, 2009
Gertrude (not her real name; other identifying details have been changed) was 99 years old. Having survived the Holocaust and overcome many other challenges in her long life, she thought it ironic that she had to ask her children to help her die.
Although she was not terminally ill, the quality of her life was significantly diminished by many chronic ailments. Despite two hearing aids, her hearing loss was such that she could no longer indulge her one remaining pleasure: listening to classical music. She had fallen and broken a hip when she was 96 and now had to use a wheelchair when moving around her apartment. She had severe arthritis, and she rarely left her apartment except for medical appointments. All friends and many family members had long since died, and her deteriorating vision-a result of a recent bout of shingles-left her unable to read or watch television. After years of living with these and other chronic conditions, she told her family she was tired of life and was ready to leave. Her children and grandchildren told her to be patient. She was almost 100; surely she would soon die peacefully in her sleep.
The tone and frequency of her requests for help in dying changed dramatically after her ophthalmologist told her she would never regain her vision.
Read the rest of “Gertrude’s” story in the September issue of AJN here, and also a discussion of the ethics and legality of talking to patients about options for voluntarily ending their own lives. The author, Judith Schwarz, works for an end-of-life advocacy organization, and her position may be controversial with some readers. We invite respectful conversation on this or related issues. Whatever our beliefs or opinions, this is a topic we shouldn’t shy away from, since, as Schwarz points out, studies have revealed that a large percentage of nurses will at some point be asked by patients for help or advice about ending their lives.
Nurses, have you ever been confronted with such a request, whether for active help or for advice? And if so, how did you handle it?
Posted in ethical issues, healing/holistic, palliative care | Tagged controversy, end of life, ethical, Holocaust survivor, legal, palliative care, quality of life, stopping eating and drinking, suicide | 1 Comment »
September 17, 2009
Shawn Kennedy, MA, RN, AJN editorial director & interim editor-in-chief
by bludgeoner86/via Flickr
Earlier this month, Diana Mason, AJN’s editor-in-chief emeritus, wrote here about head injuries in soccer. A related news story about high school sports should make all school nurses, coaches, and parents take notice: student athletes suffer—and sometimes die—from heat stroke during intense workouts in hot weather.
According to an Associated Press report, Fred Mueller, director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina, attributes 39 deaths since 1995 to heat-related causes. And that doesn’t count three deaths this past summer that he notes may also be associated with heat stroke.
Most of the deaths are associated with football preseason training in August. My middle son played high school football and every August he went to “preseason camp.” He and his teammates slept on air mattresses in the non-air-conditioned high school gym, and spent the last week of summer vacation in grueling drills and practices, wearing shorts, T-shirts, shoulder pads, and helmets. One year he arrived home looking thin and gaunt. He related stories of teammates vomiting on the sidelines during practices and of restricted water breaks. It took a player fainting during one session and an onslaught of parent complaints and pressure on school administrators (the word “lawsuit” does get attention) for coaches to change their methods. Read the rest of this entry ?
Posted in children's health, nursing perspective, school nurses, Shawn Kennedy, AJN editor-in-chief | Tagged coaches, guidelines, heat stroke, high school football, safety | 2 Comments »
