Archive for June, 2011

h1

Tragedy into Policy: A Hepatitis C Outbreak and a Study of Nevada RNs Lead to New Protections for Whistleblowers

June 7, 2011

By Sylvia Foley, AJN senior editor

In 2008, more than 62,000 people who had undergone procedures at one of two southern Nevada endoscopy clinics were notified that “they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices.” As author Lisa Black reports in this month’s CE–Original Research feature, a subsequent investigation by federal and state agencies found multiple breaches of infection control protocols. Indeed, 115 patients were found to be “either certainly or presumptively infected” with HCV through the reuse of contaminated medication vials.

Especially distressing was strong anecdotal evidence that because of a general fear of workplace retaliation, staff at the two clinics had often failed to report unsafe patient care conditions. At the request of the Nevada legislature, a study was conducted to examine Nevada RNs’ experiences with workplace attitudes toward patient advocacy activities. Black was the principal investigator. Read the rest of this entry ?

h1

A Primary Source Reminder from the Early Days of HIV/AIDS

June 6, 2011

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week, I received a press release from the National Institutes of Health noting the publication 30 years ago of the first ‘official’ report that many consider to have heralded the beginning of the AIDS epidemic—a report in the MMWR (Morbidity and Mortality Weekly Report), a publication of the Centers for Disease Control and Prevention (CDC), about cases of Pneumocystis carinii pneumonia and Kaposi’s sarcoma in otherwise healthy young men who all happened to be gay.

This report (which included various causative theories, including speculation that the weakened immune system among these gay men might somehow have resulted from the use of lifestyle drugs such as amyl nitrate!), seemed late in coming for those of us who’d been seeing unusual infections among gay men since the mid-1970s.

In 1975, I became aware of these young men when they started coming for diagnostic consultation with the physicians I worked with in a private hematology–oncology practice in New York City. No one could figure out why they had developed opportunistic infections that were normally seen only in patients who’d been on chemotherapy or who had other immune disorders. We talked about the fact that similar cases were being seen at the (now defunct) St. Vincent’s Medical Center in Greenwich Village. Read the rest of this entry ?

h1

The Monkey in Room 100

June 2, 2011

By Karen Gonzol, MSN, RN. Karen is an assistant professor in the division of nursing at Shenandoah University in Virginia. This is her first post for AJN.

I saw him again, just a few days ago. It has been nearly two years since Mother died, but there he was, peering at me from his perch in my sister’s laundry room.

Mother had been placed on hospice care for her congestive heart failure. She settled somewhat reluctantly into the nursing home and waited for the end.

As she discovered that the wait was going to be much longer than she’d planned, she decided to go on with living. Her room was on the first floor, with a window facing out into the courtyard. The staff loved her, and she loved to tease them. She made an effort to learn their names, and when she couldn’t remember she made up nicknames, such as “Bow Lady” for the assistant who always wore a huge bow to tie back her hair. One July day she began asking, “Do you see those monkeys in the tree out there?” Read the rest of this entry ?

h1

Bullying Wars: Theresa Brown vs. ‘the entire physician profession’

June 1, 2011

By Maureen Shawn Kennedy, AJN editor-in-chief

On May 11, an op-ed piece written by nurse and New York Times blogger Theresa Brown on bullying by physicians caused some physicians to protest (full disclosure: Brown’s honest and moving ethical meditation on a very different topic, “Right Treatment, Right Patient?”, was just published in our June issue).

Notable among her critics was Kevin Pho of the popular blog, Kevin MD, who wrote that Brown “unfairly blames doctors for hospital bullying.” He claimed that Brown uses her writing outlet to “metaphorically bully the entire physician profession.” Another commentary (by physician Ford Vox, writing in The Atlantic Monthly) accused Brown of publicly “drawing and quartering” her colleagues.

Spare me, please. Brown used a recent personal encounter to illustrate a problem that is, unfortunately, commonplace in hospitals.  She used it as a lede and parlayed the story into an insightful piece about bullying in hospitals.  (From experiences I had and witnessed during my clinical years, I actually thought it was a fairly mild example.) Ironically, the strong language used to counter Brown’s commentary made it seem that physicians were trying to bully Brown into silence because she’d spoken out. As if to say: how dare a nurse challenge physician behavior?  Read the rest of this entry ?

Follow

Get every new post delivered to your Inbox.

Join 258 other followers