Archive for the ‘media depictions of nursing’ Category

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Placenta Facebook Photos: Nurse and Mommy Tribes See Student Expulsion Differently

January 12, 2011

By Shawn Kennedy, AJN editor in chief

Many of you may be familiar with the recent “nursing-in-the-news” topic involving nursing students and a placenta. (For those who’ve been out of touch, here it is in a nutshell: three students were involved in photographing themselves with a placenta from a recently delivered mother and posting it on, where else, Facebook. The students were expelled. One student sued; the judge ordered all the students reinstated. See this article by the Kansas City Star that sums it up.)

The incident has provoked debate on various Web sites, including our own Facebook page, where the discussion mainly concerns whether the students were treated fairly or too harshly:

“It’s a placenta. I agree that it can seem a bit juvenile to photograph yourself with it, but an offense worthy of expulsion?”

“Juvenile? Perhaps. Punishable by expulsion? Absolutely not, imo. What exactly was wrong with taking a picture of a placenta? It’s not like you can identify who the placenta came from.”

“I think she should be punished but not expelled. in all reality a placenta is medical waste after delivery but it showed no respect for her patient, which needs to be addressed.”

And a really interesting question:

“Would she have been handed the same punishment had it been a picture of a full bed pan?”

Other sites also argue the “no harm, no foul” rationale—since there was no way to link the organ to a patient and so no breach of privacy, what was the harm? Comments on one of several posts about this issue at Those Emergency Blues came out in favor of the students. Nurse and blogger Phil Baumann’s post, “The Placenta Incident and The Shawshank Redemption,” did as well.

The school did seem to react harshly, especially when there seems to be some question as to whether the clinical faculty member might have been aware of the students’ activities.

However, there was a decidedly different tone on a blog called The Stir at CafeMom, a Web site focusing on pregnancy and motherhood, that should give us pause. Author Jean Sager writes the following in a post called “New Pregnancy Fear: Who’s Got Your Placenta Now?”: Read the rest of this entry ?

Posted in ethical issues, legal issues, media depictions of nursing, nurses, nursing perspective, nursing students, patient perspective, professional identity, Shawn Kennedy, AJN editor-in-chief, social media | Tagged , , , , , , , , , | 18 Comments »

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Dr. Oz’s Sexy ‘Nurses’: Here We Go Again

December 8, 2010

By Shawn Kennedy, AJN interim editor-in-chief

In the “what could he have been thinking?” category, Mehmet Oz, MD, wins first place—well, at least, for now. I’m sure someone else will come along soon and take his place.

In case you’ve been MIA the last month, Oz became a target for nursing ire when, on his November 4 show, he danced with several women who were wearing nurses’ uniforms revealing red lingerie. The segment apparently had nothing to do with nurses, but rather weight loss through dancing. (So of course that would make one think of nurses with red lingerie???)

I’m hoping it was a case where he “just didn’t think”—rather than that he thought that the segment might possibly offend nurses but decided to go with it anyway. Dogged by a letter-writing campaign spearheaded by Sandy Summers of the nursing image advocacy and watchdog group, The Truth About Nursing, and from criticism from other nursing groups like the American Nurses Association, Oz apparently released a statement on December 6 apologizing, according to various news reports. However, one can’t find it anywhere on his Web site or on the Web, for that matter.

It’s always interesting to see the level of offense colleagues and others feel. Comments posted on news sites carrying the story ranged from “oh geez, when did everyone get so freaking sensitive about everything?” and “I am a nurse and I can honestly say this doesn’t bother me one single bit. Some people really need to get a grip on life” to “I like Dr. Oz, but I have to agree, it was poor taste.” I have to say the majority of comments I read did not view this as something worth making a fuss about. In fact, The New York Daily News included a poll asking if the segment was offensive: 51% of respondents voted “of course not, it’s just a joke”; 22% voted “absolutely, he shouldn’t have done it”; and 26% voted “who cares?”

I myself am torn at times as to which battles are worth making a ruckus about, but not this time. The Dr. Oz Show—and yes, it is a TV show, so it’s first about entertainment and ratings—is purported to be about health teaching; it refers to Oz as “America’s doctor.” Oz has millions of viewers who take their cues from him. In this instance, he clearly pandered to entertainment and crowd pleasing.

So I wonder about his credibility—what else does he not think through thoroughly? Does he really carefully think about the health information he shares with his audience, or is that something staffers prepare and he just delivers? Oz blew it, and I’m grateful for Sandy Summers and other individuals and groups that watch out for nursing and raise awareness

When the Dr. Oz show was being developed, I received a call from someone on the staff asking if I (meaning AJN) would help promote the show. I told him I couldn’t do that; I said I could write a review about it, but only after seeing several segments to judge the content and I couldn’t guarantee it would be favorable. He kept trying to “sell me” on the show, how it was going to be different and couldn’t I write something before it aired so nurses would at least watch. I made him a deal: I said I would write something to urge nurses to watch if they had a nurse co-host, because THAT would be different to see. Stammer, silence, thank you for your thoughts, we’ll take that under consideration, yada yada.

What message would it send to viewers if Oz had a nurse co-host, as a colleague? I challenge TV health programmers to be different—nurses are (for the 9th consecutive year) the most trusted profession. When are you guys going to get it?

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Posted in media depictions of nursing, nursing perspective, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , , | 3 Comments »

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On the Road to the Future of Nursing

November 29, 2010

By Shawn Kennedy, interim editor-in-chief  

by wfyurasko/via Flickr

I’m writing this on the train to Washington, DC, heading to the National Summit on Advancing Health through Nursing, which is taking place November 30 and December 1. This is the next step of the Robert Wood Johnson Foundation’s Initiative on the Future of Nursing (see my October 8 blog post) and will launch the Campaign for Action—the plan for implementing the recommendations of the Institute of Medicine’s report, The Future of Nursing. (You’ll be able to access the webcast and a live chat of webcast users on November 30 here.)

If you haven’t read anything about this initiative, do so. If you’re a nurse and plan to be working for the next 10 years, the recommendations from this report, if implemented, will affect you in some way. Expect to see changes in the following areas, to name just a few:

  • how and where nurses practice
  • undergraduate and graduate curricula
  • licensing and certification criteria
  • reimbursement policies
     

Other nursing initiatives have come and gone, some more successful in achieving their goals than others. AJN will cover the progress of this initiative as it attempts to evolve from a written report to an active process that creates sustainable change. As a start, in the December issue, now available at ajnonline.com, AJN brings you a guest editorial by Susan Hassmiller, director of the Initiative on the Future of Nursing. There’s also a summary and analysis of the report in AJN Reports, and a podcast interview with Marla Weston, CEO of the American Nurses Association, discussing the recommendations. And I’ll be posting updates here on the blog.

The weight of the IOM, the Affordable Care Act mandating health reform, the aging of America, and the numbers of Americans living with chronic diseases—all have come together to create the “perfect storm” for significant change. This is perhaps the best opportunity nursing will have in our lifetime to become a decision maker in shaping health care delivery in this country. Here’s hoping . . .

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Posted in media depictions of nursing, nursing shortage, patient safety, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged , , , , | 1 Comment »

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‘Goodbye Cherry Ames’ – On Whether Nurses Change the World

November 2, 2010

For a moment of respite from the beeps and buzzes, I walked back to the stillness of my office, wondering how I’d ever questioned the reason for the toughness and practicality of the nurses when I first came here. How could they be otherwise and survive?

But it wasn’t even 15 minutes later that a nurse about my age stood in my doorway and proudly introduced her college-age son. “Kids today have great opportunities,” she said. “He wants to change the world.” Then she looked away and said, “Me, I just do a job.”

I looked at her in disbelief. “You really feel you aren’t changing the world too, the world of these patients? People who come here with a chronic disease—who could view it as a life sentence? Don’t you realize that you help them know they can actually live with it, resume their lives, move ahead?”

She listened, but seemed unconvinced. Her eyes shining, she replied, “It’s me who learns from them, who’s come to realize that if I’m ever in a situation like theirs, I can go on.”

That’s an excerpt from “Goodbye Cherry Ames,” the Reflections essay in the November issue of AJN. It’s by a social worker who planned to become a nurse. Click through (the PDF version is best), read the short essay, and (if you’re feeling inspired) let us know in the comments below what you would have told that discouraged nurse.—JM, senior editor/blog editor

Posted in media depictions of nursing, nursing perspective, professional identity, writing and nursing | Tagged , , , , | 1 Comment »

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Harm Reduction or Stigmatization: What’s Your Approach to Drug-Addicted Patients?

November 1, 2010

By Alison Bulman, senior editorial coordinator

How much of your nursing education focused on how to handle drug addicts and substance abuse? Probably not much, according to speakers at a recent event I attended with my colleague Christine Moffa, AJN’s clinical editor, at the Center for Health, Media, and Policy at Hunter College.

The event was focused around a clip (longer than the one above) from “Bevel Up: Drugs, Users and Outreach Nursing,” an award-winning film by Canadian documentary filmmaker Nettie Wild. (A photo of a street nurse from the program appeared on AJN’s cover in July 2009, along with an article about the program.) Fiona Gold, BA, RN, and Juanita Maginley, MA, BSN, RN, whose work in Vancouver is the subject of the film, spoke on the panel about the value of harm reduction and about the systemic flaws and tendency to stigmatize drug addicts that prevent health care from reaching this population.

The powerful clip showed street nurses searching the city’s alleys and housing complexes for drug addicts, dealers, and sex workers. They carry bags full of syringes, condoms, and crack pipe mouthpieces which they deliver to those willing to take them. They ask street patients whether they might be pregnant, have unsafe sex, may have a disease, and if they want to have the nurses draw blood for testing.

The outreach project started in response to Vancouver’s alarming increase in HIV infections. Medical services were not reaching the most vulnerable people, so nurses devised a plan to go to them, a strategy they referred to as “meeting the client where they are.”

The nurses in the film show an amazing ability to balance gentle persistence and respect for the autonomy of their patients. We all know that some health care workers, including nurses, can be contemptuous of drug addicts, and may perceive addiction as self-indulgent and little more than a burden to the system. And far more money is spent on criminalizing drug use than on treating drug addiction as a disease.

My colleague Christine’s reaction to the clip reflected her experience as a nurse: ED nurses’ job “is difficult, and patients who are using drugs are not always easy to deal with.” But she also stressed that nurses don’t have a choice who they work with, and that the best approach we can take is to make sure they get enough training, both at school and at work, to meet the needs of this population.

To order the DVD of this film, which includes  a teaching module, go here. It’s sure to start some lively conversations among health care workers.

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Posted in advocacy/political action, HIV/AIDS, international nursing, media depictions of nursing, nursing innovations, nursing perspective, patient perspective, public health nursing, videos | Tagged , , , , , , , | 22 Comments »

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IOM Report: The Evidence Shows the Future of Health Care Rests on the Backs of Nurses

October 8, 2010

By Shawn Kennedy, AJN interim editor-in-chief

This past Tuesday, I attended the release of the highly anticipated (at least by nursing) report by the Institute of Medicine (IOM) on the future of nursing. Spearheaded and supported by the Robert Wood Johnson Foundation (RWJF), the report provides a review of nursing’s role in health care and details what changes need to occur for the future—not just of nursing, but for the future health of the health care system.

While the findings support what nursing has been claiming all along—that nurses have a critical role in health care and the health care system needs nurses to practice to the full extent of their capability—what is especially important about this report is that it is backed by the IOM’s multidisciplinary panel and an “objective evaluation of evidence according to the robust evaluation processes of the National Academy of Sciences,” said John Rowe, a committee member and professor at Mailman School of Public Health at Columbia University.

The panel at the public briefing for the release of the report included some health care heavyweights who voiced strong support for the findings:

Harvey V. Fineburg, president of the IOM: “One thing shouts out—nurses are critical to the nation’s health and central to the goals of high quality care.”

Risa Lavizzo-Mourey, president and CEO of the RWJF: “This is not a report about nursing but a report about a key missing piece to fixing health care; it establishes the centrality of nursing in providing safe, high quality, patient-centered care.”

Donna Shalala, president, University of Miami: “This report will usher in the golden age of nursing. Nursing has to be allowed to practice to the full extent of its scope of practice and to be a full partner with other professions in redesigning the U.S. health care system. It’s not about one profession substituting for another but about true collaboration.”

Later, in an interview I conducted with ANA CEO Marla Weston, she made a point of saying that allowing nurses to fully practice “isn’t just about NPs—nurses in all settings need to be allowed to practice according to their education and professional scope.  Nurses in institutional settings are often limited by bureaucratic policies and procedures.”

Prior reports by the IOM have spurred transformation of health care delivery—think of the 1999 report on medical errors, To Err is Human: Building a Safer Health System, and how that initiated a focus on creating a culture of safety and brought about new standards for hospital safety. I’m hoping the same will happen now with this report.

What the MDs say. And I hope our professional colleagues will be open to the report’s findings, though I have some doubts. The American Medical Association issued a statement that, after initially noting that “health care professionals will need to continue to work together,” goes on to reveal that the AMA believes in  “a physician-led team approach to care—with each member of the team playing the role they are educated and trained to play.” Further, it says, “increasing the responsibility of nurses is not the answer to the physician shortage.”

In that they are correct—the report is not about nurses taking on the functions of physicians; it’s about nurses doing nursing and yes, some nursing and medical tasks and procedures are the same. Physicians need to change their entrenched way of thinking that they and only they know what’s best for patients (case in point: see “No Country for Old Women,” a recent blog post by AJN associate editor Amy Collins about her grandmother) and for health care. Otherwise, we will all fail those we purport to serve.

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Posted in advocacy/political action, audio interviews, health care reform, media depictions of nursing, nursing innovations, nursing perspective, nursing research, nursing shortage, patient safety, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged , , , | 6 Comments »

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After the Angels: In Search of A ‘Knowledge-Based’ Professional Identity

September 14, 2010

If you’re looking for angels, you’ve come to the wrong place. So says GuitarGirlRN in her latest blog post.

One stereotype of nursing (and it’s perpetuated by nurses as well as by those not in the medical or nursing fields) that bothers me is that of nurses as “angels of mercy.”

We’re expected to smile while up to our elbows in bloody shit and vomit, be pleasant to rude and sometimes violent people, put up with crap from doctors, managers, patients, their families, nurse techs, and janitors yet keep our cool, never cry, never sweat, never lose our tempers with each other, always be prepared and be right there when we are needed.

by shioshvili/via Flickr

Her point is that nurses are human; they do the best they can with scant resources, but they aren’t superhuman. They aren’t saints, they have lives of their own, and they can’t always be all things to all people. Back in 2005, noted author Suzanne Gordon wrote, with Sioban Nelson, an article for us called “An End to Angels.” In it, they presented the idea that nursing is a profession with a serious image problem, one that undercuts recruitment efforts and ill prepares new nurses for the reality of their work. The arguments in the article are subtle and thought provoking, and impossible to summarize. Here, anyway, is the introduction:

Nurses often disagree on the causes of and possible solutions to the current nursing shortage. Mandatory staffing ratios versus Magnet hospitals? Sign-on bonuses for nurses versus more unionization of RNs? The aging of the nursing workforce versus working conditions? Still, most nurses agree that the profession needs a contemporary image to attract new recruits and reinforce the idea that nursing is a profession grounded in science, technology, and knowledge. To present a modern image and solve the crisis, dozens of different groups have produced advertising campaigns and promotional messages to attract new recruits to the profession.

A close analysis of the words and images used in these campaigns reveals that, instead of creating a modern, accurate version of today’s nurse, many simply repackage nursing’s traditional stereotype of women born to be good, kind, and self-sacrificing-not educated to provide care based on science and practical skill. Although many studies-conducted by nursing, medical, and public health researchers-have documented the links between nursing care and lower rates of nosocomial infections, falls, pressure ulcers, deep-vein thrombosis, pulmonary embolism, and death, most promotional campaigns are conspicuous for their failure to promote these data. Even when ads feature a mix of men, women, and minorities, what is often communicated is a sexist, archaic message: nursing is virtuous work.

The subtitle of Gordon and Nelson’s article is “moving away from the ‘virtue script’ toward a knowledge-based identity for nurses.” So, five years on, how is the nursing profession doing with this? Do you feel you have a “knowledge-based” professional identity? Is that how patients, physicians, nursing instructors, administrators, your friends and family, and the general public see you?—JM, senior editor

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Posted in healing/holistic, media depictions of nursing, nursing perspective, nursing shortage, patient perspective, professional identity | Tagged , , | 4 Comments »

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You Call This a Promotion? The Return of Nurse Hawthorne

June 24, 2010

By Amanda Geer, AJN administrative coordinator

Tuesday night’s season two premier episode of HawthoRNe was a good example of doing what you can with limited resources. After the closing of Richmond Trinity hospital and the relocation of the nursing staff to James River Hospital, the only hospital left open in the area, former Richmond Trinity chief nursing officer (CNO) Christina Hawthorne (played by Jada Pinkett Smith) is offered the nursing director role at James River. After just one visit to the hospital, she’s left with no choice but to take on the new role—for the patients’ sake as well as that of her old Richmond Trinity nursing staff.

With James River Hospital facing possible shutdown because of its below average patient care, Hawthorne is expected to improve the quality of care of the hospital in just three months. Challenges arise left and right: on her first visit to the hospital, she discovers problems ranging from a locked crash cart (one was stolen in the past) to excessively long waiting room times (a patient with severe abdominal pains waits over five hours before being seen) to the hospital’s very own CNO leaving a dead patient in a patient room disguised as a living patient because there isn’t any available space in the morgue.

Clearly this hospital is in need of a major reorganization. At moments I was reluctant to believe there really are hospitals that are forced to function with such poor working conditions. Do such places exist? Have you worked in them? Does Nurse Hawthorne have a chance?

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Posted in media depictions of nursing, patient safety, professional identity | Tagged , , | 1 Comment »

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Doing the Doctoring–A Nurse Who’s Filling the Primary Care Gap for Needy Children

May 27, 2010

By Peggy McDaniel, BSN, RN

A while back, a poll on the AJN Website asked if PhD-prepared nurses should be addressed as “doctor.” My answer was an emphatic “yes!” Janie, an old friend of mine, just graduated with her doctor of nursing practice (DNP) degree this past spring. She recently opened up her own clinic, serving kids as a primary health care provider in Portland, Oregon. She is the inspiration for my vote, but her chosen path isn’t easy.

Janie is filling a void in Portland that few providers are willing to address. She’s called Dr. Janie, and she well deserves the title. I have been a foster parent here in Oregon for the past few years. The kids that enter foster care often come from neglectful and/or abusive situations. These children can be hungry, fearful, wary, dirty, sad, and often confused and angry. They also deeply crave a sense of safety.

The state requires that these children be seen within 30 days of entering foster care. Getting them seen is a huge challenge. The requirement is, in theory, a great idea—these children often have multiple medical and psychosocial needs that have been neglected. But I couldn’t find a clinic in Portland that would take a “new patient” with welfare insurance within that time frame. It was often days or longer before I would find out basic information such as allergies about the children I was asked to care for. As a nurse, I found this lack of information to be unsettling, to say the least.

Janie has largely focused her practice on these children in need of prompt medical care. The article I linked to above points out the time and energy that Janie is willing to invest in these kids. I would argue that this style of “doctoring” is rarely seen in caregivers that do not have nursing as their base education. As the saying goes, “Once a nurse, always a nurse . . . ” From the reports of parents visiting Janie, this has never been more true.

There has been much discussion around nurses making a big difference in our health care system. Janie is a shining example of the new model of primary care—and a nurse on the front line. I’m sure there are many other nurses out there quietly answering the much debated question of how a nurse can be called a doctor.

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Posted in children's health, media depictions of nursing, nursing perspective, professional identity | Tagged , , | 7 Comments »

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The Manifold Talents of Nurses Who Are Artists

May 5, 2010

By Sylvia Foley, AJN senior editor

Ferris wheel through the sunroof in the rain, by aturkus / Alan Turkus, via Flickr

As the coordinator of AJN’s Art of Nursing department, I’m intrigued by intersections between the two fields: Art and Nursing. About a year ago I profiled several multitalented nurses (The Triple Talents of Some Nurse Bloggers), including Julianna Paradisi, an RN, artist, and writer who blogs about “where science, humanity, and art converge” at JParadisi RN’s Blog. (Her painting Love You to Death appeared on our October 2009 cover.) In March Paradisi launched a second blog, Die Krankenschwester, which emphasizes images. One series depicts rituals followed “From Cradle to Grave”; another considers the iconography of call lights. Paradisi’s work is beautiful and thought-provoking; stop by and have a look.

Recently I happened upon Nurse–Artists International, Inc. Started in 2009 by Kathy Iwanowski, an artist and former oncology and hospice nurse, the organization has an ambitious vision that includes “promoting the arts, humanities, and the therapeutic benefits of creativity in all aspects of life and living,” “creating and collaborating on projects related to arts and health with corporate, educational, healthcare, and other community partners” and “assessing the impact of the arts on health and healthcare costs.” Among its programs are the International Association of Nurse Artists, with membership open to nurses working in any artistic medium; Our Space to Create, a collaborative program for developing arts projects that meet community needs; and the Arts and Health Co-Lab, open to anyone interested in the connection between the arts and health. Iwanowski’s personal Web site offers samples of her found-object sculpture and visual art.

Art by Nurses states that its aim is to “bring nurses together as a community using art as a powerful self-care resource.” Based in Vancouver, British Columbia, Canada, it offers members an online venue for showing and selling art. A percentage of works sold goes into an Art Fund for Nurses, to which “any registered nurse can apply for funds to use art as a strategy to maintain balance and meaning in their lives as healers.” Worth a visit simply for its Art Galleries, which include striking photographs and artwork by more than 20 nurse-artists, including founder Lynda MacLeod, Shona Lalonde, and Pasquale Fiore, as well as Catherine Fraser, whose watercolor “Herb Store” was featured on AJN’s August 2007 cover.

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Posted in art and nursing, media depictions of nursing, nursing perspective, writing and nursing | Tagged , | 6 Comments »

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