Confronting the New Normal: A Family Caregiver’s Perspective

By Kay Patterson, MA. The author is a retired licensed mental health counselor from Buffalo, NY. Before her career as a counselor, she was a newspaper reporter. Recent essays, profiles, and travel pieces have been published in the Buffalo News and other publications.

fork-in-the-road“All I wanted was a cortisone shot,” my wife moaned as we left the doctor’s office after an MRI investigating several falls she’d taken. Her dazed look reflected my feeling exactly. She was one hip surgery down, another one to go, and now . . . back surgery?

The neurosurgeon had been breezy but concerned as he showed us the results on his tiny iPhone screen.

“The lumbar MRI caught a small area of your thoracic. Good thing. You’ve got a stenosis and if we don’t decompress it right away, you could lose all function in your legs.”

What?

He said he needed another MRI for a closer look. We had just enough time to buzz home for a sandwich and some frantic research. Thoracic stenosis, Google told us, is a compression in the middle of the spine that cuts off messages from the brain to the lower extremities. It’s rare and potentially dangerous.

Potentially. Was the neurosurgeon rushing it? “He’s like Hawkeye on MASH,” Susan groused. “A hot shot.”

“Uh-huh,” I mumbled, struggling to remain in helper mode after two months of watching her mysterious wobble. My heart […]

2017-05-05T17:23:16-04:00September 26th, 2016|Patients|0 Comments
Read More

A Nurse Ethicist’s Analysis of a Recent Nursing Home Sexual Consent Case

By Douglas P. Olsen, PhD, RN, associate professor, Michigan State University College of Nursing in East Lansing, associate editor of Nursing Ethics, and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

scales of justice/by waferboard, via Flickr scales of justice/by waferboard, via Flickr

An 78-year-old retired state legislator and farmer in Iowa is currently on trial for having sex with his wife, who has severe Alzheimer’s disease, in her shared room in a nursing home. He has been charged with rape.

The case highlights two ethical questions or conflicts:

  • When is protection needed and when is it intrusive and harmful?
  • What are the mental abilities required to consent to sex?

Consenting to sex is not the same as informed consent for treatment. In treatment, a clinician obtains consent to act on (treat) the patient in a way that will benefit the patient. By contrast, proper consent for sex is mutual and both parties benefit.

To extend the comparison: a patient’s decision to consent to treatment is generally made by balancing the benefits, harms, and risks to the individual patient. The decision to engage in sex often involves consideration of another’s satisfaction—it is not unknown for one spouse to agree to sex to please the other, even though he […]

2016-11-21T13:02:41-05:00April 21st, 2015|Ethics, Nursing, nursing perspective, Patients|4 Comments
Read More

The Kiss: Hope in the ICU

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

by limegreeen9, via flickr creative commons

I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.

My report, though, is politely cut short by the medical director.

“What’s changed?” he wants to know.

And I feel pressed to produce some crumb of improvement. 

“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”

A few people smile, and I hear a few chuckles.

“It’s a reflex!” I hear someone say as they move away.

I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant […]

2016-11-21T13:09:58-05:00June 4th, 2012|Nursing, nursing perspective, nursing stories, Patients|4 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top