Posts Tagged ‘Theresa Brown’

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When a Fellow Nurse Abuses Drugs on the Job

September 28, 2012

. . . the nurse wasn’t anywhere on the floor. I started looking around, asking other nurses. My frustration grew when I realized that something about the entire floor felt wrong. The entire night shift had disappeared. My chest tightened and I started to worry about what had happened at the hospital last night.

That’s a short excerpt from the Reflections essay in the October issue of AJN, “A Good Nurse.” It’s by oncology nurse Theresa Brown, who happens to also have a new column out this week at the New York Times Opinionator blog. Never one to shy away from sensitive topics, in this essay she takes on the shock and betrayal in learning a fellow nurse has been abusing drugs on the job. Click the link above or the image on the right to read the whole short essay (click through to the PDF version for the best reading experience). We welcome your responses here, of course.—Jacob Molyneux, senior editor
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If the Patient Doesn’t Understand the Treatment: New Essay by Theresa Brown

June 27, 2011

Ben’s inability to understand even the basics of his situation, combined with his lack of family support, made it seem that we were in effect imprisoning him and torturing him.

That’s an excerpt from the Reflections essay in the June issue of AJN. By Theresa Brown, a nurse who regularly writes for the New York Times “Well” blog, “Right Treatment, Right Patient?” explores the ethics and emotions involved in providing an unpleasant but potentially life-saving treatment to a patient who can’t understand what’s being done to him (click through to the PDF for the best version).

We hope you’ll read it through and let us know if you’ve ever faced a similar ethical quandary as a health care professional (or, for that matter, as a family member or patient).—JM, senior editor

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Maybe Palliative Care SHOULD Go to the Dogs

September 13, 2010

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

Sam in his hospice quilt

Last week, we took Sam, our ailing 14-year-old Labrador Retriever, on what became his last trip to the vet. Sam had been diagnosed with bone cancer in February after we noticed the right half of his head enlarging. Because of where the tumor was, it was inoperable. We felt that at his age chemotherapy wasn’t a realistic option, and we didn’t want the last few months of his life to be bad ones.

His veterinarian, who’d treated Sam since his puppy days, supported the decision, saying she would make the same choice for her dog. And so we spent the last few months adjusting doses of steroids and pain meds to enable him to live as normally as possible. For Sam, “normal” was being able to greet all comers to our door, to be the leader on his walks, to be smack in the middle of where his family was. (If people were in the basement and on the second floor, he would lie equidistant from where everyone in the house was. If we were in the same room, he sat, front legs crossed in his “elegant dog” pose, where he could see us all.)

So last month, when we saw that he would no longer get up to greet visitors or his family; was reluctant to go on walks (he did, but with a great sigh and lots of panting after even the shortest walk); and, finally, stayed in a corner of the back hallway, no longer making the effort to be part of the family, we realized Sam’s quality of life was diminishing. It became abundantly clear when he wouldn’t eat his normal food or even cookies, his favorite, that Sam was suffering.

When we took him to the vet, secretly my husband and I were hoping the vet would give us a different regimen that would restore Sam to the dog of a few months ago. But the vet pointed out that, at most, any measures we could take would only gain us another few weeks—and there was no guarantee of even that. She also asked us about our motives. Clearly, prolonging Sam’s life meant prolonging his discomfort. It became obvious that “keeping him going” would be only for our benefit and not for Sam’s. And so we decided it was time to say goodbye.

The technician brought out a quilt for Sam to lie on, and we fed him cookies and petted him and talked to him while the vet gave him a large dose, an overdose, of sedative. It was all very peaceful, and we were grateful for the support and guidance of the vet and her staff in helping us let Sam go.

I couldn’t help contrasting Sam’s death with Theresa Brown’s story of her oncology patient in her recent opinion piece, “A Dying Patient is Not a Battlefield.” Yes, I know Sam was a dog, and I’m not advocating euthanasia, but I am advocating that people deserve a good death and shouldn’t be cajoled into decisions for the benefit of others.

I worked as a chemotherapy nurse during graduate school, and I remember discussions with patients who made treatment decisions they really didn’t want to make but made anyway—because they didn’t “get” that things were not going to get much better, or they didn’t want to let their families down or, worse, felt they “owed it” to the physicians and staff who were working hard to keep them alive. What messages are we giving to patients and to families if they feel they owe us anything? What happened to what we learned from the work of Cicely Saunders or Florence Wald in creating hospice care? What happened to those of us who are charged to be advocates for our patients? Brown’s piece is a reminder to make sure our patients have the right information to make informed decisions, and then to listen and support their decisions.

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Workplace Violence Against Nurses — Neither Inevitable Nor Acceptable

March 17, 2010

I’ve read about hospital nurses dealing with violence at work, but I always told myself that was something that happened in the emergency room or the psych ward. In oncology, I reasoned, we have relationships with our patients, and I have always felt safe with them.

So begins a harrowing—and remarkably nonjudgmental— story of a really bad day at work, written by Theresa Brown, a nurse who blogs regularly for the NY Times. (AJN will be featuring a profile of Brown in the May issue.)

Unhappy coincidence: It so happens that AJN published a Viewpoint essay on workplace violence in the March issue. Here’s how it starts:

I was working in the ED one day when a patient looked up and threatened to kill me. Grabbing my hand, he squeezed it until I thought it would break. It took several staff members to restrain him and force him to let go. I’ll never forget how he looked into my eyes and smiled as I screamed in pain.

Some of my colleagues said I should file a police report; others told me to get used to this type of behavior and toughen up. I called the police, and although they took my statement, they wouldn’t arrest the patient because he hadn’t inflicted “serious bodily injury.”

Marco Musso/via Flickr

The author, Jessica Leigh, offers advice to those who have faced workplace violence as nurses, and makes several recommendations for influencing policies at your hospital or facility, as well as for pushing for legislation to make such violence against health care workers a serious crime.—Jacob Molyneux, senior editor

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On Lobbyists, Lotteries, Nurses, and Health Care Reform

December 3, 2009

By Peggy McDaniel, BSN, RN

I read the recent post on this blog about lobbyists and reform. Does this situation bother anyone else but me? Kaiser Health News reports that $422 million was spent from January to September of this year on lobbyists. Numerous groups—in fact, over 1,000—have put money towards shaping the legislation focused on health care reform. A great deal of money is also being spent to mold the messages you hear about the health care bills. 

by pinkmoose, via Flickr (creative commons)

It’s intriguing to note the different groups trying to influence the process, from Catholic bishops to big pharma. All want to have a stake in the outcome—some from a financial perspective, some from a moral stance. As nurses, we should have something to say about health care and insurance reform. Theresa Brown, one of my favorite bloggers, recently wrote that our current system is like a “lottery”—and used a very dark story to make her point. 

I happen to agree with her: our current market-based system works, until it doesn’t.

I have been at the bedside of patients who came up with the short straw, as I have previously shared here.     

Another post noted that domestic violence is considered a “pre-existing condition” and can be used to deny coverage. Our present health care system is unacceptable, but what can we do about it?  Rules preventing paid lobbyists from playing dominant roles in shaping legislation would be a good starting point.

A recent article in the Washington Post revealed that paid lobbyists will be banned by the Obama administration from holding seats on federal advisory panels. This was announced without fanfare but is an exciting step in the right direction. When people are paid to have a point of view and are also influencing government policy it is nothing less than corrupt. That said, lobbying as a concerned citizen for what you believe in and what you want to see happen in our government is not only a right, it’s a responsibility. Let’s promote an agenda that we can stand behind as individuals and as nurses.

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Financial Strain and Childhood Cancer: What’s Your Definition of ‘Freedom’?

September 14, 2009

By Peggy McDaniel, BSN, RN  

I recently read a stirring blog post in the NY Times from a fellow nurse, about a cancer patient she’d treated who was an insurance salesman but whose last months were dominated by a desperate attempt to manage his mounting medical bills, bills which left his wife with a second massive burden on top of her grief at his death.

by frozenchipmunk, via flickr

by frozenchipmunk, via flickr

Like Theresa Brown, I am an oncology nurse. In my work in pediatric oncology, I have also seen families ravaged by cancer treatment—physically, emotionally, and economically. Young families that fight to save their children often end up bankrupt, or with a ruined marriage from the emotional strain of dealing with a loss coupled with financial strain. Financial concerns are ever present. 

Theresa’s article really hit home. I hope you take the time to read it. As I was listening to President Obama’s health care reform speech last week, I heard him mention Senator Kennedy’s experience as a parent of two children diagnosed with cancer. When it comes to the pain and suffering that children experience during treatment, the Kennedy childrens’ experience and that of children without reliable insurance were probably quite similar.

I would guess, though, that the experience was very different for the parents. Read the rest of this entry ?

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What Obama Told Us (Nurses) in the West Wing Yesterday About Health Care Reform

September 11, 2009

By Diana J. Mason, RN, PhD, editor-in-chief emeritus

Fuzzy cell phone shot in the Rose Garden, Sept. 10, 2009

Fuzzy cell phone image from West Wing, 9/10/09

I was pleased to represent the American Academy of Nursing yesterday at President Obama’s speech on health care reform to an audience of nurses (including new Administrator of the Health Resources and Services Administration or HRSA, nurse Mary Wakefield) in the West Wing of the White House. His remarks summarized his powerful presentation to Congress and the nation on Wednesday evening, with one exception: he used the word “nurses” in Thursday morning’s speech. In fact, in that follow-up speech, he talked a lot about nurses, noting that nurses know too well the problems with our health care system, see the impact of its failings on the lives of their patients every day, are trusted by the public, and are key to reforming health care. 

The President’s speech was introduced by Rebecca Patton, president of the American Nurses Association (ANA). He spoke about his own family’s experiences with health care and the essential work of nurses in helping his family members come into this world, leave it gently, and cope with illness. He then summarized some of the major points of the plan he laid out on Wednesday night:

• People won’t have to worry about being dropped from their health insurance plans if they become ill.
• His plan would not force people or employers to change their coverage or choice of physician (and I hope he soon learns that this language should be “provider,” since many of us get our health care from a range of health care providers who may or may not be physicians).
• His plan would forbid insurers from dropping you or refusing to cover you because of a preexisting condition, would limit out-of-pocket expenses, and would provide the uninsured and others with access to an insurance exchange that would promote competition and lower costs. (I’m hoping that this exchange would include a public plan option to spur more competition.)

He’s right. Nurses do know the importance of these elements of health care reform. He shared the example of a posting on the New York Times blog by nurse blogger Theresa Brown, about treating an insurance salesman with cancer. He asked for nurses’ help in talking with people about the importance of health care reform. We can help by talking with patients, friends, and families about the importance of actively supporting health care reform now. As the President said, “We aren’t the first to take up this course, but we’re going to be the last.”

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