Loud and Clear: A Nurse Discovers the Hazards of Learning Spanish By Audio

By Alice Facente, MSN, RN

I was determined to learn to speak Spanish. To deliver truly competent nursing care to my many Spanish-speaking patients, I felt compelled to gain a working knowledge of the Spanish language. I found a four-week course offered at the local community college, entitled “Spanish for the Medical Professional.” Perfect! I enrolled and eagerly went to the first class. My five classmates and I immediately started learning about the parts of the body, numbers, dates, how to ask and tell your address, and how to tell time. It was surprising how much we learned in that first three-hour class.

To reinforce what we had learned the professor instructed us to purchase a pocket medical Spanish guide, as well as the corresponding audio CD, which could be played at home or in the car. I wanted to get started quickly. On the way home from class I dutifully put the CD in my car tape player and repeated the Spanish translation after the English narration.

“Good morning: Buenos días.”

“I am the nurse: Soy la enfermera.”

So far, so good. At this rate, I began to think, I would be fluent in a short time. I listened to the CD every chance I got.

“Do you have a headache? Le duele a usted la cabeza?”

A few days later, I gave a gracious, elderly neighbor a ride home from the grocery store. As she slowly buckled herself in, I turned the key in the ignition. Immediately, the CD asked in loud, clear English, “Does […]

2016-11-21T13:19:30-05:00February 10th, 2010|Nursing|1 Comment

Want to Achieve the ‘Greatest Good’? Listen to Your Patients

Ethical dilemmas abound in nursing practice. Consider these commonplace scenarios:

* An angry patient threatens to leave the hospital against medical advice. Should you hold him against his will?

* A cancer patient fears chemotherapy. Should you give less detailed information about the effects of anticancer drugs?

* An obese home care patient with pressure ulcers refuses to cooperate in turning. Should you turn her anyway?

Such conflicts between the patient’s wishes and the nurse’s perception of the patient’s best interests occur regularly. That doesn’t make these ethical dilemmas any easier to resolve, but how nurses approach them can significantly affect clinical outcomes. Taking the time to listen to patients—and to integrate relationship skills with principles of ethical practice—can help nurses achieve solutions that are both ethical and appropriate for individual patients.

ky olsen/via Flickr

That’s from the February issue of AJN, in which nurse–ethicist Doug Olsen (who has in the past written for this blog on ethical issues related to mandated H1N1 vaccinations for nurses) offers a thoughtful discussion that may resonate for all nurses who’ve ever faced a situation like those in the above examples. It may seem obvious or cliched to say that listening to patients can help solve apparently intractable problems—but just because listening as a skill is hard to measure doesn’t mean that it’s not sometimes effective where more rigid tactics would fail.

Bookmark and Share
[…]

Will Texas Nurse Whistle-blower Case Have Dangerous Ripple Effect?

KERMIT, Tex. — It occurred to Anne Mitchell as she was writing the letter that she might lose her job, which is why she chose not to sign it. But it was beyond her conception that she would be indicted and threatened with 10 years in prison for doing what she knew a nurse must: inform state regulators that a doctor at her rural hospital was practicing bad medicine.

That’s from an article in today’s New York Times about a Texas nurse who’s being prosecuted for blowing the whistle on what she asserts were inappropriate medical practices by a doctor she worked with. We’ve posted on this as the case has developed and also written about it in the journal. Ultimately, the judgment is up to the court. But the concern we’ve expressed and which others have also voiced is that this will have the effect of silencing others who should be speaking out. In the process it may well reinforce old nurse–physician dynamics that profit no one. What do you think?

UPDATE: She was acquitted today (February 11)!Bookmark and Share

The Checklist – Taking Finger-Pointing Out of the Equation

By Peggy McDaniel, BSN, RN

Ok, I will admit right off that I am a huge fan of Atul Gawande’s writing. I have read his books Better and Complications, and I think much of his work should be required reading for all health care students. I haven’t read his newest book, The Checklist Manifesto: How to Get Things Right. I plan to soon, but it’s the 3rd book down in the pile on my bedside stand.

That confession aside, there has been some recent news around the use of checklists that bears some attention. Dr. Gawande helped develop a two-minute checklist that is to be done prior to surgery. 

Dr. Peter Pronovost was involved in the development of a similar checklist related to the insertion of central lines. 

Airlines and airplane manufacturers, such as Boeing, use checklists constantly to ensure consistent, high quality outcomes. 

I did a quick Google search for “checklists and nursing” and found various references to skills and competency checklists. As a nurse, my skills have been observed and validated with checklists over the years. I have also been party to filling out checklists on myself and my peers. Come to think of it, much of our charting has been done by filling out checklists. 

I guess I am a bit surprised that the use of checklists to validate competencies and keep track […]

Déjà Vu All Over Again: Internal Uterine Contraction Monitoring Another Case of Practice Without Evidence

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

Last week, the New England Journal of Medicine (NEJM) reported (abstract available here) on a Dutch multi-center randomized trial comparing internal versus external monitoring of uterine contractions during induced labor on rate of cesarean or instrument delivery. Among secondary outcomes they examined were use of analgesia, oxytocin and antibiotics, adverse neonatal effects, and complications from the intrauterine catheter (hemorrhage, sepsis, among others).

What caught my eye was the first sentence of the paper, which read, “The monitoring of uterine contractions by means of internal tocodynamometry during induction or augmentation of labor is advocated by professional societies in obstetrics and gynecology.” Yet, as this study points out, there has been little data to support the societies’ recommendation for internal monitoring. And, lo and behold, the results of this trial “do not support the routine use of internal tocodynamometry for monitoring  contractions in women with induced or augmented labor.”

This reminds me very much of electronic fetal monitoring. […]

Go to Top