About Jacob Molyneux, senior editor/blog editor

Senior editor, American Journal of Nursing; editor of AJN Off the Charts.

Takeaways from 2014 ANA Membership Assembly

Pamela Cipriano, incoming ANA president Pamela Cipriano, incoming ANA president

By Maureen Shawn Kennedy, AJN editor-in-chief

So far, so good

In June, the American Nurses Association (ANA) convened its second membership assembly, which included representatives of constituent and state nurses associations, individual members groups and affiliated entities, plus the board of directors. (This is the structure that replaced the House of Delegates as the official governing body of the ANA, when ANA restructured in 2012. See our 2012 report on the restructuring.)

The assembly was preceded by ANA’s annual Lobby Day on June 12th, in which nurses visited legislators on Capitol Hill to talk up legislation important to nursing, like bills on staffing, safe patient handling, and one that would remove barriers to efficient home care services.

This membership assembly was subdued—perhaps a gift for Karen Daley, the outgoing two-term president who shepherded the organization through a turbulent period of change. There were no contentious resolutions to deal with this time—there were only three issues brought to the group through dialogue forums, to develop recommendations for the board of directors:

  • scope of practice (full practice authority for all RNs)
  • integrating palliative care into health care delivery
  • promoting interprofessional health care teams

While the scope of practice topic was ostensibly promoting full practice for ALL RNs, most […]

Still a Nurse: A Shift in Professional Identity

Illustration by Jennifer Rodgers. All rights reserved. Illustration by Jennifer Rodgers. All rights reserved.

The June Reflections, “Making It Fit,” is a frank exploration of the ways health care professionals form separate cultures within each institution. It’s told by a newly minted advanced practice nurse whose previous job had been as a staff nurse in an ED. Now she’s taken a job as a psychiatric NP and finds herself on uncertain ground:

When I walked onto the unit my first day, expecting to be embraced by the nurses, I was dumbfounded and hurt that my own profession didn’t accept me with open arms. The inpatient unit is a melting pot of professions, and I found that I didn’t necessarily fit with the doctors, the social workers, or the staff nurses.

The author finds herself alone, neither nurse nor physician but instead something in between. As she describes her process of finding a new kind of nursing identity, she is very clear that this is not a case of nurses “eating their young.” Rather, it’s about finding a new normal. The short essay is an honest, smart look at career advancement and the associated challenges we hear less about, and is well worth a read.—Jacob Molyneux, AJN senior editor

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The Ethics of No-Smokers Hiring Policies: Examining the Assumptions

Army nurses light up in 1947. Photo courtesy of Everett Collection / Newscom. Army nurses light up in 1947. Photo courtesy of Everett Collection / Newscom.

By Jacob Molyneux, senior editor

The Ethical Issues column in the June issue is called “The Ethics of Denying Smokers Employment in Health Care” (free until July 16). As in his previous columns, nurse–ethicist Doug Olsen models the thinking process of an ethicist, illuminating the fundamentals of ethical reasoning even as he tackles a specific ethical question.

Most positions we take on tough questions depend on a number of assumptions, both conscious and otherwise. In this article, Olsen does a great job identifying and then testing the assumptions that underlie such no-smokers hiring policies. Here are the main ones, as Olsen describes them:

When Metrics and Testing Replace Listening and Physical Assessment

By Gail M. Pfeifer, MA, RN, AJN news director

Emergency x 2 by Ian Muttoo, via Flickr. by Ian Muttoo/via Flickr

I was appalled as I read the Narrative Matters column by physician Charlotte Yeh in the June issue of Health Affairs, for two reasons. Aside from the compassion I felt for her suffering at being hit by a car on a rainy Washington, D.C., evening in 2011, I was dismayed that most of her story took place in an ED, one of the settings in which I used to work. While there, she met with a series of omissions that included not just medical care omissions but also—though she never explicitly connects the dots—basic and serious nursing care omissions.

It saddens me to think that one of the things I fought so hard to implement on our unit more than 20 years ago—transforming the staff’s automatic labeling of arriving patients (an MI, an MVA, a gunshot wound) into a unique picture of who that patient really was under those traumatic circumstances—has still not come to pass. Yet that change of vision is so important to completing the picture and arriving at an accurate diagnosis. Noting that her care demanded a better balance […]

Preventing the Next Elliot Rodger: A Call to Push for Solutions, Despite the Obstacles

Donna Sabella, PhD, MSN, PMHNP-BC, is a mental health nurse and assistant clinical professor and director of global studies at the Drexel University College of Nursing and Health Professions in Philadelphia. She also coordinates the AJN column Mental Health Matters.

screen capture Elliot RodgerWho’s next? On May 23rd, we were once again forced to witness a scene of senseless violence. Elliot Rodger  stabbed to death three men in his apartment, after which he gunned down two women and a man. Aside from the six murders, he injured 13 people, shooting some of them and hitting others with his car, before apparently shooting himself in his car.

All of this carnage from one lonely, angry, troubled 22-year-old raised in a world of relative privilege—we feel for the victims and their families, and we feel for the Rodger family as well, who appear to have done everything they could to help their son find help for his mental instability and prevent this latest tragedy from unfolding.

While perhaps comforting to family and friends of the slain, our grief and prayers for all involved and our dismay at the other horrific events preceding this one mean little when it comes to preventing the attacks of the next Elliot Rodger.

But I believe we are wrong if we think our outrage and sadness are all we […]

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