Jacob Molyneux, senior editor/blog editor, Author at Off the Charts

What You May Not Know About Nurse Licensure

This month’s Legal Clinic installment in AJN is called “Common Misconceptions About Nurse Licensure.” Author Edie Brous, a nurse and attorney, lists these misconceptions:

1. Nursing boards are nursing advocates. Not so, says Brous; they’re there to protect the public. “Because nurses care for vulnerable populations, the state that issues a nursing license has a social contract with the public to ensure that the licensee is qualified, competent, and ethical.”

2. Private Conduct Isn’t Relevant to One’s Performance in a Professional Capacity. In fact, it can matter to a nursing board. The reasoning: “Conduct that reflects questionable judgment, impairment, or lapses in moral character may suggest to the board that a nurse poses a potential threat to the health, safety, and welfare of the public.” Ever neglect payment of student loans, child support, or taxes; have a substance abuse problem; commit a crime? It might be relevant.

3. Disciplinary action taken by a state pertains only to that state. Not so: there’s a computerized system called Nursys (Nurse System) where nursing boards enter actions they take against a nurse and learn about actions taken elsewhere.

4. Licensure is a right. “Rights are entitlements that are considered inherent and inalienable so they cannot be revoked, but privileges are granted by the state and are therefore conditional. As such, a nursing license may be restricted or revoked upon determination that the license holder poses a risk to the public.”

The article goes into more detail […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:05-05:00October 19th, 2012|career, nursing perspective|9 Comments

BRCA Gene Mutations: Knowing You’re At High Risk for Cancer

‘Autumn Washed Away,’ Diane Hammond/ via Flickr

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

October is Breast Cancer Awareness month. We thought we’d do our part with a feature article to help increase nurses’ awareness of some of the issues faced by women who find they are at high risk for breast cancer.

In the October issue, author Rebekah Hamilton describes her research with young women who learn they have a BRCA gene mutation that puts them at greater risk for cancer, especially breast and ovarian cancers. “Breast cancer risk ranges from 50% to 85% by age 50 in women with the mutation and is 12% in women without it.” Her study explores the consequences this knowledge has on decisions these women make about their future, especially those related to prophylactic surgery, relationships, and childbearing, and offers some recommendations for practice. The abstract is below, but I urge you to read the study, especially if your patients include young women.

Objective: Women who carry a BRCA1 or BRCA2 gene mutation face a risk of developing breast or ovarian cancer at an earlier age than women without such a mutation. Relatively little is known about the psychosocial consequences—especially regarding marriage and childbearing—in young women who test positive for one of these mutations.

Methods: In 2006, participants were recruited from Web sites for women with breast cancer or BRCA gene mutations. Forty-four women ages 18 to 39 from 22 states and Canada […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:06-05:00October 15th, 2012|nursing perspective, nursing research|0 Comments

What Do You Value?

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

“ ‘The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those in the shadows of life, the sick, the needy and the handicapped.’—Hubert Humphrey

These are the words that physician Donald Berwick saw as he went to work in the building that bears Humphrey’s name and houses the U.S. Department of Health and Human Services in Washington, DC. They reminded Berwick, the former administrator of the Centers for Medicare & Medicaid Services (CMS), of his most important mission: “to help the people who need our help the most.” And they are at the heart of an important topic of debate during this election season: what is the proper role of government in our lives?”

AJN Oct. cover, detail

So begins a blog post on the JAMA Forum by Diana Mason, PhD, RN, Rudin Professor of Nursing and codirector of the Center for Health, Media, and Policy at Hunter College, City University of New York, as well as president-elect of the American Academy of Nursing (and, for the sake of transparency, former editor-in-chief of AJN).

Her question is a critical one and one that has been a fundamental issue, tug-of-war even, for Americans. Our citizens take a great deal of pride in being independent, self-made, and self-reliant—yet it’s obvious that most of us also believe […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:08-05:00October 8th, 2012|nursing perspective|4 Comments

Evidence Contradicts AAFP: NPs Ideal for Leading Patient-Centered Medical Homes

By Karen Roush MS, RN, FNP-C, AJN clinical managing editor

What will it take to end the turf war physicians are waging against nurse practitioners? The latest foray is over who should lead patient-centered medical homes (PCMH). According to the American Academy of Family Physicians (AAFP), only physicians should. They insist that nurse practitioners do not have the knowledge or skills to do so and that expanding the NP’s role in primary care would create a “two-tiered health system,” with patients who are cared for by an NP receiving a lower level of care.

That’s not what the evidence says. Or patients for that matter. Studies consistently find that when care provided by NPs is compared to care provided by physicians, the care is similar as far as prescriptions ordered and referrals made—most important, outcomes are the same.

Well, there is one area where differences keep showing up: patient satisfaction. Patients consistently say that they are more satisfied with care provided by nurse practitioners. They say that nurse practitioners listen better, spend more time with them, and provide them with more information.

Not only are nurse practitioners capable of leading medical homes, their education and skills make them ideal for this role. Whereas physicians focus on pathology and have the depth of knowledge and skill to manage highly complex patients, NPs focus on the “human response to disease” and take a more holistic approach to patient care. Nurses coordinate care all the time, identifying […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:09:11-05:00October 3rd, 2012|nursing perspective|4 Comments

When a Fellow Nurse Abuses Drugs on the Job

. . . 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