About Jacob Molyneux, senior editor/blog editor

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

iPad Apps, the Future of Nursing, More: Notes from the Nurse Execs Meeting in Boston

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week, the city of Boston hosted the annual meeting of the American Organization of Nurse Executives (AONE). For those unfamiliar with this group, it’s a subsidiary of the American Hospital Association and its mission is, according to the Web site, “to shape health care through innovative and expert nursing leadership.” It’s been a few years since I last attended this conference, and I was amazed at increase in both sophistication of exhibits and number and variety of sessions. There was even an iPad app for the meeting!

Best-selling authors abounded: Dan Pink, author of Drive: The Surprising Truth of What Motivates Us, opened the conference and Thomas Goetz, executive editor of Wired magazine and author of The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine, closed the meeting. Dee Dee Myers, former press secretary to President Bill Clinton, also talked about her new book, Why Women Should Rule the World.

As at many meetings this past year, the Institute of Medicine’s Future of Nursing report figured prominently, with a track focused on interpretations and implementation of its recommendations.

I asked Linda Burnes Bolton, chief nurse officer of Cedars Sinai […]

The Affordable Care Act on Trial

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

According to the National Conference of State Legislatures, 47 states have enacted some legislation to block or limit various requirements of the Affordable Care Act (ACA). And a week from Monday, on March 26, the Supreme Court will begin hearings on the constitutionality of the law, as 26 states bring suit against the federal government. The primary issue for the Court: can the federal government mandate that individuals must purchase health insurance?

Other closely related issues the court has also set aside time to consider are whether other provisions of the law can still be implemented or must be voided if the individual mandate is struck down, the legality of the proposed Medicaid expansion, and whether the court must in fact wait until the individual mandate is actually implemented in 2015 before even considering its legality.

So how do many Americans feel? The Kaiser Family Foundation has been tracking opinions on the law and offers an excellent interactive chart that shows opinions according to different variables, including age, income, political party affiliation, gender, and current insurance status. Their findings may surprise you.

For more information about the Affordable Care Act and it implications for nursing, here are some links to AJN’s coverage since it was signed into law in 2010:

“Nurses and the Affordable Care Act,” Mary Wakefield
“What Future for the Affordable Care Act,” Diana Mason
“Health Care Reform and a System […]

Kony 2012: A Real Villain, Plus a Few Questions

By Maureen ‘Shawn’ Kennedy, MA, RN, AJN editor-in-chief

Social media is once again proving its power to engage people around the world—this time, in the efforts to find and capture Joseph Kony, the leader of the Lord’s Resistance Army (LRA), a brutal militia group that waged a war of terror in Uganda for two decades and is now operating, in a diminished but still lethal capacity, in the Central African Republic, the Democratic Republic of the Congo, and South Sudan.

Kony was indicted for war crimes by the International Criminal Court in 2005 based on his record of murder, torture, rape, and the enslavement of thousands of people, mostly women and children. At its height, his army was said to be comprised mostly of child soldiers—the children he abducted and forced to become killers, whose first victims were often their parents. Filmmakers with Invisible Children, a nonprofit organization dedicated to influencing change in Africa, created Kony 2012, a film that “went viral” last week and fuelled widespread support for a campaign to support efforts to capture Kony.

Kony and the atrocities of the LRA are not new “news.” AJN reported on the issue of child soldiers in Uganda and numerous other countries in 2005, when we profiled the work of nurses Susan McKay and Dyan Mazurana, […]

‘Like an Origami Swan’ – Remembering Tea with Miss Elsie

“Hello,” I said. “I’m the nurse. I’m here to see Miss Elsie.”

“I know,” he answered, grabbing my wrist and pulling me inside.

The heat of the cramped house slammed into my face. The windows were closed and the shades pulled down. Without a word, my little escort guided me down a narrow hallway into a room not much bigger than a closet, then deftly released my wrist and slipped out of sight.

So starts “Tea With Miss Elsie,” by Claire Schuster, MSN, RN, APRN-BC, CWS, associate professor emerita in the nursing program at Berea College, Berea, Kentucky. The Reflections essay in the March issue of AJN is a subtle, quiet portrait of a moment and the gesture at its heart, and it’s well worth a read. (For the most appealing version, click through to the PDF version link in the upper right of the landing page.)—JM, senior editor  

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Are You Ever Justified in Deceiving a Patient?

A patient’s irrational refusal to take medication can be frustrating for the nurse. Crushing the pill into applesauce or ice cream saves time and effort, and spares the patient the aggravation of quarreling. But while hiding medication is sometimes ethically justified, often it is not.

That’s the start of the “Putting the Meds in the Applesauce,” an article (free for March) by nurse ethicist Douglas Olsen in the current issue of AJN. Olsen notes that studies suggest hiding medications in food may be a relatively common practice, considers the ethical principles at play in such a decision, and offers advice for those who may be considering it. (Added: The column chiefly concerns the nursing care of cognitively impaired patients—not those who simply don’t want medications or those with with psychiatric illnesses who may be endangering themselves or others by refusing medication.)

Says Olsen, “[t]wo factors must be considered in determining whether hiding medication is justified or not: the nurse–patient relationship and the patient’s rights.” He adds that such a decision “requires the nurse and surrogate decision maker to imagine how the patient might have reasoned: would the earlier, cognitively intact patient have agreed that, given the present impairment, the providers shouldn’t be morally bound to accept the patient’s decision to decline medication?”

Another question he suggests asking oneself is this: “could the deception survive public scrutiny, including that of professional peers?”

What’s your take? What’s your experience?—JM, senior editor

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