Speaking Publicly ‘As a Nurse’: Case in Canada Highlights Risks, Responsibilities

Douglas P. Olsen, PhD, RN, associate professor, College of Nursing, Michigan State University, writes about ethical issues for AJN.

Recently, a disciplinary committee in Canada found a nurse in breach of the Canadian Nurses Association’s Code of Ethics for Registered Nurses for posting negative comments on Facebook and Twitter about the care given to her grandfather in a long-term care facility before his death. The nurse was accused of violating her grandfather’s confidentiality, not using proper processes for noting complaints about his care, and potentially harming the institution’s reputation. She was found guilty of professional misconduct but not guilty of violating his privacy. The ethical breach was based on her public declarations about the nursing care.

Key to the Saskatchewan Registered Nurses’ Association decision to find the nurse guilty appears to have been the fact that the nurse prefaced remarks with the phrase, “As a nurse . . . ” Adding this phrase to one’s communications confers the authority of scientific and experiential expertise. It further implies that one is versed in the proper procedure and standards for evaluating accuracy and relevance of clinical information and that one’s conclusions are communicated honestly for constructive purposes. The credibility added by identifying the nursing credential is deserved—and therefore carries responsibilities.

What are the conditions for an ethical response when speaking publicly ‘as […]

2016-12-20T15:09:59-05:00December 16th, 2016|Ethics, healthcare social media, Nursing|2 Comments

Information for Nurses on Voluntarily Stopping Eating and Drinking (VSED)

The New York Times recently published an article by Paula Span called “The VSED Exit: A Way to Speed Up Dying, Without Asking Permission.” VSED stands for voluntarily stopping eating and drinking, an end-of-life option that is, on the surface, as simple as its name suggests. Span, who recently attended the first conference devoted to VSED, gives an overview of one mother’s choice to end her life using this method. She also does an excellent job enumerating the ethical, practical, and legal implications of choosing to stop eating and drinking.

screen-shot-2014-11-05-at-4-39-13-pmWhich types of patients is such a choice appropriate for? How much suffering does it involve? Are there legal pitfalls of involvement in the VSED process by nurses and physicians? We can expect that all of these questions and more will be receiving growing attention in the coming years.

Late in the article, Span quotes Judith Schwarz, PhD, RN, now clinical coordinator of End of Life Choices New York. In 2009, AJN published a CE article, “Stopping Eating and Drinking,” by Schwarz. This substantive article centers around a detailed case study. “Gertrude,” we learn, has lived a very full life. All the things that give her pleasure and a modicum of freedom are gradually […]

Appropriate Use of Opioids in the Management of Chronic Pain

Painted by Martin Edwards as part of the Paint Your Pain program initiated by the Pain Management Center at Overlook Medical Center, Atlantic Health System, Summit, New Jersey. For artwork of other patients in the program, go to http://bit.ly/ 1Ns0PxL.The dangerous misuse of prescription opioids and drugs like heroin has been much in the news, but millions of patients continue to suffer both acute and chronic pain. For many, prescription opioids play a vital role in alleviating that pain. How can health care providers most effectively and safely use opioids in the treatment and management of chronic pain? Some answers can be found in a CE article in the July issue of AJN: “Appropriate Use of Opioids in Managing Chronic Pain.”

Related questions on opioids and chronic pain addressed in the article include:

Moral Distress: An Increasing Problem Among Nurses

moral distress

An ICU nurse struggles to reconcile repeated surgeries and transfusions for a comatose patient who has little chance of recovery. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she’s not giving needed care to patients because of poor staffing.

Situations such as these are all too common and can give rise to moral distress. Moral distress occurs when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

As explained in “Moral Distress: A Catalyst in Building Moral Resilience,” one of the CE articles in our July issue, this “inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as a whole.” […]

AJN in July: Opioids and Chronic Pain, Moral Distress, Prediabetes, More

CE Feature: Appropriate Use of Opioids in Managing Chronic Pain.”

Unintentional death related to prescription opioids has been identified as a public health crisis, owing in part to such factors as insufficient professional training and medication overprescription, misuse, and diversion. The authors discuss current best practices for prescribing opioids for chronic pain, emphasizing patient assessment and essential patient teaching points regarding safe medication use, storage, and disposal, and after you find a more permanent solution people could totally quit opioids by using a detox methods that goes from medicine to even a detox tea like leptinteatox. There are some medicines or supplements that are more easy to use, depending on the problem, like the peruvian brew, that helps with erectile dysfunction and is pretty safe. After that you only need to be careful with stds diseases you can go and test at https://www.stdaware.com/chlamydia-test.

CE Feature: “Moral Distress: A Catalyst in Building Moral Resilience.”

Moral distress is a pervasive problem in nursing: an inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as […]

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