Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Good Jokes, Bad Jokes: The Ethics of Nurses’ Use of Humor

By Douglas P. Olsen, PhD, RN, associate professor, Michigan State University College of Nursing in East Lansing, associate editor of Nursing Ethics, and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

Humor has real benefits. But when does nurses’ joking about patients, each other, and the care they provide cross a line?

Photo from otisarchives4, via Flickr. otisarchives4/Flickr

“Nurses make fun of their dying patients. That’s okay.” That was the provocative title of an op-ed by Alexandra Robbins in the Washington Post on April 16. The author’s treatment of the topic was more complex than the title suggested, but some examples of humor given in the article were troubling.

For ethical practice, nurses must consider if it is ever appropriate to discuss the clinical care of patients for humorous purposes. An easy answer would be—never. If patient care is never joked about, then no one’s feelings are ever hurt and nothing inappropriate is said as a joke. However, my experience as a nurse in psychiatric emergency and with human nature suggests two arguments against this approach:

  • Jokes will be made despite any prohibition.
  • Considerable good comes from such humor.

If jokes are going to be told anyway, it’s better to provide an ethical framework than to turn a blind eye. If joking about patient care […]

2016-11-21T13:02:39-05:00April 29th, 2015|career, Ethics, healthcare social media, Nursing, nursing perspective, Patients|1 Comment
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May AJN: A-Fib and Epilepsy Updates, an Ethics Collection, Diversity, Resolving Conflict, More

AJN0515.Cover.2ndAJN’s May issue is now available on our Web site. And in honor of the upcoming Nurses Week, we are offering free access to the entire issue for the month of May. In addition, because the American Nurses Association has designated this the “Year of Ethics” and the theme of this year’s Nurses Week is “Ethical Practice, Quality Care,” we have also made available a collection of some of our top ethics articles from 1925 to the present. Here’s a selection of what else not to miss in our May issue.

Atrial fibrillation adversely affects the quality of life of millions of people, resulting in significant morbidity and mortality and health care costs. Our CE feature, “Atrial Fibrillation: Updated Management Guidelines and Nursing Implications,” reviews the recently updated guideline for the management of atrial fibrillation and stresses how nursing intervention in patient education and transition of care can improve outcomes. This feature offers 3 CE credits to those who take the test that follows the article.

Epilepsy is a serious neurologic disease that affects around 2.2 million people in the U.S. “Epilepsy Update, Part 1: Refining Our Understanding of a Complex Disease,” the first in a two-part CE series, discusses new research on the causes of epilepsy, new definitions that are changing the ways we evaluate the disease, and the psychosocial […]

2016-11-21T13:02:40-05:00April 24th, 2015|career, nursing perspective|0 Comments
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A Nurse Ethicist’s Analysis of a Recent Nursing Home Sexual Consent Case

By Douglas P. Olsen, PhD, RN, associate professor, Michigan State University College of Nursing in East Lansing, associate editor of Nursing Ethics, and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

scales of justice/by waferboard, via Flickr scales of justice/by waferboard, via Flickr

An 78-year-old retired state legislator and farmer in Iowa is currently on trial for having sex with his wife, who has severe Alzheimer’s disease, in her shared room in a nursing home. He has been charged with rape.

The case highlights two ethical questions or conflicts:

  • When is protection needed and when is it intrusive and harmful?
  • What are the mental abilities required to consent to sex?

Consenting to sex is not the same as informed consent for treatment. In treatment, a clinician obtains consent to act on (treat) the patient in a way that will benefit the patient. By contrast, proper consent for sex is mutual and both parties benefit.

To extend the comparison: a patient’s decision to consent to treatment is generally made by balancing the benefits, harms, and risks to the individual patient. The decision to engage in sex often involves consideration of another’s satisfaction—it is not unknown for one spouse to agree to sex to please the other, even though he or […]

2016-11-21T13:02:41-05:00April 21st, 2015|Ethics, Nursing, nursing perspective, Patients|4 Comments
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AJN’s Spring Break with the Student Nurses in Phoenix: Sunnier Job Outlook for New Graduates?

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

PhoenixSkylineAfter a long winter in the Northeast, it was wonderful to visit Phoenix last week for the 63rd annual convention of the National Student Nurses’ Association (NSNA).

Like other meetings, this one was packed from morning to late evening with educational sessions, exhibits, resume-writing consultation, and for some, deliberating over 60 resolutions at the House of Delegates. Keynotes addressed:

  • health care reform (Gerri Lamb).
  • progress on implementing recommendations from the Future of Nursing report (Susan Hassmiller).
  • clinical ethics and moral distress (Veronica Feeg and Cynda Rushton).
  • and, the closing speech, a charge to continue nursing’s legacy into the future (yours truly).

Concurrent sessions, most of them well attended by Starbucks-fueled students, covered nursing specialties, exam help, licensure and legal/ethical issues, and clinical topics. (Betsy Todd, AJN‘s clinical editor, who is also an epidemiologist, led a session called “Is It Safe: Protecting Ourselves and Our Patients from Infectious Diseases.”)

Changing job climate? Several students I spoke with who were graduating at the end of the semester didn’t seem to have the anxiety of previous years’ students over securing a job. Maybe this is because things are looking up in the job market for new graduate nurses, at least according to recent figures in NSNA’s annual survey of graduates.

Reporting in the January issue of Dean’s Notes, researcher Veronica Feeg, associate dean of Molloy School […]

2016-11-21T13:02:41-05:00April 17th, 2015|career, Nursing, nursing perspective, students|0 Comments
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Recent End-of-Life Care Links of Note, by Nurses and Others

nature's own tightrope/marie and alistair knock/flickr creative commons nature’s own tightrope/marie and alistair knock/flickr creative commons

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

End-of-life care and decision making have been getting a lot of attention lately. The Institute of Medicine released a new report earlier this year, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life (available for free download as a PDF).

Nurses who write often write about end-of-life matters. A couple of recent examples:

On the Nurse Manifest Web site, a look at the realities and challenges of futile care in America. Here’s a quote:

“I am currently teaching a thanatology (study of death and dying) course for nurses that I designed . . . to support students to go deeply in their reflective process around death and dying, to explore the holistic needs of the dying, and to delve into the body of evidence around the science and politics of death and dying.”

Or read another nurse blogger’s less abstract take on the tricky emotional territory nurses face when a patient dies.

Elsewhere on the Web
Vox reporter Sarah Kliff collects five strong end-of-life essays that recently appeared in various sources.

And here’s something very practical that might catch on: according to a recent

2016-11-21T13:02:42-05:00April 13th, 2015|career, Nursing, nursing perspective, patient engagement|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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