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

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:

2016-11-21T13:04:29-05:00June 16th, 2014|career, Ethics, nursing perspective|10 Comments
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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 […]

2016-11-21T13:04:30-05:00June 13th, 2014|career, nursing perspective|3 Comments
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Life Drawing

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

by julianna paradisi - all rights reserved by julianna paradisi – all rights reserved

With one double-gloved hand I pull the unblemished skin of her buttock laterally. Holding a syringe in the other, I pierce the large muscle with a needle, injecting acid-yellow methotrexate deep inside. Its purpose is to deplete the tiny, nonviable embryo inside her of folic acid, preventing its growth, a rupture, and potential harm to the woman.

Usually I administer chemotherapy to stop the life cycle of tumors, not the rapidly dividing cells of an embryo that missed its mark, mistakenly lodged in a fallopian tube instead of finding its way into her uterus where both of them could have been safe. Ectopic, it sacrificed viability, and threatens the life of its host.

Prone on the stretcher after the twin injections, she cries quietly. I hand her a box of tissues. She blows her nose. I try to think of something comforting to say, something that lets her know this is sad for me too. Resources are limited, so the powers that be decided that the safety provided by a chemotherapy-certified nurse outweighs the education, skill, and emotional support provided by an obstetrics nurse. Most likely […]

2016-11-21T13:04:31-05:00June 11th, 2014|career, nursing perspective|4 Comments
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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 […]

2016-11-21T13:04:33-05:00June 6th, 2014|nursing perspective|2 Comments
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Writer or Nurse? The Costs of an Untold Story

Amanda Anderson, BSN, RN, CCRN, works in critical care in New York City and is enrolled in the Hunter-Bellevue School of Nursing/Baruch College of Public Affairs dual master’s degree program in nursing administration and public administration. Her blog is called This Nurse Wonders.

via Wikimedia Commons via Wikimedia Commons

I found myself getting annoyed with a dying cancer patient today. I don’t think this is an occurrence any honest nurse would deny, but when I could feel my blood pressure rise every time she dry-heaved, I knew it’d been a mistake to come to work this morning.

Not my proudest moment.

You see, I’ve felt my nursing self change of late, with an urge growing within me to slowly step back from the bedside, at least for a bit. Perhaps it’s school and the clarification of future goals forming in my mind, but clinical work has felt more like job-work, and this other work, this future work that largely centers on telling my nursing story, is becoming what I think of as calling-work.

Staring down at my poor patient, I realized I’d swung the balance of bedside work and calling-work too much to one side lately. I’ve been working—as a nurse—too much, and working—as a writer and a student—too little. After seven years of bedside nursing, and the joys and trials […]

2016-11-21T13:04:34-05:00June 4th, 2014|career, healthcare social media, nursing perspective|8 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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