Cochrane Reviews: An Oft-Overlooked Evidence Source for Nurses at the Bedside

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

“Research holding the torch of knowledge” (1896) by Olin Levi Warner. Library of Congress, Thomas Jefferson Building, Washington, D.C./Photo by Carol Highsmith, via Wikipedia

Long ago, in an ICU far away, I picked up the habit of saying, during rounds, “Well, you know, research suggests the practice…” I have trouble remembering who taught me this tactic, but it has always been a highly effective way of advocating for my patients.

The eyes of doctors, never ones to be silenced by a nurse who reads research, usually light up at the challenge.

I’ll admit that, for a while, many of my conversational citations came from ‘clinical pearls’ or tidbits I read from certifying organizations via social media. While my knowledge was based on credible sources, my analysis was topical, at best.

Then I started graduate school. Although my program isn’t a clinical one, the need to seek out evidence for class assignments intensified my practice of trying to apply research evidence at the bedside.

It’s tricky to find and discuss credible research as a bedside nurse. Services like Lexicomp and UpToDate, which most hospitals hold subscriptions to, compile current […]

2016-11-21T13:02:38-05:00May 1st, 2015|Nursing, nursing perspective, nursing research|1 Comment
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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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The Challenge of Eating Disorders: A Teacher Learns a New Mindfulness Technique

“She’s brought a cup with her. This is not unusual. Clients often bring food or drinks they’re required to finish—but when Mariko reaches inside the cup, I hear the brittle clicking of ice and look closer. There’s no beverage. She pulls out a piece of ice and, without a word, curls up on her side, cradling the cube tenderly in her palm.”

By Jacob Molyneux, senior editor

Illustration by Anne Horst for AJN. Illustration by Anne Horst for AJN.

We hear a lot lately about mindfulness and its benefits in the workplace for dealing with stress, increasing productivity, and the like.

It’s been pointed out lately that mindfulness has become a tool with many uses, some more in keeping with its role in various spiritual traditions than others. Such traditions seem to use meditation practices in order to cultivate compassionate awareness of the varieties of suffering arising from the impermanence of everything from pleasant and unpleasant feelings and the weather to the lives of our loved ones.

This month’s Reflections essay in AJN is by a mindful movement teacher at an eating disorder treatment center. Eating disorders can involve mental and physical suffering that’s unrelenting and self-sustaining. Many clinicians and therapists find patients with eating disorders very challenging to work with. The essay, called “Distress Tolerance,” tells the story of an encounter in which the patient […]

2016-11-21T13:02:39-05:00April 27th, 2015|Nursing, patient engagement, Patients|0 Comments
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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 challenges […]

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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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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