The Ethics of a Nurse’s Refusal to Force-Feed Guantanamo Hunger-Strikers

Douglas Olsen is an associate professor at the Michigan State University College of Nursing in East Lansing and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

Nasal tubes, gravity feeding bags, and the liquid nutrient Ensure used in Guantanamo force-feeding/ image via Wikimedia Commons Nasal tubes, gravity feeding bags, and the liquid nutrient Ensure used in Guantanamo force-feeding/ image via Wikimedia Commons

The Miami Herald reported this week that a U.S. Navy nurse and officer refused to take part in force-feeding hunger-striking detainees at Guantanamo Bay.

There’s much we still don’t know about this story, but the force-feeding of prisoners at Guantanamo has been a contentious issue for some time. The practice has been compared by some to torture, and ethicists in the medical literature have urged the physicians involved to refuse to participate, while the U.S. government and President Barack Obama defend the practice on humanitarian grounds of preventing the deaths of the detainees.

Whether or not one feels that nurse participation in the force-feeding is justified, this officer, whose identity has not been released, appears to deserve the profession’s praise for taking a moral stand in an extraordinarily difficult circumstance. All nurses have the […]

2016-11-21T13:04:16-05:00July 18th, 2014|career, Ethics, Nursing, Patients|10 Comments
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Getting Patients Involved in Care Redesign: What the Research Says

By Sylvia Foley, AJN senior editor

“I think the whole thing is we’re trying to im­prove care. It’s all about [patients] anyways. So if we’re gonna make changes that impact them I think we have to get them involved.” —study participant

Although there is considerable support for increasing patient involvement in health care, it’s not clear how best to achieve this. And few researchers have specifically investigated the views of patients and providers on patient engagement. In this month’s CE–Original Research feature, “The Perceptions of Health Care Team Members About Engaging Patients in Care Redesign,” Melanie Lavoie-Tremblay and colleagues describe findings from their recent study. Here’s a brief overview.

Objective: This study sought to explore the perceptions of health care workers about engaging patients as partners on care redesign teams under a program called Transforming Care at the Bedside (TCAB), and to examine the facilitating factors, barriers, and effects of such engagement.
Design: This descriptive, qualitative study collected data through focus groups and individual interviews. Participants included health care providers and managers from five units at three hospitals in a university-affiliated health care center in Canada.
Methods: A total of nine focus groups and 13 individual interviews were conducted in April 2012, 18 months after the TCAB program began in September 2010. Content analysis was used to analyze the quali­tative data.
Findings: Health care providers and managers benefited from engaging patients in the decision-making process because the patients brought a new point of view. Involving the patients exposed team members to valuable information that they […]

2017-07-27T14:45:30-04:00July 16th, 2014|nursing perspective, nursing research|1 Comment
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Flight Nursing Notes – The Feel of a Homecoming

Observations of an experienced ICU nurse and long-time AJN blogger who recently made the transition to flight nursing.

clouds-photo-from-airplaneMarcy Phipps, BSN, RN, CCRN, ATCN, TNCC, is an occasional contributor to this blog. Some details have been changed to protect patient privacy.

“We’ve been married for 58 years,” my patient’s wife says. “Fifty-eight years…”

She turns her attention from me and gazes out the window of the plane.

We are on a medevac flight, 35,000 feet over the Pacific en route to an urban, American hospital near “home.” Her husband is being transferred to receive aggressive care for a grave illness.

We collected him hours earlier from a hospital on a foreign island. Local paramedics picked my partner and me up from the barren, windy tarmac. As we sped to the hospital in the back of an ambulance with a cracked windshield, the driver turned to warn us that we were going to “the worst hospital in the city.”

“It’s open-air,” he told us, as he dodged mopeds and swerved through narrow, crowded streets.

This didn’t surprise me. I’d been forewarned that hospital conditions on many of these remote islands could be shocking when compared to American standards. It was something I’d been curious to see firsthand.

Yet when we picked our patient up, we found him in a small and clean room in an intensive care unit. Despite the paramedic’s prediction and […]

2016-11-21T13:04:17-05:00July 14th, 2014|career, Nursing|3 Comments
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Preparing Patients to Care for Themselves After Discharge

Here’s your prescription. Don’t drive if you take it. Call your surgeon if you have a temperature or are worried about anything. See your doctor in two weeks. Want a flu shot? If you need a wheelchair to take you to the door, I’ll call. If not, you can go. Take care of yourself. You’ll do great!”

These were my nurse’s parting words before I left the hospital after a weeklong stay and surgery to remove my stomach and the tumor in it. I said goodbye. Then I panicked. What did I need to know about my new digestive system? What about that big scar? Until then I’d been closely monitored and checked on every 90 minutes.

Now it was 8:45 in the morning. My husband hadn’t arrived. I was supposed to move on.

Jessie Gruman Jessie Gruman

That’s the start of our July Viewpoint column, “Preparing Patients to Care for Themselves,” written by Jessie Gruman, president and founder of the the Center for Advancing Health, a nonpartisan policy institute that’s played an important role in the growing patient engagement movement.

In this essay and elsewhere, Gruman draws on her own experience as a cancer patient as well as her public health expertise to bring insight and clarity to the often nebulous concept of […]

2016-11-21T13:04:18-05:00July 11th, 2014|Nursing|2 Comments
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VA Nursing Leadership Silent on Veterans’ Wait Times Scandal

By Gail M. Pfeifer, MA, RN, AJN news director

Audie L. Murphy Veterans Administration Hospital in San Antonio, TX / Wikimedia Commons Audie L. Murphy Veterans Administration Hospital in San Antonio, TX / Wikimedia Commons

I’ve been trying to arrange an interview with a nurse in a leadership role at the VA’s Office of Nursing Services (ONS) for over a month now, with little success.

Granted, an excessive wait time for an interview pales in comparison with how long many veterans have had to wait for health care. Still, this has given me a tiny taste of what it must be like to enroll with the Veterans Health Administration for services: you can contact them, but you have to wait a really long time to even schedule a first appointment.

A substantive interview with AJN might have been a golden opportunity for the ONS to get out ahead of the story that has plagued the VA since the Phoenix scandal about lengthy waiting times at the VA broke in early May. (I did finally get a response of sorts. More on that below.)

To recap: The allegations in May that the Phoenix VA system had manipulated data about appointment wait times to hide the fact that veterans were not getting timely appointments galvanized public and Congressional attention.

But […]

2016-11-21T13:04:19-05:00July 9th, 2014|Nursing, nursing perspective|5 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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