A Fine Line Between Patient and Provider, and a Mother’s Plea for More Epilepsy Research

by Eric Collins, ecol-arts.com by Eric Collins, ecol-arts.com

Thomas is a frequent flier in our ER, a bespeckled 40-something with coke-bottle glasses, a man who seems to run, like a dog out for a joyride, right into the arms of the dogcatcher. The police bring him in, one man on each arm, his legs limp. Thomas has schizoaffective disorder, dives into the fountain at the mall, screams at strangers at the YMCA, paces outside the grocery store. In a way, I understand—sometimes behaving according to convention can be a little dull.

That’s the start of “Thomas,” the July Reflections essay in AJN by Emily Maloney. It’s about the fine, but still absolute, line that can exist between paid provider and patient at moments when life feels overwhelming to both. Or something like that—it’s hard to summarize a nuanced, lightly ironic account like this in a few words. Like all Reflections essays, it’s short, free, and worth a full read.

The July Viewpoint essay, “A Son’s Seizures,” is written from the perspective of a mother, Linda Breneman, who looked beyond her own experience to become an advocate for all those with epilepsy, particularly those with the intractable sort that doesn’t respond to most treatments. While most people with epilepsy respond to medications and can eventually live more or less normal lives, it’s the author’s well-argued conviction that more research needs to be done to help the subset of those with […]

2016-11-21T13:06:58-05:00July 19th, 2013|Nursing|1 Comment
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Who Will Watch the Watchers? Consider Nurses

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

Sometimes my surgical mask feels like a gag/by Julianna Paradisi Sometimes my surgical mask feels like a gag/by Julianna Paradisi

Does anyone else find it ironic that, while the National Security Agency (NSA) is seeking to extradite and prosecute the contractor who revealed the agency’s alleged widespread spying on ordinary Americans and visitors from other countries, nurses can get fired for far more local breaches of privacy?

When the government gives 500,000 private contractors access to data hoards compiled from the electronic and phone conversations of U.S. citizens, is HIPAA still relevant?

Two years ago, the nurse blogosphere raged over the expulsion of three nursing students for posting the photo of a placenta on Facebook. Today, in light of the NSA’s potentially far-reaching privacy violations, the decidedly insensitive exploits of those students seem a bit less newsworthy.

More famously, the ordeal of Vickilyn Galle and Anne Mitchell, nurses who were fired after they blew the whistle on medical malpractice while exposing a conflict of interest affecting patient safety within the hospital, illustrates the high accountability placed upon nurses to protect patient privacy. […]

2016-11-21T13:06:59-05:00July 17th, 2013|Ethics, Nursing, Patients|2 Comments
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When Loved Ones and Patients Don’t Choose Life

By Karen Roush, AJN clinical managing editor

Photo by the author Photo by the author

This isn’t the blog post I started out to write. That was a more personal story about someone close to me, let’s call this person Jess, who died after years of chronic illness worsened by self-neglect—after years of being that person Olsen talks about in this month’s article (free until August 15) on helping patients who don’t help themselves (and in his related blog post from last week).

But as I wrote, I realized that it wasn’t fair, that I was leaving out the complex story behind their persistent unhealthy behaviors, behaviors that eventually led to a lingering, awful death.

And without that background knowledge, it was too easy to be judgmental—as it is sometimes too easy for us as nurses to be judgmental of patients who don’t help themselves, who even seem to be willfully destroying their own health: the obese person who keeps drinking those giant sodas, the smoker who lights up another cigarette. As a nurse it can be very frustrating to care for a patient who ignores health recommendations, to their own detriment. As a family member or friend, it can be heartbreaking and infuriating.

There are limits to what we can do. We cannot force patients to eat well, take necessary medications, quit smoking, modify their alcohol intake, wear their seatbelts . . . the list goes on and on. Yes, we […]

2016-11-21T13:07:02-05:00July 15th, 2013|nursing perspective|4 Comments
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Hand Washing: What’s It Going to Take to Get the Job Done?

Handwashing Handwashing (Photo credit: kokopinto)

By Shawn Kennedy, AJN editor-in-chief

I took a few days off last week and caught up on some reading. Perhaps the article that struck me most was one from the New York Times on the various methods that many hospitals are using to improve rates of hand washing among nurses, physicians, and other direct care providers. Hospitals are trying everything from buttons that offer gentle reminders to camera monitors to mandating that direct caregivers wear electronic sensors that indicate whether or not they washed their hands.

Perhaps the most disturbing part of the article was the remarks made by Elaine Larson, a nursing professor at Columbia University School of Nursing who had done extensive research on hand washing. She spoke of how some health professionals go out of their way to avoid washing their hands, even ducking under scanners.

A 2009 report from the Centers for Disease Control and Prevention estimated that HAIs (hospital-acquired infections), cost U.S. hospitals between $28.4 to $33.8 billion annually in direct medical costs. Just think about what could be done with that money.

I don’t get it. We all know the importance of hand washing. From Ignaz Semmelweis, who introduced hand washing in obstetrical clinics in 1847 and as a result reduced puerpal fever, to Florence Nightingale, whose insistence on good hygiene and basic cleanliness helped to reduce death rates during the Crimean War, to the extensive body of research conducted by […]

2016-11-21T13:07:04-05:00July 10th, 2013|nursing research|7 Comments
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Get the Job Done

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

Dietetics class for nurses, 1918/Cornell University Library/via Flickr Nursing students, 1918/Cornell University Library/via Flickr

I remember being a new nurse and having an order to place a Foley catheter in a female patient.

I was filled with dread. Urinary catheter placement was the only skill I’d failed in nursing school (I’d contaminated my sterile field), and placing a catheter in this patient was sure to be a challenge, as she was obese and unable to cooperate. It was not a one-person job, even for a far more experienced nurse.

When I asked a coworker for help, she sighed and said, “I don’t have time. This isn’t nursing school, you know. You just do the best you can and get the job done.” […]

2016-11-29T13:33:01-05:00July 8th, 2013|nursing perspective, nursing stories|3 Comments
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