Snow
I stepped toward him and put my hand on his shoulder, thinking that I’d just seen this man’s last breath, and that he was gone.
Workplace Violence: Whose Problem Is It?
By Julianna Paradisi, RN
Once upon a time, I was the assured quality (AQ) representative for a nursing unit. I attended monthly AQ committee meetings with members from medicine, pharmacy, laboratory, and respiratory therapy to review incident reports. We developed processes for improving patient safety and work flow. Agenda items changed monthly, except for the paper towel dispenser problem.
The unit had a paper towel dispenser, which operated by a lever. It was noisy, disturbing the patients. It did not hold enough paper towels for 24 hours. Since housekeeping did not staff to fill paper towel holders on night shift, physicians and nurses entering the room found them empty after washing their hands in the morning. This angered everyone, so it went on the AQ committee’s agenda.
The unit needed new towel dispensers. However, the committee could not determine whose job it was to research replacements. No one knew which department was responsible for ordering new dispensers, or whose budget would pay for them. Since there were other agenda items to discuss, every month the towel dispenser problem was “parked” for the next meeting. This continued for the entire time I served on AQ. The problem remained unresolved when I moved on.
Workplace violence toward nurses feels like the “irresolvable dilemma” of the paper towel dispenser. Over the years, statistics […]
When Patient Safety Trumps All: Conversations With the Texas Whistleblower Nurses
Image via Wikipedia
You may not remember February 11, 2010, all that well, but it’s a date nurse Anne Mitchell will never forget. It was the date she was acquitted of all criminal charges in a case that garnered widespread coverage not only in the nursing world (see our October 2009 report) but in the general media (see the New York Times article). Mitchell was the Texas nurse criminally prosecuted for filing a complaint with the Texas Medical Board against a physician for unsafe and substandard practices (that board did agree with her). She and a colleague found themselves embroiled in a nightmare in which they were fired, arrested, and indicted. (Charges were eventually dismissed against Vicki Galle and only Mitchell went to trial.)
The case raised questions about a nurse’s professional and legal duty to safeguard patients—and about the strength of whistleblower protections (Texas has a whistleblower protection law).
In a “what goes around comes around” scenario, this past February those who pressed the charges—the sheriff (who was a patient, friend, and business partner of the physician); the Winkler County attorney; the former hospital administrator; and the physician—were all indicted by a grand jury. Ironically, the indictment was partially for misuse of official information, the same charge they had brought against the nurses.
On February 18, I interviewed Mitchell, Galle, and another colleague, Naomi Warren, who also wrote a […]
Alone, Isolated, At Risk
By Shawn Kennedy, AJN editor-in-chief
I saw the following headline this week: “LA woman dies in her cubicle at work; body is not discovered until the following day.” The article said it was unclear how she had died. I hope it was at the end of the day after everyone had left; I really hope they don’t find out that she died midday, amidst coworkers who were going about their business. Maybe they were so busy that they never noticed the silence from her cubicle.
This story reminded me of two articles I read recently. One was an article that will be published in the Emerging Infections department in our March issue, which goes live at the end of next week on ajnonline.com. “The Contact Precautions Controversy” examines the issues around placing patients on contact precautions and in isolation—an approach that many hospitals use almost routinely for some patients. (We covered this issue in a news piece last July as well.) Recent studies are raising questions about this practice and the risks to these patients, who often have fewer interactions, get less care, and may feel neglected because health care providers limit contact.
The other article is one that’s in the headlines now. The Boston Globe ran a story about […]
Treating Kids With Asthma in the ED Means More Than Just Putting Out Fires
EDs play an important role in the care of children with asthma. ED clinicians often treat families who don’t have a consistent relationship with a primary care provider. Given this opportunity, it’s essential that all members of the pediatric ED health care team be informed, educated, and updated on the latest asthma treatment guidelines to ensure best practice and high quality outcomes.
In this month’s Emergency column, “Managing Pediatric Asthma Exacerbations in the ED” (which will be free for the next six months), three nurses at Children’s Hospital Boston present a composite case, review the evidence regarding treatment options, describe practices at their own hospital and asthma treatment guidelines, and emphasize the crucial importance ED nurses can play in making sure these children don’t end up back in the ED because of lack of follow-up care or poor care in the home.
Have a look and let us know what you’re doing to make sure you’re not just putting out fires when you treat a child with asthma in the ED.—JM, senior editor
