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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Diabetes and Puberty – How Nurses Can Help Teens and Their Parents Manage Blood Glucose

Trenton Jantzi replaces his insulin pump infusion site during a break at school. The high-school senior must change his infusion site every three days. Photo by Mark Ylen / Democrat-Herald. Trenton Jantzi replaces his insulin pump infusion site during a break at school. The high-school senior must change his infusion site every three days. Photo by Mark Ylen / Democrat-Herald.

A new article in AJN gives crucial information on the challenges to managing diabetes, both type 1 and type 2, that are faced by teenagers and their parents during the physical and psychosocial changes of puberty.

Any nurse can tell you that it’s not easy to manage diabetes. I got type 1 diabetes when I was 27 years old and it took me more than ten years to really understand how to balance the effects of diet, exercise, insulin intake, and other factors like illness or stress.

There’s a lot at stake, too, in terms of long-term complications linked to poor blood glucose control, including blindness, heart disease, neuropathy, and a host of other unpleasant complications. In addition, there are serious potential short-term risks of diabetes like hypoglycemia or hyperglycemia that can land you in a coma or worse.

Even […]

2016-11-21T13:04:19-05:00July 7th, 2014|Nursing, patient engagement, Patients|1 Comment
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Telehealth as ‘Disruptive Innovation’ in Nursing

A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady. A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady.

“Telehealth: A Case Study in Disruptive Innovation” is a CE article in AJN‘s April issue. The author, Janet Grady, vice president of academic affairs and chair of the Nursing and Health Sciences Division at the University of Pittsburgh in Johnstown, Pennsylvania, describes the concept of disruptive innovations in nursing and delves into the evolving field of telehealth as a current example.

The article considers the following:

  • uses and potential uses of telehealth in chronic and acute care, home care, and rural medicine, and the evidence supporting its use.
  • obstacles to wider use and acceptance of telehealth, which include cultural resistance within nursing, licensure issues across states, reimbursement challenges, and the need to adapt nursing curriculum to these new ways of delivering care.
  • forces that drive or obstruct disruptive innovations like telehealth.

Here’s the article overview:

Technologic advances in health care have often outpaced our ability to integrate the technology efficiently, establish best practices for its use, and develop policies to regulate and evaluate its effectiveness. However, these may be insufficient reasons to put the brakes on innovation—particularly those “disruptive innovations” that challenge the […]

2016-11-21T13:05:00-05:00April 18th, 2014|digital health, Nursing, patient engagement|1 Comment
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The Power of Imagination: Helping Kids with Sickle Cell Disease to Cope with Pain

By Sylvia Foley, AJN senior editor

Many people with sickle cell disease suffer from both acute and chronic pain, which can be severe. Although the exact mechanism isn’t known, the pain is believed to result when sickled erythrocytes occlude the vascular beds, causing tissue ischemia. Such pain, which often begins in early childhood, arises unpredictably. Although some pain crises may require ED visits, hos­pitalization, opioid treatment, or a combination of these, most are managed at home. Yet little is known about at-home pain management in people with sickle cell disease, especially children.

Table 2. Changes in Self-Efficacy, Imaging Ability, and Pain Perception in School-Age Children After Guided Imagery Training Table 2. Changes in Self-Efficacy, Imaging Ability, and Pain Perception in School-Age Children After Guided Imagery Training

Cognitive behavioral therapy (CBT) has shown promise in helping patients with other chronic illnesses to cope with pain. Cassandra Elaine Dobson and Mary Woods Byrne decided to test guided imagery, a form of CBT, among children enrolled at one sickle cell treatment clinic in New York City. They report on their findings in this month’s original research CE, “Using Guided Imagery to Manage Pain in Young Children with Sickle Cell Disease.” The abstract below offers a quick overview; if you click the image above, you’ll see an enlarged view of one table showing key results.

Objectives: The purposes of this study were to test the effects of guided imagery training on school-age children who had been diagnosed with […]

2017-07-27T14:47:16-04:00April 2nd, 2014|nursing research, pain management, patient engagement|0 Comments
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Staffing and Long Shifts – Some Recent Coverage

By Shawn Kennedy, AJN editor-in-chief

by patchy patch, via flickr by patchy patch, via flickr

The March issue will soon be published and be featured on the home page of our Web site, so before the February issue is relegated to the archive section, I want to highlight two articles. Knowing that some readers of this blog may not be regular readers of AJN (I know, hard to believe), I wanted to bring them to your attention.

I don’t usually blog about my own editorials, but the February editorial (“It All Comes Back to Staffing”) has apparently resonated with many readers. I’ve received several letters and a request to reprint it from a state nursing association. (The editorial includes a portion of a poignant letter I received from a reader in response to an editorial I’d written for the December 2013 issue, “Straight Talk About Nursing,” in which I discussed missed care—that is, the nursing care that we don’t get to but is often at the heart of individualizing care.)

The February editorial ties in with a special report, “Can a Nurse Be Worked to Death?”, by Roxanne Nelson from Van Insurance, which addresses the recent death of a nurse who was killed in a car accident while driving home after […]

2017-05-11T21:22:34-04:00February 24th, 2014|nursing perspective, nursing research, patient engagement, patient safety, safe staffing|2 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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