Patients Archives - Page 69 of 71

Open Medical Records: A Question of Safety

By Christine Moffa, MS, RN, AJN clinical editor

We’ve all watched our health care provider writing or typing while we answered questions or described our symptoms. Before becoming a nurse I used to wonder what they were putting in my chart and if they got it right. And now that I am a nurse I can’t believe how often a medical assistant or nurse will take my vital signs and write them down without telling me what they are. How can it be possible that adults are kept from knowing their own or their children’s health information? Back when I worked on a pediatric floor my colleagues gasped in shock when I allowed a parent of one of my patients to look at his child’s chart. And I actually let them make me feel like I had done something wrong!

Last week this issue was the topic of a column by Dr. Pauline W. Chen in the New York Times, where two related blog posts (here and here) also received much reader commentary. The sudden flurry of interest in the subject was occasioned by an article published in the Annals of Internal Medicine detailing the preliminary findings of a study following a national project called OpenNotes, funded by the Robert Wood Johnson Foundation, in which “more than 100 primary care physicians and 25,000 of their patients will have access to personal medical records online for a 12-month period beginning in summer 2010.” Readers’ comments ranged from one extreme to the other, such […]

Guest Author2016-11-21T13:16:18-05:00August 3rd, 2010|nursing perspective, patient engagement|3 Comments

Reflections on the Freedom to Harm Yourself

By Marcy Phipps, RN

(Identifying details of the patient and clinician mentioned in this post have been changed to protect their anonymity.)

Last week I took care of a woman who’d shot herself in the abdomen. This was the third suicide attempt she’d survived. She was physically compromised, to say the least, and was looking at a long recovery. Her despondence was palpable.

A clinical psychologist came to evaluate her and determined that she was experiencing major depression with suicidal ideations.

Usually, such patients are “Baker Acted.” In accordance with the Florida Mental Health Act, commonly referred to as the Baker Act, individuals who are deemed to be a danger to themselves or to others are held involuntarily and transferred to a treatment facility.

But because this patient stated to the psychologist that she was not only willing to seek mental health treatment, but also planned on checking herself into a facility near her home, she didn’t qualify to be involuntarily hospitalized. She was free to leave at any time.

As the psychologist explained to me, the first criterion of the Baker Act only considers whether or not the person in question is refusing treatment. According to Florida Statute 394.463, as long as said person does not refuse to be examined, the Baker Act does not apply.

Although the psychologist assured […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:16:51-05:00July 8th, 2010|Ethics, nursing perspective, Patients|3 Comments

Will Anyone Miss Accidents As ‘Preexisting Conditions’ and Other Insurance Doubletalk?

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

It’s interesting to have a firsthand encounter pertinent to the HCR story that is consuming the headlines. Recently, my son had a fall and dislocated his shoulder. He knew what had happened because he did it as a freshman in high school, some 10 years ago while playing sports. So he went to an ER and had the shoulder popped back in, saw an orthopedist as recommended, and went for physical therapy—all covered by his insurance plan. But all his claims for reimbursement were denied. The reason the company gave: his dislocated shoulder was considered a ‘preexisting condition.’

After my husband peeled me off the ceiling, we approached this methodically—we gathered forms, wrote letters, requested letters from the hospital, the orthopedist, the physical therapists—and appealed the ruling. After a bit, we received a response saying that they’d reconsidered and would cover the injury according to policy.

This is not a terribly compelling or poignant case, but it’s an example of the “first deny all claims” approach of some companies. Yes, it was resolved on appeal fairly easily, but why did it need appealing in the first place? I can’t imagine what patients and families with chronic illness must go through in trying to get treatment covered.

If the only thing health reform does is to eliminate the unjust use of preexisting conditions to deny coverage, it will get rid of one of the most critical obstacles to access to care.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:41-05:00March 22nd, 2010|health care policy, Patients|5 Comments

Disabled Musicians Featured in Podcasts, AJN Cover, Subject of Oscar-Winning Film

By Shawn Kennedy, interim editor-in-chief

At the Academy Awards ceremony last night, “Music by Prudence,” the documentary about Prudence Mabhena, won the award for best documentary short. Prudence is the lead singer of Liyana, a group of young Zimbabwean musicians who graced the above cover of our August issue last year. All of the band members have some kind of disability and attended the King George VI School and Centre for Children with Physical Disabilities in Bulawayo, Zimbabwe. When they performed throughout the United States last year, AJN’s senior editorial coordinator Alison Bulman interviewed them after their concert in New York.

Go here for links to podcasts of interviews with the band and the Oscar-winning documentary filmmaker Roger Ross Williams—and also to some of the music of Liyana (the podcasts will load, but right now can take up to 30 seconds on some computers!). You can also read Bulman’s short article about this remarkable troupe here, or a blog post about Liyana we published some months back. Congratulations to Liyana, and to Williams, who helped them tell their story!

(And click here to read an interview posted yesterday on Huffington Post and WalletPop with Alison about her experience interviewing the film’s director and producer, whose relationship has been the subject of controversy since an awkward moment at the Academy Awards ceremony.)

Jacob Molyneux, senior editor/blog editor2016-11-21T13:18:55-05:00March 8th, 2010|patient engagement|0 Comments

‘Ask Me Three Questions’: Engaging Patients to Promote Safety

By Peggy McDaniel, BSN, RN

Next week, March 7–13, is Patient Safety Awareness Week. The National Patient Safety Foundation (NPSF) has sponsored Patient Safety Awareness Week since 2002 to help promote awareness of patient safety issues among hospital staff, patients, and communities. This year’s campaign focuses on engaging patients in theior own care, and it draws upon the NPSF template “Ask Me Three,” which encourages patients to ask these questions: