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 […]

2016-11-21T13:16:18-05:00August 3rd, 2010|nursing perspective, patient engagement|3 Comments
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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.)

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2016-11-21T13:18:55-05:00March 8th, 2010|patient engagement|0 Comments
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‘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:

  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

[…]

2018-03-13T10:46:32-04:00March 3rd, 2010|health care policy, Nursing, patient engagement|0 Comments
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‘Jenny’s Daydream’: February’s ‘Art of Nursing’ Disturbs the Quiet

By Sylvia Foley, AJN senior editor

“Stuck to the chair, locked door, locked window, / watching for wrens and sparrows, Jenny closes her eyes.” These lines open “Jenny’s Daydream,”  the poem featured in this month’s Art of Nursing (please click through to the PDF). The daydream is no idyll; though Jenny “remembers sparse blue and yellow flowers” and “herring gulls sunning on the pier, peaceful,” she’s also “waiting for / God’s voice to disturb the interstellar quiet.” Why? The answer, at once harrowing and poignant, might surprise you.

Karen Douglass, a writer and retired RN, has been published in many literary and mainstream magazines, including Sunken Lines, The Other Voices International Project, and Yankee. Her most recent collection is The Great Hunger (Plain View Press, 2009).  Douglass also blogs about writing and life at KD’s Bookblog.

And if you’re a poet or a visual artist, we hope you’ll consider submitting to Art of Nursing. Read this blog post for details. Guidelines can be found here. Still have questions? Write to the Art of Nursing coordinator (me) at sylvia.foley@wolterskluwer.com.

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2016-11-21T13:19:17-05:00February 17th, 2010|nursing perspective, patient engagement|2 Comments
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Want to Achieve the ‘Greatest Good’? Listen to Your Patients

Ethical dilemmas abound in nursing practice. Consider these commonplace scenarios:

* An angry patient threatens to leave the hospital against medical advice. Should you hold him against his will?

* A cancer patient fears chemotherapy. Should you give less detailed information about the effects of anticancer drugs?

* An obese home care patient with pressure ulcers refuses to cooperate in turning. Should you turn her anyway?

Such conflicts between the patient’s wishes and the nurse’s perception of the patient’s best interests occur regularly. That doesn’t make these ethical dilemmas any easier to resolve, but how nurses approach them can significantly affect clinical outcomes. Taking the time to listen to patients—and to integrate relationship skills with principles of ethical practice—can help nurses achieve solutions that are both ethical and appropriate for individual patients.

ky olsen/via Flickr

That’s from the February issue of AJN, in which nurse–ethicist Doug Olsen (who has in the past written for this blog on ethical issues related to mandated H1N1 vaccinations for nurses) offers a thoughtful discussion that may resonate for all nurses who’ve ever faced a situation like those in the above examples. It may seem obvious or cliched to say that listening to patients can help solve apparently intractable problems—but just because listening as a skill is hard to measure doesn’t mean that it’s not sometimes effective where more rigid tactics would fail.

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2016-11-21T13:19:32-05:00February 9th, 2010|Ethics, Nursing, patient engagement|0 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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