The Words We Use to Talk About the Act of Suicide

    marie + alistair knock/flickr creative commons

Suicide. A dear friend of mine died this way almost 40 years ago, leaving behind a beautiful six-month-old boy and a beloved and loving husband. I have never given any thought to the way we friends and family refer to her death. Then last week, I came across a 2015 blog post by the sister of a man who died in the same way.

In the post on a website that shares experiences of disability and mental illness, former hospice social worker Kyle Freeman argues that this term suggests criminality. She points to laws in the U.S. that, until a little more than 50 years ago, defined suicide as a criminal act. Kyle feels this history has perpetuated a sense of shame and embarrassment in survivors.

“…the residue of shame associated with the committal of a genuine crime remains attached to suicide. My brother did not commit a crime. He resorted to suicide, which he perceived, in his unwell mind, to be the only possible solution to his tremendous suffering.”

Kyle believes that the common use of the phrase “committed suicide” is not only inaccurate but can add to the suffering of those who have lost friends or family in this way. She prefers the term dying by suicide. […]

2017-09-15T09:29:16-04:00September 15th, 2017|family experience, patient experience|0 Comments
Read More

Safety vs. Independence: When Is a Person Too Old to Drive?

I’d venture that many of us have had family discussions about whether it’s safe for a grandparent or elderly aunt or uncle to be driving. Driving is often the last vestige of independence and one that is fiercely held onto.

I had an aunt and uncle who worked out a unique and very shaky scheme so they could still get around independently: he couldn’t drive because of severely diminished eyesight, but he would direct his wife, my aunt, who had early Alzheimer’s, as she drove. Between the two of them, they could get to grocery stores, church, medical appointments, and bingo.

And one colleague, to prevent her father from driving after multiple accidents, told him she needed the car to get to work; in reality, she just drove it a few blocks from the house and parked it.

While author Loren Staplin and his colleagues note in ”Can Your Older Patients Drive Safely?” that “decline in driving abilities is related to functional status, not chronological age,” they also observe that the “greater risk associated with driving at age 75 and older is . . . evident in these drivers’ greater level of involvement in fatal motor vehicle accidents relative to their representation in the licensed driver population.” […]

2017-09-13T09:26:54-04:00September 13th, 2017|Public health|1 Comment
Read More

Please Nurse: Needing to Feel Human Again in the ICU  

Ruby Vogel circa 1970. Courtesy of Shannon Perry.

The patient perspective below was written by Ruby Vogel in 1976, shortly after she was discharged from the hospital following a cholecystectomy and colon surgery. Her daughter Shannon Perry, PhD, RN, FAAN, professor emerita at San Francisco State University, recently received the document from her sister, also a nurse and former nursing educator, to whom their mother had originally given it.

According to Perry’s sister, who found the document while cleaning out some files, Vogel had thought her daughter could use the information to help her students understand the experiences of patients in the ICU. Some things were different back then—for example, says Perry, a cholecystectomy and colon surgery were major surgeries with several days in the hospital for recovery. But some things stay the same, and this vivid account highlights how patient-centered care—a touch, a hand on the brow—can make the difference. Ruby Vogel died in 1985.

Intensive care put me in a different world—of noises, silly ideas, and feelings. I seemed apart from people. They came and went but I wasn’t people, just that big sore place. I could hear and I could see. People didn’t seem to speak to me nor stay around long enough for my eyes to focus or my lips to form words. In and out. Checking! Checking! Checking! I could see and hear. Family, nurses came in, took a look and left. I was still there.

That awful machine next […]

2017-09-11T10:45:55-04:00September 11th, 2017|patient experience, Patients|0 Comments
Read More

How Long Should Routine Health Screening Continue in Older Adults?

Photo by Johner Images / Alamy Stock Photo

Communicating to older patients that routine screening tests are no longer recommended can prove difficult. Recent research, however, offers guidance on how nurses and other clinicians should approach such conversations.

As we report in a September news article, a study focused on cancer screening found that older adults unlikely to benefit from certain tests were receptive to recommendations to stop screening, with a caveat: they preferred that life expectancy not be a part of the conversation.

The study’s accompanying editorial notes that broaching the topic of life expectancy can turn a discussion about maintaining health into an unexpected discussion about the end of life, which “may be a shock in the primary care setting at a routine visit.” The authors of the study recommend changing the language used in these conversations—for example, saying “This test would not help you live longer” instead of referring to “life expectancy.” […]

2017-09-06T09:21:09-04:00September 6th, 2017|Nursing, patient engagement|1 Comment
Read More

A Nurse Takes a Stand—and Gets Arrested

image via Wikimedia Commons / Jacklee

Douglas P. Olsen, PhD, RN, associate professor, College of Nursing, Michigan State University, writes about ethical issues for AJN.

On July 26, Alex Wubbels, charge nurse at the University of Utah Hospital burn unit in Salt Lake City, showed extraordinary ethical courage that will serve as an example for my students for a long time to come. She refused a police detective access to an unconscious patient so he could draw a blood sample, citing clear violation of hospital regulations, which require patient consent, a court warrant, or that the patient is under arrest. After a short, tense discussion, she was roughly handcuffed and put in a police vehicle by the detective. I recommend watching the video of the incident, although parts of it are quite disturbing. According to various analyses reported in the media, the hospital and Wubbels were legally correct and the detective’s view of her legal obligations was wrong.

All treatment, even the most minimally invasive, can be refused by a patient and therefore requires the patient’s informed consent. There are limited exceptions under which treatment can be provided without patient consent. These include:

2017-09-02T09:55:06-04:00September 2nd, 2017|Ethics, Nursing|11 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top