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:

  • When the patient lacks decision-making capacity
  • When the patient is dangerous and has a mental disorder
  • An emergency […]
2017-09-02T09:55:06+00:00 September 2nd, 2017|Ethics, Nursing|11 Comments

Becoming a Family Caregiver

Photo by Judith E. Bell, via Flickr.

For me, the saga began six years ago, when I offered to help a family member with some spring cleaning. I knew his place was a mess, but attributed this, stereotypically, to a single man’s lack of interest in housekeeping.

When I dove into the work, I was first puzzled and then fearful at what I found: hundreds of pieces of unopened mail, years old, randomly stacked around the apartment; threatening letters from the Internal Revenue Service; correspondence from the city about a tax lien on his condominium. This, in the home of a man who, as an actor and writer, memorized scripts in two languages, had served on the national board of his union, and could solve complicated math problems without using a calculator. Clearly, something was wrong well beyond the state of his apartment.

In AJN’s September original research article, “The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia,” Kathleen Czekanski notes that “caregivers often assume the role of caregiving before they quite realize they are doing so.” In this qualitative study, Czekanski set out to gain an understanding of the caregiver’s experience in taking […]

2017-09-01T08:54:00+00:00 September 1st, 2017|nursing research|0 Comments

The Health Impacts of Hurricane Harvey—What Nurses Need to Know

Geocolor imagery of Hurricane Harvey on verge of making landfall. Image created by the Cooperative Institute for Research in the Atmosphere.

As Hurricane Harvey, now a tropical storm, continues to affect a large area of southern Texas and other parts of the South, the full impact on human health has yet to be determined. But it’s clear the flooding has caused a historical crisis in Houston and surrounding areas—and that nurses and other health professionals will be in great demand in the coming days, weeks, and months.

Short- and Long-Term Health Concerns

The short- and long-term health consequences people are facing as they escape rising water levels are detailed in the Washington Post. Although drowning is the most immediate and dangerous threat during a flood, those seeking safety are also endangered by sharp objects and even wild animals caught up in floodwaters. Mold and its impact on human health will be a concern in the coming weeks and months, as water-damaged buildings are reoccupied.

In the meantime, health authorities are worried about the spread of infectious diseases. As sewage contaminates the floodwaters and people crowd into shelters, they may be more susceptible to the development of skin, gastrointestinal, and respiratory infections. A prolonged lack of power, and thus air conditioning during the […]

When a Patient Turns Scary, a Nurse’s Options Aren’t Always Clear

I was leaning over my patient, listening to his lung sounds, when his hand tightened around my wrist. “Why don’t you get in the bed with me?” he said.

Illustration by McClain Moore

That’s the arresting opening of “The Squeeze,” the Reflections essay by nurse Danielle Allen in the September issue of AJN. Such scary experiences happen, as many nurses can attest. What behaviors cross the line? Who decides? After all, nurses put up with lots of challenging behavior. What’s unacceptable, and what constitutes a real safety issue?

Complicating these questions may be the responsibility a nurse feels to not let down their equally burdened nursing colleagues. No one, as Allen writes, wants “to be that nurse. You know, the complainer, overly sensitive, not-a-team-player nurse.”

Allen vividly evokes her encounter with the patient, the varied responses of nursing colleagues later, the emotional aftereffects of the event, and the larger question she finds herself asking about what can be done to keep nurses and other health care workers safe. […]

2017-08-28T08:37:02+00:00 August 28th, 2017|Nursing, nursing stories|1 Comment

AJN September Issue: Family Caregivers and Alzheimer’s, Older Adults and Driving, C. Diff. Prevention, More

The September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE: Original Research: The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia

This qualitative study explores the experiences of people who transitioned to the role of caregiver for a family member with Alzheimer’s disease or a related dementia. Vivid interview excerpts illuminate the inner struggles caregivers may experience as they navigate a radically changed existence as well as the strategies that have helped them find their way.

CE: Can Your Older Patients Drive Safely?

Many older Americans depend on their cars for independence and connection to the outside world. What are the driving risks associated with advanced age? What behaviors and situations put older drivers at greatest risk, and what are the key indicators of an older patient’s ability to drive safely? Nurses are in a position to raise patients’ awareness of these risks and inform them about transportation alternatives.

Six Things You Can Do Today to Prevent Hospital-Onset C. Difficile Tomorrow

What changes can you make in your practice to prevent transmission of this common bacterial infection?

Lessons Learned from Litigation: Legal and Ethical Consequences of […]

2017-08-25T09:03:28+00:00 August 25th, 2017|Nursing|0 Comments