Something Like Grace

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

ViewFromPlaneWindowMark was in town to be the best man in an old friend’s wedding—on a vacation, of sorts—when the unthinkable happened and he was involved in a horrendous traffic accident. He was ejected from his rental car. His injuries were severe and life threatening.

Mark’s family was halfway across the country. Getting to Mark quickly seemed impossible. But this is where the story takes a turn:

Mark’s family found a flight leaving that morning from their local airport, with the exact number of available seats that they needed. As they bought the tickets, they explained the nature of their emergency. They got to the airport in the nick of time. While checking in, they were approached by an airline employee who asked if they’d already arranged a rental car. They told him that they hadn’t—they hadn’t even stopped to get their clothes.

They didn’t know it at the time, but the employee who’d approached them was the pilot of the plane. He’d learned of the family emergency and held the plane for them. He knew how serious Mark’s accident had been, as he’d happened to drive right past the accident scene on his way to the airport before the first leg of the flight.

When the plane landed, the pilot requested that Mark’s family […]

2016-11-21T13:06:57-05:00July 22nd, 2013|nursing perspective, Patients|4 Comments
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A Fine Line Between Patient and Provider, and a Mother’s Plea for More Epilepsy Research

by Eric Collins, ecol-arts.com by Eric Collins, ecol-arts.com

Thomas is a frequent flier in our ER, a bespeckled 40-something with coke-bottle glasses, a man who seems to run, like a dog out for a joyride, right into the arms of the dogcatcher. The police bring him in, one man on each arm, his legs limp. Thomas has schizoaffective disorder, dives into the fountain at the mall, screams at strangers at the YMCA, paces outside the grocery store. In a way, I understand—sometimes behaving according to convention can be a little dull.

That’s the start of “Thomas,” the July Reflections essay in AJN by Emily Maloney. It’s about the fine, but still absolute, line that can exist between paid provider and patient at moments when life feels overwhelming to both. Or something like that—it’s hard to summarize a nuanced, lightly ironic account like this in a few words. Like all Reflections essays, it’s short, free, and worth a full read.

The July Viewpoint essay, “A Son’s Seizures,” is written from the perspective of a mother, Linda Breneman, who looked beyond her own experience to become an advocate for all those with epilepsy, particularly those with the intractable sort that doesn’t respond to most treatments. While most people with epilepsy respond to medications and can eventually live more or less normal lives, it’s the author’s well-argued conviction that more research needs to be done to help the subset of those with […]

2016-11-21T13:06:58-05:00July 19th, 2013|Nursing|1 Comment
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Who Will Watch the Watchers? Consider Nurses

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Sometimes my surgical mask feels like a gag/by Julianna Paradisi Sometimes my surgical mask feels like a gag/by Julianna Paradisi

Does anyone else find it ironic that, while the National Security Agency (NSA) is seeking to extradite and prosecute the contractor who revealed the agency’s alleged widespread spying on ordinary Americans and visitors from other countries, nurses can get fired for far more local breaches of privacy?

When the government gives 500,000 private contractors access to data hoards compiled from the electronic and phone conversations of U.S. citizens, is HIPAA still relevant?

Two years ago, the nurse blogosphere raged over the expulsion of three nursing students for posting the photo of a placenta on Facebook. Today, in light of the NSA’s potentially far-reaching privacy violations, the decidedly insensitive exploits of those students seem a bit less newsworthy.

More famously, the ordeal of Vickilyn Galle and Anne Mitchell, nurses who were fired after they blew the whistle on medical malpractice while exposing a conflict of interest affecting patient safety within the hospital, illustrates the high accountability placed upon nurses to protect patient privacy. […]

2016-11-21T13:06:59-05:00July 17th, 2013|Ethics, Nursing, Patients|2 Comments
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When Loved Ones and Patients Don’t Choose Life

By Karen Roush, AJN clinical managing editor

Photo by the author Photo by the author

This isn’t the blog post I started out to write. That was a more personal story about someone close to me, let’s call this person Jess, who died after years of chronic illness worsened by self-neglect—after years of being that person Olsen talks about in this month’s article (free until August 15) on helping patients who don’t help themselves (and in his related blog post from last week).

But as I wrote, I realized that it wasn’t fair, that I was leaving out the complex story behind their persistent unhealthy behaviors, behaviors that eventually led to a lingering, awful death.

And without that background knowledge, it was too easy to be judgmental—as it is sometimes too easy for us as nurses to be judgmental of patients who don’t help themselves, who even seem to be willfully destroying their own health: the obese person who keeps drinking those giant sodas, the smoker who lights up another cigarette. As a nurse it can be very frustrating to care for a patient who ignores health recommendations, to their own detriment. As a family member or friend, it can be heartbreaking and infuriating.

There are limits to what we can do. We cannot force patients to eat well, take necessary medications, quit smoking, modify their alcohol intake, wear their seatbelts . . . the list goes on and on. Yes, we […]

2016-11-21T13:07:02-05:00July 15th, 2013|nursing perspective|4 Comments
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Obesity as Disease and the Health Care Culture’s Take on Personal Responsibility and Suffering

Doug OlsenBy Doug Olsen, PhD, RN, associate professor, Michigan State University College of Nursing, and AJN contributing editor. Olsen regularly addresses topics related to nursing ethics. His most recent article for AJN was “Helping Patients Who Don’t Help Themselves” (July issue; free until August 15).

Why does the American Medical Association’s recognition of obesity as a disease (AMA, 2013) stir strong feelings? People are just as heavy as before, their health is suffering as much, and the therapies for obesity remain the same. The main difference is that the label may give clinicians a better rationale to seek reimbursement for obesity-related services, which might help increase treatment rates. No one yet knows if the new label will really have an effect on treatment rates; in any case, this is not what people are concerned about.

The issue is what labeling a health problem with a behavioral component as a “disease” implies about personal responsibility—or what people think it means. How does personal responsibility relate to individual suffering?

The relationship between decision making, suffering, and personal responsibility is at the heart of bioethics as it is practiced in the United States. But bioethics didn’t invent our cultural tendency to connect personal responsibility and sympathetic regard for suffering, and our current approach to the issue was developed through […]

2017-04-03T12:12:36-04:00July 11th, 2013|Ethics, patient engagement, Public health|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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