Off the Charts

“Let Patients Help”: Nurses and e-Patients

Joy Jacobson is a health care journalist and the poet-in-residence at the Center for Health, Media, and Policy at Hunter College, where she teaches writing to nursing students.

In the March issue of AJN, a letter writer responds critically to my news report, “Leveling the Research Field Through Social Media,” published last October. My report summarizes some recent trends in medical research, including patients using Facebook and other social networking sites to push for the funding of research into treatments that the science may not support. I go on to discuss PatientsLikeMe, which describes itself as “a health data-sharing platform” designed to “transform the way patients manage their own conditions.”

The letter writer objects to the idea of patients sharing their own data online. Can vulnerable, mentally ill patients, she asks, consent to participate in online research? Is enough being done to safeguard them? “I suggest we disseminate information to nurses that helps them steer patients away from Web sites such as PatientsLikeMe,” she concludes, “until programs and processes are in place to better protect the public we’ve pledged to serve.”

Several PatientsLikeMe researchers responded to this nurse’s points; a synopsis of their responses was included along with the reader’s letter in the March issue. “What we are doing is new and as such should be scrutinized frequently and rigorously by peers to ensure we are meeting the ethical standards one would expect for our patients,” they write. “We believe our […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:25-05:00March 30th, 2012|digital health, healthcare social media, patient engagement, patient experience|3 Comments

Grief: The Proposed DSM-5 Gets It Wrong

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Today is my son’s birthday. I remember so clearly the day of his birth, the overwhelming sense of recognition the first time I saw him, as if I had known him forever.

April 16^th is the anniversary of his death. When a birth is so closely followed by a death, they are forever intertwined. I remember watching him sleep, how he turned to the music when I turned the key of his music box and “It’s a Small World” unwound its notes against the side of his warming bed. I remember his three-year-old brother holding him, sitting in the rocking chair in their father’s lap. I remember rocking in that chair three weeks later, holding him against my chest as his few last breaths faded. I remember the long walk back down the hall, the drive home, the blur of a funeral. And then the first long cold winter, visiting his grave day after day, distraught that my baby lay in frozen earth, unprotected from the cold. And the months that stretched on into a future I sometimes couldn’t bear to think about, because I couldn’t imagine my way out of the pain of grief into a day when I would feel joy again.

I was grieving. I listened for the phone, certain the hospital would call any minute to tell me it was all a […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:26-05:00March 28th, 2012|Nursing|11 Comments

iPad Apps, the Future of Nursing, More: Notes from the Nurse Execs Meeting in Boston

By Maureen Shawn Kennedy, AJN editor-in-chief

Last week, the city of Boston hosted the annual meeting of the American Organization of Nurse Executives (AONE). For those unfamiliar with this group, it’s a subsidiary of the American Hospital Association and its mission is, according to the Web site, “to shape health care through innovative and expert nursing leadership.” It’s been a few years since I last attended this conference, and I was amazed at increase in both sophistication of exhibits and number and variety of sessions. There was even an iPad app for the meeting!

Best-selling authors abounded: Dan Pink, author of Drive: The Surprising Truth of What Motivates Us, opened the conference and Thomas Goetz, executive editor of Wired magazine and author of The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine, closed the meeting. Dee Dee Myers, former press secretary to President Bill Clinton, also talked about her new book, Why Women Should Rule the World.

As at many meetings this past year, the Institute of Medicine’s Future of Nursing report figured prominently, with a track focused on interpretations and implementation of its recommendations.

I asked Linda Burnes Bolton, chief nurse officer of Cedars Sinai […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:26-05:00March 26th, 2012|nursing perspective|1 Comment

Losses: In Search of an Honest Prognosis

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Several years ago I took care of a lady who’d suffered a small cerebral hemorrhage after falling and hitting her head. She was in the ICU for several days. Her husband stayed at her side constantly, and he became a part of a never-ending loop in which she would wake up startled to be in a hospital, and then notice her husband and ask him where she was and what had happened. He’d hold her hand and gently relay the events of her injury, after which she’d react with mild surprise, every single time. Then she’d close her eyes and doze until she woke up to reinitiate the same conversation.

Her husband, after days of patiently playing his role in this repetitive scene, was clearly wearing down. He waited anxiously for the neurosurgeon, expecting explanations and hoping for reassurance.

When the neurosurgeon rounded later that day I heard him speak at great length about the details of her injury and the treatment plan. He ultimately advised that, although he thought she’d recover well, only time would tell.

Her husband wanted more than that, […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:10:27-05:00March 19th, 2012|patient engagement|1 Comment

The Affordable Care Act on Trial

By Maureen Shawn Kennedy, MA, RN, editor-in-chief

According to the National Conference of State Legislatures, 47 states have enacted some legislation to block or limit various requirements of the Affordable Care Act (ACA). And a week from Monday, on March 26, the Supreme Court will begin hearings on the constitutionality of the law, as 26 states bring suit against the federal government. The primary issue for the Court: can the federal government mandate that individuals must purchase health insurance?

Other closely related issues the court has also set aside time to consider are whether other provisions of the law can still be implemented or must be voided if the individual mandate is struck down, the legality of the proposed Medicaid expansion, and whether the court must in fact wait until the individual mandate is actually implemented in 2015 before even considering its legality.

So how do many Americans feel? The Kaiser Family Foundation has been tracking opinions on the law and offers an excellent interactive chart that shows opinions according to different variables, including age, income, political party affiliation, gender, and current insurance status. Their findings may surprise you.

For more information about the Affordable Care Act and it implications for nursing, here are some links to AJN’s coverage since it was signed into law in 2010:

“Nurses and the Affordable Care Act,” Mary Wakefield
“What Future for the Affordable Care Act,” Diana Mason
“Health Care Reform and a System […]