Off the Charts

Web Crawl: Unprofessional Workplace Behavior Irks Nurses; APNs Seek Primary Care Rights; Whistleblowers on Trial; More

Shawn Kennedy, MA, RN, AJN interim editor-in-chief

I spend a lot of time checking various web sites for news or new information nurses need to know, for interesting items for blog posts or articles, or for trends that may be coming down the pike. Here’s some “food-for-thought” items I found in my recent web crawls:

On nursingworld.org, the American Nurses Association, in a recent poll, asked site visitors if they had been “a target of unprofessional behavior” in the workplace. A startling 82% of respondents said yes. While “unprofessional behavior” was not defined (when you think about it, it could be any number of things, ranging from gossip and practical jokes to bullying and unwanted sexual advances), the fact that so many people feel this way deserves further exploration. What about you? What have you seen on your unit that might fit this category of “unprofessional behavior”?

Vindy.com, an Ohio news outlet, reports that advanced practice nurses (APNs) in the state want more recognition and freedom to practice. According to the article, the Ohio Association of Advanced Practice Nurses (OAAPN) is seeking legislators to remove restrictions that prevent them from heading the medical home models of primary care. Currently, physicians must be the designated head of the medical home. (See our article on this.) Jacalyn Golden of OAAPN said APNs “have proved themselves since they began providing primary care in 1965.” Amen.

Remember the “Sentosa Nurses,” the nurses from the Philippines who became embroiled in prosecution after they quit en masse from New York nursing […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:20:12-05:00January 14th, 2010|Nursing|4 Comments

AJN’s Top 10 Articles in 2009

So, what were the most highly viewed articles of 2009 on AJNonline?

Here’s our Top Ten list – check them out:

1. Sex and Violence in the Media Influence Teen Behavior – duh!

2. Recognizing Sepsis in the Adult Patient – every nurse should know what to look for

3. Bullying Among Nurses – sad reminder that we might be our own worst enemy

4. Leech Therapy – it may be disconcerting, but it works wonders

5. The Marketing of Osteoporosis – how they turned a risk factor into a disease

6. The Nursing Shortage – this problem’s not going away soon

7. Understanding and Managing Burn Pain: Part 1 – it’s still misunderstood . . . and undertreated

8. Infection Control: Whose Job Is It? – unsafe nursing practices, you say?

9. Staging Pressure Ulcers: What’s the Buzz in Wound Care? – definitions matter!

10. Do Rapid Response Teams Save Lives? – well, it sounded like a neat idea . . .

–Shawn Kennedy, AJN interim editor-in-chief

Jacob Molyneux, senior editor/blog editor2016-11-21T13:20:13-05:00January 13th, 2010|nursing perspective, nursing research|1 Comment

H1N1 Influenza Hasn’t Left Yet — And May Be Back

By Shawn Kennedy, MA, RN, AJN editor-in-chief emeritus

At the Centers for Disease Control and Prevention (CDC) press briefing yesterday on pandemic H1N1 influenza, spokesperson Dr. Anne Schuchat noted that while H1N1 activity was down, the virus was still more prevalent than what is normally seen for influenza. Warning that people should still get immunized against it, she also noted, “We also saw an uptick in pneumonia or influenza deaths in this past week. And that isn’t something that we necessarily see around the Christmas holiday.”

The CDC is worrying about a growing complacency among the public. To illustrate the need for continued vigilance and immunizations, she showed this graph (also reproduced below) mapping the deaths from the 1957 influenza activity. You’ll note there was an initial wave in fall 1957, followed by a lull in which deaths decreased, and then a resurgence in which the number of deaths peaked in March 1958, close to the level in the first wave.

Hit it while it’s down. According to Schuchat, the lull (where we currently are) “essentially gave the all-clear whistle in that [1957] December/January time period.” “They had vaccine,” she noted, “but they didn’t encourage its use.” For now, she said, the message is this: “The illness is down. There’s plenty of vaccine. It’s a key window of opportunity. We don’t want to repeat the story from 1957.”

Nuff said.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:20:15-05:00January 8th, 2010|Nursing|2 Comments

Some Observations In Response to the NY Times Article on Palliative Sedation

By Judy Schwarz, PhD, RN*

The NY Times article of 12/26/09 that described use of palliative sedation in hospice institutional settings provided helpful and clinically accurate informative—for the most part. These few notes are meant to address those issues raised by the article that may unduly alarm dying patients, their families, and their clinical caregivers.

1) There is a consensus among palliative care clinicians that “palliative sedation to unconsciousness” (a descriptive term that eliminates some of the visceral reaction elicited by use of the term “terminal sedation”) is an intervention used only when other therapies that do not compromise patient consciousness have failed and the patient continues to experience intolerable and intractable suffering that cannot otherwise be relieved.

2) Use of palliative sedation to unconsciousness has NOT been shown to cause a hastened death. Research showing that patients at the very end of life who receive palliative sedation do not die more quickly than patients who are not sedated has been published in such peer-reviewed journals as Annals of Oncology, Journal of Palliative Medicine, Journal of Pain and Symptom Management, Archives of Internal Medicine, and Palliative Medicine. (In response to the Times article, the National Hospice and Palliative Care Organization has made available a bibliography of these articles.)

This intervention is generally only provided when patients are “imminently” dying (a condition the recognition of which requires experience and clinical judgment) and is distinct from “respite sedation,” which is used when clinicians plan to awaken a patient from the unconscious state to […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:20:16-05:00January 7th, 2010|Nursing|1 Comment

Nurses Express Concerns About Colleagues’ Commitment, Training

Back in November AJN clinical editor Christine Moffa posted a short anecdote. She told how she’d been at a training to give H1N1 vaccinations and encountered another nurse with apparent contempt for learning the basic facts about the virus. While it’s obvious that you can’t generalize about the state of an entire profession based on one stranger’s off-the-cuff comment, the responses to this post do indicate that the anecdote touched a nerve in some readers and that other nurses have also had similar experiences with their colleagues. Here are some brief excerpts from longer comments:

From Naomi: “If I fail a class by 1 point and go to the director of my nursing program demonstrating my professionalism, critical thinking, and self responsibility i would get a pat on the back and a registrar’s form in the hopes that I could repeat the class if there are enough seats. My 3.8 GPA allowed me gain admission into my nursing program not my professionalism, critical thinking, and self-responsibility even though those are key qualities for a good nurse.”

From Nursevon: “I am a faculty member in an undergraduate BSN program at a university in the midwest. I have become increasingly discouraged in my job as an educator. The focus of students is very short-sighted: typically on points and grades. As hard as I try to instill professionalism, critical thinking, and self-responsibility for one’s own learning, I frequently come away profoundly discouraged.”

From Richard Crosby: “Hearing a new nurse explain a drug or […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:20:18-05:00January 6th, 2010|career, students|1 Comment