What Do Medical Researchers and Legislators Have in Common? Conflict of Interest, for One

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

LiebermanProtestIn a not-so-old blog post I did last month, I reported on a conference I attended in Vancouver.  There, editors from JAMA presented a study revealing that ghostwriting was a major problem for the leading medical journals. Articles were being drafted by writers other than the researchers. In some cases, the writers didn’t have access to all the data, which meant that analyses, conclusions, and—in some cases—recommendations for treatment were based on incomplete or misinterpreted findings.  As described in a New York Times article on the issue, medical product and pharmaceutical companies have much to gain if the safety and efficacy of their products are reported in a positive light.

Conflict of interest is a major concern whenever someone who stands to personally benefit can influence a decision. The National Institutes of Health, which is the leading medical and health research agency in this country, has imposed strict rules for employees limiting consulting and speaking fees involving outside companies and institutions that may have a stake in research outcomes. Most government agencies, research or not, impose rules to avoid conflicts of interest.

Last week, NBC News reported that protestors staged a sit-in at the Hartford, Connecticut, offices of Senator Joe Lieberman, demanding that he stop taking campaign contributions from insurance companies. 

2016-11-21T13:21:04-05:00November 16th, 2009|Ethics, health care policy|0 Comments
Read More

FDA Commissioner’s Letter to Health Care Professionals About H1N1 Vaccine Safety

fluIMAGEBelow we reproduce a letter from Margaret Hamburg, Commissioner of the U.S. Food and Drug Administration (FDA), to all U.S. health care professionals. It explains why the FDA (and most experts) believe the current H1N1 vaccine is as safe as any of the seasonal flu vaccines that are produced using the same process. Many nurses remain reluctant to get the vaccine, as are many patients. Some we’ve heard from have changed their minds as they’ve seen the sudden and devastating effects of this virus on patients in their hospitals. We hope this letter will provide some context for thinking about the current H1N1 vaccine, and for addressing the concerns of patients.

Dear Healthcare Professional,

I am writing first to thank you for your extraordinary efforts during the 2009 H1N1 influenza outbreak. 

As this new infectious disease sweeps through communities across the country, you must juggle your usual patient care responsibilities with a special role in influenza response.  Delays in vaccine delivery and the persistence of myths about vaccination have not made your job any easier.  Thank you for rising to this public health challenge.

I am also writing to provide information that can be helpful as you talk to patients about the 2009 H1N1 influenza vaccines — the best tools we have to prevent severe illness and death caused by the virus. 

As the Commissioner […]

2016-11-21T13:21:06-05:00November 13th, 2009|Nursing|1 Comment
Read More

Overcoming Barriers to Kidney Transplantation

By Genevieve Coorey, BSN, MA(Ed.). Coorey is the quality assurance and program director at the National Kidney Foundation and was the lead author of “Barriers to Preemptive Kidney Transplantation,” published in the November issue of AJN.

 

DadTransplantTattoo

Talk with any nursing colleague who cares for people with a chronic, complex disease and you will hear about the resilience and patience with which they accept—even triumph over—the effects of their illness.  

Cheryl learned nine years ago that her kidneys were failing. “At one point, I was so weak from anemia and malnutrition I could barely lift a dinner plate. Walking through a grocery store was a struggle. I used a wheelchair briefly because my legs were so filled with fluid. My husband . . . had to carry me at times, because I was too weak to walk.” 

A long-time school friend gave Cheryl one of his kidneys. She took up biking when her recovery allowed and the next summer she rode a 69-mile segment of a huge annual bike ride across Iowa; two years later she rode all 500 miles. Now Cheryl is a seven-time gold medal winner at three separate National Kidney Foundation U.S. Transplant Games events and a two-time bronze medal winner at the World Transplant Games. Extraordinary.

2016-11-21T13:21:07-05:00November 12th, 2009|nursing research|5 Comments
Read More

Saving SimBaby – Teaching Nurses to Speak Up

AJNReportsNov09The baby’s condition is going downhill fast. A medical team surrounds the infant, tersely exchanging instructions. The gripping scenario has the participants’ hearts beating fast, but the baby on the table is SimBaby, a manikin with sophisticated robotics that’s used in health care simulation training.

As in a real situation, “there is adrenalin in a simulation,” explains Elaine Beardsley, MN, RN, clinical nurse specialist in the pediatric simulation program at Seattle Children’s Hospital. “Even though it is a simulated environment, people get nervous. People talk more.” However, Beardsley says, the structured communication training within the simulation “cuts the chatter.”

The November AJN Reports focuses on ways that SimBaby is helping teams of nurses and physicians at Seattle’s Children’s Hospital learn to avoid the kinds of communication breakdowns that, studies have shown, can lead to errors in stressful situations. The training includes creating a safe environment in which nurses and residents are encouraged to speak up to physicians “when they perceive mistakes being made.”

“Simulation, in my mind, is about getting us to communicate better,” says Jennifer Reid, MD, assistant professor of pediatric emergency medicine at the University of Washington School of Medicine and Seattle Children’s Hospital and codirector of the hospital’s ED simulation program. “Our training is such that physicians and nurses are usually educated, trained, and practice more or less in parallel. Simulation is an opportunity-a rare one-for us to learn and train together, working consciously on our communication skills. When else do I […]

2016-11-21T13:21:09-05:00November 11th, 2009|students|1 Comment
Read More

‘Mercy,’ Revisited: A Nurse Goes from Harsh Critic to Fan

MercyScreen2

By Peggy McDaniel, BSN, RN

The new NBC television series Mercy is starting to grow on me. Like some other recent shows (Nurse Jackie and Hawthorne), this drama features nurses as the lead characters. As I explained here a while back, my response to the first episode was very negative. Disparaging comments made about nurses by other staff and by patients’ family members struck me as unnecessary and irritating. Lines like “what do you know, you’re only a nurse?” were hard for a real nurse to take. My first impression was that the characters could have been women in almost any career. The words and actions of Veronica, one of the lead characters, seemed harsh and inappropriate. The overall image of nursing was negative.

So now for my confession: I have continued to watch Mercy. And I’ve become less of a critic and more of a fan. We still get more dramatic effects than convincing reality. For example, in a recent episode, Veronica runs in and bangs a patient’s chest with her fist, an action which ultimately restarts the patient’s heart. I still miss the comparatively realistic practices depicted in ER; Mercy doesn’t attempt to get such details right. 

But recent story lines have shown our nurse heroines to be strong patient advocates. This is a true (believable, and inspiring) nursing role. Even if the story line takes liberties with what a real nurse would do—such as when a character visits a patient’s son at his home to encourage him to visit his dying mother—the point about patient advocacy is made and appreciated. Advocating […]

2016-11-21T13:21:12-05:00November 10th, 2009|nursing perspective|1 Comment
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