AJN in October: Nursing Student Errors, Septic Shock Resuscitation, the Ethics of Workarounds, More

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

CE: Original Research: Exploring How Nursing Schools Handle Student Errors and Near Misses

The authors investigate nursing school policies and practices for reporting and tracking student errors and near misses. The first part of a two-part series.

CE: Assessing Patients During Septic Shock Resuscitation

How to integrate capillary refill time and skin mottling score into the perfusion reassessment after initial fluid resuscitation—as recommended by revisions to the Surviving Sepsis Campaign six-hour bundle.

Obesity and Sexual Dysfunction: Making the Connection

Obesity affects patients’ general health, but does it affect their sexuality? A review of the evidence on obesity and sexual functioning, plus nursing considerations for addressing weight-loss strategies with patients.

Workarounds Are Routinely Used By Nurses—But Are They Ethical?

How nurses can be creative problem solvers without resorting to workarounds that may be ethical in intent yet potentially harmful in their consequences.

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2017-09-29T08:30:14-04:00September 29th, 2017|Nursing|0 Comments
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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:

2017-09-02T09:55:06-04:00September 2nd, 2017|Ethics, Nursing|11 Comments
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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 […]

2017-08-25T09:03:28-04:00August 25th, 2017|Nursing|0 Comments
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Do Patients Have a Right to Choose Providers Based on Race?

By mmarcotte51/via Flickr

By Shawn Kennedy, AJN editorial director

We have a wonderful librarian here at AJN who is always on the alert for news about nursing and nurses. Recently she sent me a clipping about a legal case, Chaney v. Plainfield Healthcare Center in Indiana’s Court of Appeals, which has important ramifications for nurses. The court ruled in favor of Brenda Chaney, a certified nursing assistant, and reversed the decision of the lower court that had ruled in favor of the Plainfield Healthcare Center nursing home.

Brenda Chaney brought suit against the nursing home for complying with a resident’s request not to have any black health care workers provide care or enter her room, and leaving her in the care of her automated medical alert system. (She also claimed her firing had been racially motivated. The court agreed that it seemed discriminatory.) The court agreed with Chaney that by acceding to the patient’s wishes, her employer created a hostile workplace and violated her rights. The nursing home claimed it was protecting the patient’s rights and that not doing so “risked violating state and federal laws that grant residents the rights to choose providers, to privacy, and to bodily autonomy.” The court did not agree. The crux of the decision is this:

“In any event, Indiana’s regulations do not require Plainfield to instruct its employees to accede to the racial preferences of its residents. The regulations merely require Plainfield to allow residents access to health-care providers of […]

2017-02-15T15:02:40-05:00October 11th, 2010|Nursing|6 Comments
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Nurses Under the Influence of Pharma—Not Just an NP Problem

The danger of an NP succumbing to influence is obvious—she or he may prescribe for reasons (which may be on an unconscious level) other than clinical ones. The issues for nurses who do not prescribe medications are subtle and different. AJN's ethics columnist Doug Olsen did a two-part series exploring this last year—in January and February 2009. And AJN's editor-in-chief emeritus Diana Mason wrote on this even earlier, in an editorial in December 2000, noting, among other concerns, that "it's not unusual to see drug company underwriting of speakers at nursing conferences; of course, the topic addressed is almost always related to one of the company's top drugs."

2017-02-02T12:17:38-05:00July 1st, 2010|career, Ethics, Public health|1 Comment
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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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