Moral Courage in a Pandemic: a 14th Century Physician and Health Care Workers Today

What does it mean to be human? What values should we live by? How should we respond to those in need during a time of crisis? What would I do?

A physician during the Black Death.

Guy de Chauliac

As a hospice social worker who loves the humanities, I find that historical figures often come to mind when there’s a parallel with things that are happening with patients and their families. Amidst the COVID-19 pandemic, I’ve been thinking a lot about a 14th century French physician named Guy de Chauliac.

Although little known today, in his time he was one of Europe’s most respected medical practitioners. In fact, his text Chirurgia Magna was a standard part of medical education for 200 years.

I came across de Chauliac’s story years ago while researching the ‘Black Death,’ the plague that decimated Europe in the 1340s, killing up to a third of its population.

Those who have read Giovanni Boccaccio’s contemporary account of this plague in his work Decameron are often left with a cynical impression that, as Boccaccio puts it, “such […]

2020-03-27T12:15:38-04:00March 27th, 2020|Ethics, infection control, Nursing, nursing perspective, Public health|0 Comments
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‘We Request Your Quiescent Contribution’: Predatory Publishers Are Absurd, But Not Funny

Multiple daily solicitations.

The screenshot below shows an excerpt from an email our editor-in-chief recently received. Editors at AJN receive multiple emails daily from mysterious publishers soliciting them for article submissions, important roles on editorial boards, or as conference speakers. If it weren’t alarming, it would be flattering. We’re not scholars and experts in sub-specialties of botany or engineering, in fossil fuel geology, neurosurgery, or, for that matter, microbiology. Our advice on such topics might well be dangerous, or at least irrelevant and wrong.

Some open access journals are highly respected in their fields; the journal that sent this letter also bills itself as open access, but if it contains legitimate articles on microbiology, and I’m not saying it doesn’t, they may find themselves with strange bedfellows.

Despite obvious warning signs, some authors are not deterred.

It’s impossible to keep ahead of the flood of such emails, most of which are characterized by typographical oddities and peculiar juxtapositions of tone. There are many other tell-tale signs of predatory publishers, most of which have little or no oversight from real content experts and no editing or filtering of content (one must simply pay a fee to be published or attend a conference).

But what’s most worrisome about this trend is that their strategy of casting a […]

2019-02-28T11:46:34-05:00February 28th, 2019|Nursing, nursing research, writing|0 Comments
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Got Ethics?

Photo © Getty Images

We’ve published articles on all sorts of champion programs developed for various hospital initiatives. Central to these creative models (which address problems in areas like pain, mobility, elder care, and skin care, for example) is enlisting nurses to become knowledgeable about a key subject so that each patient care unit can have its own readily available resource, or “champion.”

Ethics champions programs at three hospitals.

In our July issue, we present “Ethics Champion Programs” (free to access until August 1), which describes how three pediatric hospitals—Children’s Mercy Kansas City, Children’s Hospital Colorado, and Children’s Healthcare of Atlanta—have implemented such programs to ensure that nurses have access to resources to address ethical issues. These resources include ethics rounds, monthly forums, education sessions, and unit-based and family consultations. While each program has unique components, the common goals of all three are to create a safe space for discussing ethical issues, to address moral distress, and to cultivate a climate of ethical practice.

To me, there seems to be no more important issue than ensuring ethical practice. As nurses, we face many instances in which we may question our interventions or find ourselves at odds with colleagues over treatment decisions, or in the midst of family angst over such decisions. These are […]

2018-07-26T14:17:54-04:00July 25th, 2018|Ethics|0 Comments
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July Issue: Ketamine Analgesia During Burn Care, Breast Cancer Screening Update, Difficult IV Access, More

“How powerful would it be if every nurse took one action today to improve her or his community’s health?” —Barry Ross, MPH, MBA, BSN, RN, author of this month’s Viewpoint

The July issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: The Efficacy and Safety of an RN-Driven Ketamine Protocol for Adjunctive Analgesia During Burn Wound Care

Because of its unique mechanism of action and lack of association with respiratory depression, ketamine may be an ideal agent for adjunctive analgesia in burn patients. The authors of this study evaluated the efficacy and safety of a practice protocol allowing critical care RNs to independently administer IV ketamine for burn wound care.

CE: Breast Cancer Screening: A Review of Current Guidelines

In light of recent changes to national breast cancer screening guidelines, this article reviews the guidelines of the American Cancer Society, the U.S. Preventive Services Task Force, and the National Comprehensive Cancer Network and provides guidance to nurses as they support and educate patients.

Special Feature: Ethics Champion Programs

The authors, all of whom lead ethics champion programs at their respective […]

2018-06-29T08:14:55-04:00June 29th, 2018|Nursing|0 Comments
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On Ethical Short-Term Medical Missions: An Argument from Experience

“In the absence of clearly articulated intentions and approaches, how can we be sure that short-term medical missions won’t have unintended long- or short-term consequences?”

Garrett Matlick

That’s the central question posed by Garrett Matlick’s Viewpoint essay, “Short-Term Medical Missions: Toward an Ethical Approach,” in the April issue of AJN. Matlick, currently enrolled in the Family Nurse Practitioner/Master of Public Health Program at Johns Hopkins University School of Nursing, Baltimore, had an opportunity to observe short-term medical missions (STMMs) that succeeded as well as some that failed.

What works and what doesn’t?

Having considered the current paucity of quality research on STMMs and their effects, Matlick both calls for more rigorous future research and offers a few basic considerations that he believes should be applied to all STMMs that offer direct care to local communities. His case is immensely strengthened by the use of multiple real world examples he observed or participated in while in Cambodia.

AJN sometimes receives Reflections essay submissions from nursing students and others about their experiences in STMMs in various countries. (Unlike the Viewpoint column discussed in this post, Reflections essays tend to focus more on personal reflections and story than on making an argument.) Some submissions reflect a nuanced awareness of limitations and benefits of […]

2018-04-11T11:53:31-04:00April 11th, 2018|Ethics, nursing students, 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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