Speaking Publicly ‘As a Nurse’: Case in Canada Highlights Risks, Responsibilities

Douglas P. Olsen, PhD, RN, associate professor, College of Nursing, Michigan State University, writes about ethical issues for AJN.

Recently, a disciplinary committee in Canada found a nurse in breach of the Canadian Nurses Association’s Code of Ethics for Registered Nurses for posting negative comments on Facebook and Twitter about the care given to her grandfather in a long-term care facility before his death. The nurse was accused of violating her grandfather’s confidentiality, not using proper processes for noting complaints about his care, and potentially harming the institution’s reputation. She was found guilty of professional misconduct but not guilty of violating his privacy. The ethical breach was based on her public declarations about the nursing care.

Key to the Saskatchewan Registered Nurses’ Association decision to find the nurse guilty appears to have been the fact that the nurse prefaced remarks with the phrase, “As a nurse . . . ” Adding this phrase to one’s communications confers the authority of scientific and experiential expertise. It further implies that one is versed in the proper procedure and standards for evaluating accuracy and relevance of clinical information and that one’s conclusions are communicated honestly for constructive purposes. The credibility added by identifying the nursing credential is deserved—and therefore carries responsibilities.

What are the conditions for an ethical response when speaking publicly ‘as a […]

2016-12-20T15:09:59-05:00December 16th, 2016|Ethics, healthcare social media, Nursing|2 Comments
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Hospital Shootings: Unacknowledged Job Hazard?

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog. Illustration by the author.

Active_shooter_post_illustrationRecently, while preparing for work, I received the following text from a coworker already at the hospital:

We’re on lockdown
Armed gunman
Stay home, they announced “active shooter now outside building”

Shocked, barely able to comprehend the message, I texted back:

WTF?
Are you safe?

She texted back that she and others were in lockdown in the cafeteria. Numbly, I switched on the TV, looking for more information, but found nothing. Not a single report of the event on any station. Turning to the Internet, I found a single tweet referring to an event in progress. Feeling helpless, I texted my husband and daughter and then called my mom, letting them know I was at home, safe, just in case they heard something. Then I waited.

Within an hour, the same coworker texted again:

All clear!

I stared at my phone, not knowing what to do. I went to work.

The resolution of the shooting situation was heartbreaking. However, no patients or hospital staff were harmed. The outcome could have been much worse.

That evening, local media coverage of the crisis remained scant to the point I nearly felt I’d imagined it. It was as though it never happened.

We were lucky. Our shooting occurred outside, on the hospital grounds—as do 41% of hospital shootings, […]

2016-11-21T13:01:30-05:00February 3rd, 2016|career, Ethics, Nursing, nursing perspective|1 Comment
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Ethical Practice with Patients in Pain

Photo @ AJ Photo / Hop Americain / Science Photo Library Photo @ AJ Photo / Hop Americain / Science Photo Library

Pain is difficult to define and hard to convey. The way both patients and clinicians respond to it can be influenced by a multitude of possible biases. This month’s Ethical Issues column in AJN is by Doug Olsen, PhD, RN, an associate professor at Michigan State University College of Nursing. In “Ethical Practice with Patients in Pain,” Olsen summarizes the challenge nurses and other clinicians face in treating patients’ pain:

Responding to a patient’s pain is a fundamental ethical obligation in nursing. However, nurses caring for patients in pain can run into ethical conflicts from both over- and undertreatment of pain. Undertreatment of pain represents a failure to fulfill the core nursing obligation to alleviate suffering—but overtreatment may ultimately harm the patient, contradicting a core nursing value, nonmaleficence. The complex nature of pain complicates efforts to provide treatment that is ‘just right.’ Nurses must understand that complexity if they are to make ethical decisions in the care of patients who experience pain.

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2016-11-21T13:01:32-05:00January 20th, 2016|Ethics, Nursing, nursing perspective, pain management, patient experience|1 Comment
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Nursing Ethics: Helping Out on the Unit vs. Teaching Nursing Students Crucial Skills

By Jacob Molyneux, AJN senior editor

scalesJust as no two hospital units are exactly alike, rarely are two ethical conflicts exactly alike. There are too many variables, too many human and situational differences. This month’s Ethical Issues column, “Teaching Crucial Knowledge vs. Helping Out on the Unit,” explores potential ethical and practical issues faced by a clinical instructor who must balance the duty to teach essential skills to nursing students against the staff’s need for help in meeting patient care needs.

Will there be an easy, cut-and-dried answer? Probably not. In the course of their analysis of a hypothetical scenario, the authors make the following point:

Because new situations arise all the time, and every situation varies in its ethically relevant aspects, rigid rules often cannot guide ethical action. Instead, analytic skills and transparent negotiation are crucial for resolving conflicts between values as they arise in day-to-day interaction—and for supporting the solutions we choose.

While people skills may be as important as abstract ethical analysis in dealing with real world situations, determining which ethical principles or priorities are coming into conflict may provide us with a certain measure of clarity in our approach. The authors frame the conflict described in the article in the following way:

[…]

2016-11-21T13:01:59-05:00September 23rd, 2015|Ethics, Nursing, nursing perspective, safe staffing, students|0 Comments
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Revisiting Katrina’s Lessons 10 Years Out, from a Nursing Perspective

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

Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons

This past week we’ve seen many media retrospectives on the devastation Hurricane Katrina visited on the Gulf Coast on August 29, 2005. I remember it vividly—as AJN’s news director at the time, I cut short a Labor Day vacation and flew to Mississippi on September 10 to report firsthand on how relief efforts were progressing.

I visited the emergency shelter staged at the Meridian Naval Air Station and then drove as far as I could south from Meridian toward the Gulf of Mexico. I got as far as Hattiesburg, Mississippi, before I had to turn around because there were no open gas stations and my gas tank was at half-empty. The devastation along the highway was remarkable; trees were completely flattened and debris of all sorts was scattered about as if a giant trash can had been overturned. And this was still about 70 miles inland from the Gulf.

Over the following months and then years, AJN published a number of articles and reports on health-related issues that arose from Hurricane Katrina (see the list below). We highlighted the heroics of many nurses who found ways to deliver care with few resources, discussed ethical […]

2016-11-21T13:02:05-05:00August 31st, 2015|career, Ethics, Nursing, nursing perspective|0 Comments
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