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November 2005 Archives


Take Action "House" Part II
What do nurses do all day?

November 29, 2005 -- Hi kids! My name is Peter Blake. I'm a Hollywood screenwriter, and I'm going to tell you a story. My story is called "The Mistake." It is actually just part of a much longer story called "House." "House" is on television every week, on the Fox network. And millions of people watch it--like the 15 million who are watching right now. My story is about what physicians do in hospitals to make sick people better. Physicians are really smart and cool and pretty and they save people's lives every day. But they have a few flaws, and when they make a mistake, people may die! Oh, and nurses help patients get to see physicians. Nurses also move objects around for physicians, and do secret naughty things with big powerful male physicians. See how it works? Let's begin! Please click here to read more and join our letter writing campaign...


Pushing paper

November 27, 2005 -- Today the Observer (U.K.) ran a leader (op-ed) and an article by health editor Jo Revill about concerns over how much time nurses now spend on paperwork. The leader, "Let nurses nurse: Their bedside manners save lives," argues that the government must find ways to reduce nurses' administrative work and get them back to the bedside. Revill's article, "Paperwork mountain keeps nurses from care," reports on a new study that is expected to confirm that some nurses spend as much as 40% of their time on "non-clinical" administrative work. Certainly, at a time of shortage it would seem that nurses should not be saddled with paperwork that does not require their special skills and judgment. And both pieces rightly suggest that the time nurses spend at the bedside affects patient outcomes. But one key theme seems to be that nurses improve outcomes because they "talk" to patients. That is literally true, but without much explanation, many readers will not get that it's because nurses are skilled professionals, not just handholders with "bedside manners." And nurses make many key clinical judgments at the bedside that are not based on talking. The pieces also seem to reflect the assumption that paperwork cannot be part of nursing, as if nurses are just there to be with patients, rather than think and write as real professionals do. But would anyone suggest that nothing physicians do away from the bedside is medicine? Lastly, neither piece mentions the role of the nursing shortage and associated short-staffing in the apparent lack of nurses at the bedside. more...


Telegraph: "Charity calls for alcohol nurses"

November 25, 2005 -- Today the Telegraph (U.K.) site posted a short but good piece by Rosie Murray-West reporting that a "leading addiction charity is calling for an alcohol nurse to be appointed in every hospital in Britain to deal with the rise in binge drinking." The piece coincided with a historic easing of British liquor licensing laws. It stressed the value of specialist nurses in identifying and addressing such alcohol problems. The piece noted that such specialists can play a key role in later patient follow-ups, which the piece reported can significantly reduce problem drinking. The piece offered a good illustration of nursing's holistic health focus. more...


"OK, folks, the good news is the hospital has approved four-to-one ratios."

November 17, 2005 -- In a plotline begun in the November 3 episode and resolved tonight, NBC's ER" again showed nurses managing nurses, contrary to years of "ER" practice in which physicians did that. The show also made an unprecedented, if brief and unclear, statement about nurse short-staffing, overtime and the shortage. We applaud those efforts. In the first episode, ED nurse manager Eve Peyton abruptly hired major nurse character Sam Taggart as her lieutenant, and together they abruptly fired veteran nurse Haleh Adams for working excessive overtime. Adams was later rehired, but as you may have guessed, some elements of the plotline left something to be desired. They suggested that hiring nurse managers and firing veteran nurses were fairly casual affairs, and that the big OT problem now is some nurses seeking to work too many extra shifts, rather than the reverse problem of mandation, in which hospitals force nurses to work excessive hours in order to cut costs. The Nov. 3 episode was "Dream House" by David Zabel, and the Nov. 17 episode was "Two Ships" by Joe Sachs, MD, and Virgil Williams. more...


Tip No. 76: For even quicker attention, drive your Hummer straight into the ER. Then offer the triage nurse a chocolate if he'll let you see the physician before all those little pedestrians!

November 2005 -- This month's Good Housekeeping includes 75 "surprising" health tips from "doctors" nationwide. Though nurses excel at such practical advice, not one tip comes from a nurse. That's not "surprising," but we were a bit puzzled by the contempt for nurses we saw in several tips. Michael Roizen, MD, of the Cleveland Clinic, advises readers to "get better [hospital] care" by "supplying the staff with treats." "Dr. X," whose ED tips are presumably considered so hot that his or her identity must be shielded, tells patients to lie to the triage nurse about when symptoms began in order to be seen faster, but to "tell the doctor exactly when symptoms began." In addition to being offensive, uninformed, and likely to backfire, this advice shows real indifference to public health. The tips were "reported" by Janet Bailey, Janice Graham and Leslie Pepper. Good Housekeeping has a reported circulation of five million and a readership of 22 million. more...


Benghazi Six court decision delayed until January 31; negotiations continue

November 17, 2005 -- The final court ruling in the case of the five Bulgarian nurses and one Palestinian physician imprisoned in Libya for seven years for allegedly infecting over 400 children with HIV has been delayed until January 31, 2006. The Libyan Supreme Court ruling had been scheduled for November 15. The health workers were sentenced to death before a firing squad for allegedly causing infections that independent experts have determined were caused by poor infection control systems, not by any intentional act of the health workers. Some infections occurred before the workers arrived in Libya. Today South Africa's Cape Times reported that the delay could help give Libyan leader Col. Muammar Ghaddafi time to negotiate with Europe and the U.S. for a face-saving way out of the situation. The piece reports that diplomatic sources say that following through with the executions would be a huge impediment to Libya's efforts to normalize relations with the West. Yesterday's Arabic News had a report on the somewhat volatile situation in Libya, where relatives of the infected children called for the sentences to be carried out. Please send a polite, respectful letter to the Libyan government expressing sympathy for the plight of the children (many of whom have died) and asking for the unconditional release of the health workers, who should not be discouraged from caring for vulnerable populations because of a fear that they may be blamed for systemic issues beyond their control. Thank you. Also see more details on the Benghazi six from the Bulgarian Medics Solidarity Project.


Take Action with us as we kick off our "House" campaign!
And on the eighth day, the Lord Physician created nurses, to clean up the mess

November 15, 2005 -- Both Fox's "House" and ABC's "Grey's Anatomy" have shown utter contempt for nursing. But the two new prime time hits have taken somewhat different approaches. "House" is addicted to physician nursing. Its six physician characters are constantly doing key care tasks that nurses do in real life. The rare nurse characters are silent, barely visible clerks, like wallpaper that assumes human form to move or hold objects. "Grey's Anatomy," with nine physician characters, has at times had nurses utter a minor substantive line. However, it has often insulted nursing directly. Its interns regard the word "nurse" as a slur, and the nurses who do appear tend to be bitter or fawning losers, whose lives revolve around the godlike physicians. But two recent episodes of "House" (Thomas L. Moran's "Daddy's Boy," aired on Nov. 8, 14 million viewers, and Sara Hess's "Spin," aired on Nov. 15, 13 million viewers) prove that the Fox show is more than capable of its own specific anti-nurse slurs. In these, "House"'s brilliant physician heroes suggest that they consider nurses unskilled clean-up staff, "nurse-maids" who are good for handling stool and patients who have fallen down. The money quote? Über-diagnostician and wit Greg House has just temporarily relieved a patient's thymoma with a Tensilon injection, and gone off on a "playing God" riff. When the drug wears off, as expected, the patient falls to the floor. House says this is "exactly why I created nurses," then calls out into the hallway, "clean-up on aisle three!" click here to read more and join our letter-writing campaign!


Reclaiming Midwives: Pillars of Community Support

November 14, 2005 - April 2, 2006 -- "Reclaiming Midwives" is a moving tribute to African-American lay midwives in the South. The multi-media exhibit does a fine job of placing the midwives in a community context, with a focus on their social and cultural importance. Three accompanying contemporary art exhibits celebrate the bonds among black women and their children. The main exhibit might have taken a closer look at the midwives' actual care, particularly its non-cultural merits under modern scientific models. The exhibit makes clear that nurses were part of the white-dominated health system that ultimately marginalized the lay midwives. But it does not fully explore the extent to which nursing's holistic focus may be compatible with the midwives' community-oriented vision. The exhibit does profile one current African-American nurse-midwife. And it suggests that the lay midwives' strong commitment to the common good offers important lessons for today's troubled society, presumably including health workers. To that end, the exhibit urges a renewal of African-American midwifery. On the whole, "Reclaiming Midwives" is a valuable look at an under-recognized group of health providers who really were "pillars" of their communities. Sound familiar? See the exhibit (before it ends on April 2) at the Smithsonian's Anacostia Museum and Center for African American History and Culture in Washington, DC. more...


Everything's turning to white?

November 14, 2005 -- Today the Chicago Tribune published a generally good story by Dahleen Glanton about the ongoing debate over what nurses should wear, and especially the return to more traditional white uniforms in some hospitals. The piece, headlined "White garb returning to hospitals," was soon picked up by other Knight Ridder newspapers nationwide. The piece gives a good sense of the "divisive and heated" debate in some quarters over how to identify nurses in an increasingly diverse and often confusing hospital environment. It notes that perspectives range from those who believe that white uniforms enhance professionalism to others who feel it prevents individual expression. The piece also includes several quotes from Center executive director Sandy Summers about the underlying identification problem, white uniforms, and "RN" patches. more...


Fast, Cheap & Out of Control

November 14, 2005 -- This morning, NBC's popular "Today" show included a short, troubling segment with reporter Janice Lieberman about the recent growth in nurse practitioner-staffed "quick clinics" at U.S. supermarkets and drug stores. The piece did stress that the clinics offer convenience and affordability for basic care that consumers appreciate. Lieberman even got her flu shot on camera. But the item also degraded the "cheap" NP care available at the "quickie" clinics, ignored NPs' vital role in more comprehensive primary care, and suggested that autonomous NP care presents safety risks, relying on a baseless, paternalistic quote from AMA president "Dr. Edward Hill." The piece did not allow NPs to defend their care from these sloppy attacks. Instead, the only audible NP speech it offered its audience consisted of an NP, identified only as "Kathy," saying "ready" to indicate that she was ready to give Lieberman her flu shot. Please click here to read more and join our letter-writing campaign!


Here comes the fear again

November 12, 2005 -- Two recent press pieces highlight the reaction from organized medicine to the seemingly inexorable increase in nurses' authority to prescribe medications. In a good November 10 piece in the Guardian, John Carvel reported that U.K. health secretary Patricia Hewitt would outline plans to give experienced nurses--not just nurse practitioners (NPs)--the "right to prescribe almost every medicine in the national formulary," a "historic move that smashes the demarcation barrier between doctors and nurses." The piece described the British Medical Association (BMA) reaction as one of "outrage," with a representative citing the usual training and "patient safety issues." Today, New Zealand's Stuff site ran a generally fair piece from The Press (Christchurch) about the aggressive reaction by local physicians to plans to expand prescription rights for NPs. The report, by Mike Houlahan and Amanda Warren, gives somewhat more play than the Guardian item did to the "scathing" physician attacks. Articles in the New Zealand Medical Journal have argued that nurse prescription would be unsafe because NPs have less formal training than physicians. Both the U.K. and New Zealand pieces seem to reflect a growing realization by policy makers that many people are not getting adequate care under current health systems, and perhaps a sense that the "sky-is-falling" warnings about nurse prescription have no scientific basis. more...


Center's Christina Aguilera / Skechers campaign among those recognized with 2005 AAN Media Awards

November 12, 2005 -- Tonight the American Academy of Nursing (AAN) presented one of its Media Awards to the Center for the second year in a row. The 2005 award recognized our successful campaign to end the Skechers shoe company's global advertising campaign featuring pop star Christina Aguilera dressed as a "naughty nurse." After more than 3,000 Center supporters sent letters of protest, Skechers pulled the ad from print media and point-of-sale displays worldwide. The other three 2005 Media Award winners were the Tobacco Free Nurses Initiative, "My Body Mondays" with Nurse Dr. Mimi Mahon on Philadelphia radio station WXPN-FM's "Kids Corner," and Chicago's Nurses Parade, a book by Connie Robinson, Carolyn Hope Smeltzer, and Frances Vlasses. more...


The Running Man

November 11, 2005 -- Today The Washington Post ran a fairly good Reuters piece by Adam Tanner reporting that California Gov. Arnold Schwarzenegger has ended his fight with the California Nurses Association (CNA) over the state's nurse-patient staffing ratios, in the wake of the recent defeat of his ballot initiatives. As the piece notes, the move is a major victory for CNA in its long fight for full implementation of the ratios, which became law in 1999. In countering Schwarzenegger's unwise suggestions that nurses are a special interest group whose "butt" he "kick[s]," CNA seemed to exploit stereotypes of nurses as selfless bedside females. But the union showed what nurses can do when they speak up collectively and tenaciously. And that's no stereotype. more...


A Short Herstory of Violence

November 10, 2005 -- Today South Africa's Independent Online (IOL) site posted a fairly good Cape Argus story by Di Caelers headlined "Nearly half of our nurses suffer abuse." The piece indicates that research in South Africa, the U.K., and the U.S. suggests that among health workers, nurses experience a disproportionate amount of physical and psychological violence by patients and colleagues, especially physicians. The article might have explored why nurses face such abuse, and done more on its effects on patient care and the global nursing shortage. But the piece, which was based mainly on a recent South African study, does note that 80% of nurses surveyed "blamed abuse--largely by male doctors--in the private sector for nurses leaving the profession." more...


Update on the Benghazi Six

November 9, 2005 -- As of today, the fate of the five Bulgarian nurses and the Palestinian physician who face execution for allegedly infecting over 400 Libyan children with the HIV virus remains unclear. International experts have concluded that the tragic infections were not due to intentional acts of the prisoners, but to poor infection control systems at the hospital. A wide range of governments, international organizations, and health care groups have expressed grave concern as to the conviction of the health workers. (See our initial piece on this issue.) The Center believes that nurses should not be scapegoated because of their proximity to systemic health care problems, which could inhibit efforts to improve care and promote better access to skilled nursing. Press stories indicate that negotiations between the Libyan government and concerned entities are ongoing, but accounts of the progress of negotiations vary. Some suggest that a deal to free the health workers may be imminent, perhaps involving the transfer of resources to help the infected children and their families, or the transfer to Libya of a man convicted of involvement in the 1988 Lockerbie bombing. The Center thanks the 200+ supporters who have written to Libyan leaders as part of our campaign urging the release of the prisoners. And we urge all who have not written to do so now in a polite, respectful way that expresses concern for the plight of the infected children, over 40 of whom have now reportedly died. The Center and some allied organizations have also considered other methods of advocacy, but those plans have been put on hold for now due to tactical considerations. We urge all concerned to watch closely, as we understand that the Libyan supreme court is due to consider the health workers' final appeal on November 15. Click here to send a letter now, and click here to see the press articles.


We can be "heroes"

November 7, 2005 -- This week's TIME magazine features a massive report on global health, "Saving One Life at a Time." It discusses preventable and treatable diseases that claim millions of lives each year in the developing world. The 50-page report examines the terrible effects of such diseases, but seems to focus even more on those fighting the diseases and how readers can help. This is commendable. But the piece fosters the impression that physicians provide virtually all important developing world health care, a message that itself poses a threat to public health by perpetuating the undervaluation of nursing that is a critical factor in the global nursing crisis. Slightly more than half of the total report is devoted to profiles of 18 "heroes" whose "energy and passion are making a difference" in the fight against these diseases. Of the 15 health care professionals profiled, 12 are physicians. Not one is recognized for her nursing, though one profile of a nutritionist notes that she has a nursing degree. With all the high-level journalistic effort on display here--an effort celebrated in the editor's less than modest column, "Journalism That Makes a Difference"--we saw only one passage that could be considered a tribute to the valiant work of the world's estimated 12 million nurses to stem disease. That was in the concluding essay by rock star Bono. more...


The Drunk and the Ugly

November 6, 2005 -- Tonight's episode of ABC's "Grey's Anatomy," seen by 19 million people, featured yet another anti-nurse slur from one of the show's pretty physician heroes. Hotshot intern Cristina Yang dismissed a veteran nurse from a patient's room with a comment that the physicians would let her know if a bedpan needed changing. Rather than objecting to this, the nurse took revenge by paging Yang to do a series of grotesque bodily fluid tasks. We realize that this fantasy about workplace roles was likely intended as a token effort to show nurses respect. But it still associates nursing with icky tasks that seem menial, wrongly suggests that physicians help with them, reinforces battleaxe stereotypes, and does nothing to show what nursing is really about. On the contrary, it is fully consistent with the show's vision of nurses as fawning or vindictive losers whose lives revolve the physician characters who provide all meaningful care, including key tasks that nurses do in real life. The episode suggests that the problem with anti-nurse slurs is not that they're inaccurate, or ultimately a threat to public health. It's just, as one resident notes, "stupid" to "piss[] off the nurses"-- the petty little clean-up crew of health care. The episode, "Something to Talk About," was written by Stacy McKee. The medical consultant was Karen Lisa Pike, MD. more...


Striking a rock

November 4, 2005 -- Today South Africa's Business Report ran a generally good opinion piece by Terry Bell about nurses' displeasure in the wake of the national assembly's recent passage of the Nursing Bill. The piece, "MPs leave nurses feeling angry and undervalued again," does a good job of setting nurses' objections to the Bill in the larger context of the nursing crisis that has crippled South African health systems. Relying heavily on a nursing union leader, the piece stresses that persuading the nurses who have gone overseas to return home will require that the nation address both nurses' low pay and poor working conditions, especially the "severe" understaffing that afflicts the public hospitals. more...


NPR science correspondent explains it all for you: Kenyan clinical officers are "not quite a doctor, but more than a nurse"

November 3, 2005 -- Today National Public Radio's Morning Edition ran a lengthy report by "Science Desk Correspondent and Editor" Brenda Wilson about the trend of developing world physicians migrating to wealthier nations. "Developing Countries See Health Care 'Brain Drain,'" which is part of NPR's extensive global health series airing this week, highlights some of the worrisome effects of this "exodus" on developing world health. But as the quote in the headline above makes clear, the piece regards nurses as peripheral health workers who have only basic physician skills, rather than members of a distinct profession with its own unique skills and approach to care. The report also portrays nurses as qualified to care only for patients with less serious illnesses, and as workers poor nations will have to settle for until a solution to physician migration is found. We would not necessarily ask the piece to discuss the devastating nursing exodus from these same nations. Many good nursing shortage pieces do not discuss physicians, and the brief introduction from the Morning Edition hosts does mention that the brain drain includes physicians and nurses. But because the Wilson report does focus so closely on who is left in places like Kenya when the physicians leave, its apparent failure to even mention the nursing shortage is glaring. It is, however, consistent with the overwhelming physician-centrism (even physician glorification) in the prior reports Wilson has filed on Africa as part of this week's series, which focus on the work of Doctors Without Borders and the Flying Doctors in Africa. In these reports, only diagnosis and treatment by heroic roving physicians matters in the health of the population. Nurses are ignored, except to receive the occasional "order." more...

 

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