The good doctors in Haiti

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The good doctors in Haiti

Sanjay Gupta in haloFebruary 2010 -- Countless news reports have described efforts to provide emergency health care to survivors of the tragic January 12 earthquake in Haiti. The vast majority of the reports have focused only on the work of physicians, and consulted only physicians for comment, ignoring nurses' expertise and central role in responding to such mass casualty events. Some reports suggested that few nurses had arrived on the devastated island in the early days after the quake, and that many initial foreign aid teams were mostly physicians, which itself suggests a tragic undervaluation of nursing, given the many thousands of nurses worldwide who volunteered to go. In any case, many nurses were already working for NGOs like Médecins Sans Frontières and Partners in Health (which had 600 nurses on the ground in Haiti when the quake struck, along with about 100 physicians). And surely hundreds of nurses were aboard the USNS Comfort when it arrived on January 20 with a crew of more than 1,000. Yet even reports on those efforts generally focused only on physicians. CNN commendably devoted many resources to the story, but it was also a notable source of physician-centric distortions. Consider a couple pieces built on the cable network's reporting whose physician-centrism cannot be linked to any absence of nurses on the ground. A January 13 CNN report by Madison Park explored the grave effects of the quake in a nation whose health system was already fragile, relying solely on physician experts, and implying that only physicians were involved in directing responses to the crisis. And Rahul K. Parikh, M.D.'s January 18 piece on the Salon web site was a love letter to CNN "medical correspondent" Sanjay Gupta, M.D. (above), who had apparently single-handedly saved the lives of some badly injured Haitians by caring for them overnight after a group of U.N. workers were ordered to evacuate. Oh, some unnamed Belgian U.N. nurse did "accompany" Gupta, and Parikh allowed in passing that she had the "chutzpah" to disobey the evacuation order. But that did not stop Parikh from telling readers over and over that the heroic Gupta alone was responsible for the patients' survival. On the whole, the U.S. media's reporting on the quake offered a relentless vision of post-disaster health care in which nurses play no significant role. more...

 

Staying awake and alert

Garrison KeillorSeptember 16, 2009 -- Today the Salon web site ran a piece by regular contributor and Prairie Home Companion radio host Garrison Keillor about the four days he recently spent at the Mayo Clinic following a minor stroke. Keillor offers a wry and insightful account of his "brush with mortality," and closes with a simple plea for reform of the broken U.S. health financing system. Keillor's comments about his nursing care, though all very positive, range from the perceptive to the blatantly stereotypical. Evidently Keillor's nurses were "fabulous," "smart," "brisk," "utterly capable," and possessed of the humor and psychosocial skills needed to get patients through painful and dehumanizing experiences. But the female nurses also "have the caring gene most men don't," and Keillor senses "some human tenderness ... as if she thought, I could be the last woman to hold that dude's hand." Keillor begins his comments about the nurses by referring to an ED physician's note that Keillor presented as "awake, alert, and appropriate," then admitting that he is "even more awake and alert around attractive young women (though I try to be appropriate)." Keillor refers particularly to a "dark-haired beauty named Sarah" who not only "coaches him on self-administered shots of heparin," but also inspires him to plunge the needle in without hesitation, since "no man is a coward in the presence of women." We appreciate Keillor's kind thoughts, and we don't begrudge him his honest observations. But we have to note that he seems to be responding to the nurses' gender and physical attractiveness at least as much as their skills, and that his specific examples of care do not exactly overemphasize the nurses' advanced skills and health care knowledge. We hear about Keillor's physicians too, but nothing about their appearance. In any case, nurses of both genders improve patient outcomes because of their education, experience, and skills, not because they are nice, attractive women. more...

 

Is the "best" nursing all about being "polite and communicative"?

U.S. News & World Report logoOctober 20, 2009 -- Today U.S. News & World Report posted an online item as part of its extensive annual "Best Hospitals" survey that actually lists the "best" and "worst" of the hospitals for nursing. Historically, the magazine's "best hospitals" analysis has focused overwhelmingly on physicians. In recent years, the survey has started to factor in nurse staffing and magnet status as very minor elements in its overall scores (as this year's does), but to our knowledge this is the first time it has broken nursing out in its own listings. And the simple suggestion that there is such a thing as the "best" nursing is helpful. So the item is a real step forward. Sadly, nursing is still greatly undervalued. The nursing lists are based solely on patient surveys and filed under the heading of "patient satisfaction," along with similar lists for hospitals that were judged best and worst at "pain management." That suggests nursing is important, but still just a part of what we might call "patient care services," rather than a key factor in patient outcomes. The U.S. News lists also treat nursing as if it was generic across all units at a hospital, and there is no sign that nurses have specialties, in contrast to the specialty-based analysis for physicians that is central to the overall listings. Perhaps most troubling are the standards patients were given to evaluate nursing: whether nurses were "courteous," "listened carefully," and "gave clear explanations." These standards are important, but they reinforce the prevailing public sense that nurses are about customer service and being nice, failing to measure nurses' main roles in using advanced science training to save lives and improve outcomes. That would never happen in the overall "best" analysis, which relies heavily on the hospitals' reputations among physicians. Even so, we thank U.S. News for this advance, and urge it to continue improving. Next year, perhaps the magazine could also seek the opinions of those who know the most about nursing--and about hospitals in general: nurses. more...

 

Help for Haiti: Learn What You Can Do Learn how you can donate cash, frequent flyer miles or volunteer to help the people of Haiti. Thank you.

 

Saving Lives named a 2009 AJN Book of the Year

January 2010 -- Saving Lives: Why the Media's Portrayal of Nurses Puts Us All At Risk has been named a Book of the Year, one of the "most valuable texts of 2009," by the American Journal of Nursing. As announced in this month's issue of the leading journal, Saving Lives was one of the books chosen in the Public Interest and Creative Works category. Judge Karen Roush noted that Saving Lives "provides readers with specific ideas on how to influence the media that could result in a more accurate perception of nursing that improves health care for everyone." She also praised the book's "in-depth comprehensive coverage of the issue" and "clear, well-organized writing." The Truth congratulates all of the book award winners, and thanks Ms. Roush and AJN. See the full awards... or order the book now.

 

See The Truth About Nursing Decade Awards for 2000-2009

 

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The Truth About Nursing is an international non-profit organization based in Baltimore that seeks to help the public understand the central role nurses play in health care. The Truth promotes more accurate media portrayals of nurses and greater use of nurses as expert sources. The group is led by Sandy Summers, co-author of Saving Lives: Why the Media's Portrayal of Nurses Puts Us All At Risk.

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Sandy Summers, RN, MSN, MPH
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