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April, May and June 2012 Archives
News on Nursing in the Media



Nurse Jackie on Nurse's Week: "THANK YOU NURSES!"

Patient with Zoey--ear drops in old catsMay 2012 -- As we reach Nurses Week in the United States and the fourth season of Showtime's Nurse Jackie gets underway, it's worth reviewing last year's third season, in which the show's tough, expert central character bluntly dismissed the annual appreciation week as "patronizing." The third season continued the show's run as the best dramatic U.S. television portrait of nurses in decades, perhaps ever. Sure, most of the season was not about clinical work, the show faltered badly on nursing autonomy (repeatedly suggesting that nurses report to physicians), and Jackie's ongoing drug problem remains a bit hard to reconcile with her clinical prowess. But when there were clinical scenes, Jackie remained essentially a clinical peer of the physicians, and in general, the nurse characters actually performed their own work, including triage and patient education. Jackie provided expert holistic care to emergency patients including a distraught cab driver with a pneumothorax, a gunshot victim who cared more about her dog than her wounds, and a nice man who was falling apart because of chronic hypertension. The show featured credible interactions among nurses and physicians, in clinical and social contexts, showing that nurses are sentient three-dimensional beings. The season also included nurse Kelly, a skilled, flawed younger nurse who resembled Jackie in some ways and was the strong male nurse that the show was missing in the second season. And we got periodic looks at the contempt that many people have for nursing, as well as wry commentary on the nursing image, from a patient's mockery of nurse Zoey's patterned scrubs to a more nuanced critique of Nurses Week, which went well beyond Jackie's "patronizing" comment. Yet the show repeatedly suggested that nurses "assist" physicians and that physicians control nurses' patient assignments, with emergency physician Eleanor O'Hara removing nurses from one case and putting them on another. Charge nurses or nurse managers do that in real life. Here, the closest thing to a nurse manager is Gloria Akalitus, a composite administrator who is a nurse but whose ill-defined authority seems to extend to the pharmacy and even medicine, to some extent. Despite its problems, though, Nurse Jackie shows us a world in which nurses are life-saving professionals, in stark contrast to the "yes, doctor!" model that prevails on U.S. television. more...and see the film clips!


Are your knuckles white? NPR on nurse understaffing

Linda Aiken quoteMay 25, 2012 -- Today National Public Radio's Morning Edition ran a generally helpful 5-minute report by Patti Neighmond about widespread nurse understaffing in U.S. hospitals, as part of the radio network's "Sick in America" series. Following a poll showing that one third of U.S. hospital patients reported that nurses were "unavailable" when needed, NPR placed a "call out" on Facebook for nurses themselves to explain what was going on. Nurses responded with stories of being compelled to care for patients non-stop for their 12-hour shifts, with few or no breaks, and worrying that understaffing made it impossible to provide safe care. The Morning Edition piece consults University of Pennsylvania nursing scholar Linda Aiken, who argues that the U.S. now faces not so much a shortage of nurses as a shortage of nursing care at the bedside, which matters because nurses are the "surveillance system" in health care. And commendably, the piece explains, partly through an audio clip from a direct care nurse, how under-staffing can endanger patients, for example if a nurse is too busy to note subtle condition changes or respond to an alarm. An American Hospital Association representative stresses that hospitals today face financial constraints as well as sicker patients and a proliferation of care technologies. pull out quote 1But NPR presents no advocate on the other side, like a union leader, to respond with the argument that it is conscious policy choices, not something totally beyond the control of hospitals or government, that result in nursing being severely underfunded. No direct care nurse featured on the segment is identified, because almost all who responded were "worried about retaliation" from employers. And sadly, it seems that whoever wrote the piece could not resist having Morning Edition host Renee Montaigne lead off with the inane cliché that nurses are the "backbone" of the health care system, which suggests that nurses are tough but unthinking pieces of hardware, like beds. Still, we appreciate the report's basic points that the current understaffing means nurses are working on the edge and that this can threaten patient health. We thank NPR and Patti Neighmond. more... 


Amanda Trujillo: Fired for educating a patient?

Amanda TrujilloMay 2012 -- On February 1, the Phoenix CBS affiliate KPHO-TV ran a short but good item by Peter Busch about veteran local nurse Amanda Trujillo, who said she had been fired by Banner Del Webb Hospital and had a complaint filed against her with the state board of nursing because she had educated a patient about the risks of an upcoming surgery and scheduled a consult about hospice. A hospital spokesman reportedly said that "the doctor, ultimately, is the focal point that directs care for patients" and that "company policy" forbids nurses to order a case management consult. The report does not mention other accounts suggesting that these events were set in motion because the patient's surgeon was displeased that the patient had decided against the surgery. Trujillo's case has itself become a "focal point" for nurses concerned about policies that discourage them from doing what they are trained to do, namely educate and advocate for patients and help them make informed decisions about their care--and about the failure of some in authority to support nurses who stand up for patients. As of this writing, more than a year after Trujillo spoke to her patient in April 2011, it appears that the Arizona Board of Nursing has yet to decide on her case. A "Notice of Charges" with a curiously wide-ranging list of apparent allegations against Trujillo, going back to 2009 and including her work with other employers, appeared online in March. The Notice purports to be signed by the Board's director but it is undated, and it is unclear if the document is genuine or represents the Board's position. At the same time, Trujillo's case has become a national rallying point for nurses concerned about nursing disempowerment, with some questioning the accuracy of the apparent allegations against her and the alleged relation of the Board to Banner Del Webb, and others questioning the accuracy of Trujillo's account or hesitating to prejudge the matter while the Board is apparently still considering it and many facts remain unclear. In any case, we thank KPHO and Peter Busch for this report. more...


Why do nurses abuse patients?

Zambian Watchdog opinion piece at least asks and tries to answer the question

crying patientApril 22, 2012 -- Today the Zambian Watchdog website posted an opinion piece by Andrew Silumesli entitled "Why do Zambian nurses abuse patients?" The piece says that such abuse is a serious problem in Zambia, and it discusses possible causes and solutions. Silumesii relies in part on research about abuse by nurses in the South African obstetric context and in part, we assume, on his own experience in Zambian clinical settings. The piece includes a note that Silumesii is a "Master of Public Health (MPH) candidate at the Institute of Tropical Medicine, Belgium," but does not make clear that he is a physician. The South African research on which he relies was led by a physician and a nurse, though he does not say so. Nor does he note that the research was from 1998, before the current global nursing crisis really took hold. Silumesii does deserve credit for asking the "why" question, which is rarely asked, despite the many media accounts about this kind of abuse in the region. These articles typically focus on horrific examples, but then stop at highlighting the abuse, offering no comment from the nurses involved and no ideas about why the abuse occurs; a notable exception is a March 2009 piece by Zara Nicholson in The Cape Argus, which told readers about the extreme challenges South African nurses face. Silumesii's analysis of the problem is fairly persuasive as far as it goes. He points to a complex array of factors, including inferiority and superiority complexes that may develop after a new nurse has managed to find one of the few escape routes from the generally bleak job prospects for Zambian youth. Silumesii might have looked more closely at potential factors that can't be addressed simply through changes in nurses' values and attitudes, like understaffing,  resource shortages, and relations with physicians, which research has shown to be a problem in South Africa and around the world. Most of his proposed solutions are pretty vague. And there is no indication that he has asked any Zambian nurses what they think. Even so, the piece is a positive step, and we thank Silumesii and the Zambian Watchdog site. more...


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