- Email: [email protected]
A Call for Papers
LETTERS
overcrowding—development of fast tracks, tracking systems, charting systems, development of regional centers, etc.— and process this population more efficiently. Causes of the problem are consolidated to lack of ED space, an increase in nonurgent patients utilizing the emergency room, lack of acute care beds, and lack of qualified nursing staff. The federal government has attempted to address the nurse staffing issue with the Nurse Reinvestment Act of 2002. Although the act has not solved the problem, which is expected to get worse, it is time for the federal government to examine mechanisms to improve primary care access and increase acute care beds. The government has spent billions of dollars on defense and foreign affairs without addressing this American crisis. Medical personnel have been victims of criminal charges for quality of care issues as they relate to emergency room overcrowding and continue to focus on mechanisms to solve the crisis without being provided the resources to alleviate the crisis. The federal government needs to provide some assistance to the system as it did with the Hill-Burton Act. The American population has grown, and acute care hospitals have been mandated to provide primary and emergency care in emergency departments. The population continues to age, requiring more acute care hospital beds. Does this country really possess the number of staffed hospital beds per 1000 people? When we are boarding admitted patients in the emergency department and transferring patients across state lines and to other facilities, this is certainly not the case. If we can obtain the necessary funding to increase the number of beds and utilize charity care accounts as a means of forgiveness, this would increase the number of acute care beds available and resultantly decrease the ED wait times.—Gordon B. Natal, Jr, MSN, MHA, RN, Loyola University, New Orleans, La doi: 10.1016/j.jen.2006.12.022
A Call for Papers
Dear Editor: Often, it seems, little events have big consequences, or at least, they have bigger consequences then we envisioned. Case in point: Some colleagues and I were talking about the effects of computerized charting on nursing ethics. The discussion led to a Letter to the Editor of the Journal of Emergency Nursing. It was never the intent of the letter to
100
be published; rather, we wanted to suggest that someone might want to take up the topic in more depth. The Editor’s response was to submit the letter for publication. In response, I suggested that perhaps the Journal would benefit by having a regular column on nursing ethics in the emergency department. The Editor’s response to me was, ‘‘Would you be the section editor for that?’’ That, again, was never in my mind. However, after struggling with the idea for a while, bouncing a few letters back and forth between the Editor and myself, and consulting with some of my friends and my wife, I hesitantly agreed to give it a try. When I look back on all the nurses that I have known who have gotten in trouble in nursing, it was because of ethics. For some emergency nurses a limited understanding of ethical concepts or their implications may lead to poor insight into the ethical consequences of their actions. I really believe that all of us can benefit by raising our ethical sensitivity, and that ethics is very important in everything we do in nursing. Now, it is not my intention to write a lot of papers on ethics, or to try and sell all of you on my personal ethical views. Rather, I would like to see this column become a place where we can carry on discussions, even disagreements, share insights, and ask questions about day-to-day ethical challenges we face as ED nurses. It is also not my intention for this column to become a series of theoretical ethical papers that put forward this or that theory on how to make good ethical choices. A brief review of papers on nursing ethics showed an overwhelming volume of such papers. Frankly, I wondered what most of what was written had to do with where I live, or to use an old expression, ‘‘With where the rubber meets the road.’’ I believe that the Journal would like practical papers that ED nurses can use to help them problem solve the situations that are encountered on a daily basis. This is where all of you come in. I need you to submit articles based on your own ED experiences. They can be articles that provide case presentations of ethical challenges you have faced. They can be articles in which you ask for suggestions regarding how to approach a situation ethically. They can be articles regarding concerns you have about specific challenges to ED nursing ethics. There are a wide range of options. I see an opportunity here to have a
JOURNAL OF EMERGENCY NURSING
33:2
April 2007
LETTERS
very down to earth and practical column that really helps each of us think, yet is focused on what is the right thing (that’s what ethics is all about) to do in a given situation. You can be brand new to nursing practice, and be facing new challenges, including the challenge of how to respond to the ‘‘experienced nurse’’ in your midst who thinks that the old way is the only way. You can be an ‘‘experienced nurse’’ who is concerned with the training and upbringing of our new young nurses, or who can share your years of experience in facing ethical challenges in difficult situations. You can be a thinker who sees a potential problem, and you may just want to raise ED nurses’ consciousness so that it doesn’t become a real problem. Or you can be a group of ED nurses who share a common vision you would like to share with all of us. This is an open opportunity for all of us, but I cannot do it by myself. So as you are working, as you are dialoguing with colleagues (much as I did when I sent our letter to the Editor), as you are struggling with a problem, think about writing it up as an article, as a case presentation, or as a request for assistance. We can all use your insights to help us see some things more clearly. I have an unfortunate work schedule in which half my life is nights and half is days. During the night half, I primarily use my E-mail address at my primary job: [email protected]. During the day half I use my home E-mail address: [email protected]. Please, when sending articles to me, send them to both addresses. That way I will get material in a very timely manner. I am able to open and read Microsoft Word documents, Corel WordPerfect documents, and Adobe PDF documents, so work with whichever format you are comfortable with. Our initial plan is to publish articles twice a year. When you send something to me, I will get back to you as promptly as I am able to let you know if I can use what you send. If you are unsure, send me a proposal, and we can talk back and forth via E-mail about your ideas. I thank you all in advance for your help in making this column successful.—Dave Reynolds, ED, RN, CEN, Legacy Emanuel Hospital, 2801 N Gantenbein Ave, Portland, OR 97227; E-mail: [email protected] and [email protected] doi: 10.1016/j.jen.2007.01.004
April 2007
33:2
JOURNAL OF EMERGENCY NURSING
101
overcrowding—development of fast tracks, tracking systems, charting systems, development of regional centers, etc.— and process this population more efficiently. Causes of the problem are consolidated to lack of ED space, an increase in nonurgent patients utilizing the emergency room, lack of acute care beds, and lack of qualified nursing staff. The federal government has attempted to address the nurse staffing issue with the Nurse Reinvestment Act of 2002. Although the act has not solved the problem, which is expected to get worse, it is time for the federal government to examine mechanisms to improve primary care access and increase acute care beds. The government has spent billions of dollars on defense and foreign affairs without addressing this American crisis. Medical personnel have been victims of criminal charges for quality of care issues as they relate to emergency room overcrowding and continue to focus on mechanisms to solve the crisis without being provided the resources to alleviate the crisis. The federal government needs to provide some assistance to the system as it did with the Hill-Burton Act. The American population has grown, and acute care hospitals have been mandated to provide primary and emergency care in emergency departments. The population continues to age, requiring more acute care hospital beds. Does this country really possess the number of staffed hospital beds per 1000 people? When we are boarding admitted patients in the emergency department and transferring patients across state lines and to other facilities, this is certainly not the case. If we can obtain the necessary funding to increase the number of beds and utilize charity care accounts as a means of forgiveness, this would increase the number of acute care beds available and resultantly decrease the ED wait times.—Gordon B. Natal, Jr, MSN, MHA, RN, Loyola University, New Orleans, La doi: 10.1016/j.jen.2006.12.022
A Call for Papers
Dear Editor: Often, it seems, little events have big consequences, or at least, they have bigger consequences then we envisioned. Case in point: Some colleagues and I were talking about the effects of computerized charting on nursing ethics. The discussion led to a Letter to the Editor of the Journal of Emergency Nursing. It was never the intent of the letter to
100
be published; rather, we wanted to suggest that someone might want to take up the topic in more depth. The Editor’s response was to submit the letter for publication. In response, I suggested that perhaps the Journal would benefit by having a regular column on nursing ethics in the emergency department. The Editor’s response to me was, ‘‘Would you be the section editor for that?’’ That, again, was never in my mind. However, after struggling with the idea for a while, bouncing a few letters back and forth between the Editor and myself, and consulting with some of my friends and my wife, I hesitantly agreed to give it a try. When I look back on all the nurses that I have known who have gotten in trouble in nursing, it was because of ethics. For some emergency nurses a limited understanding of ethical concepts or their implications may lead to poor insight into the ethical consequences of their actions. I really believe that all of us can benefit by raising our ethical sensitivity, and that ethics is very important in everything we do in nursing. Now, it is not my intention to write a lot of papers on ethics, or to try and sell all of you on my personal ethical views. Rather, I would like to see this column become a place where we can carry on discussions, even disagreements, share insights, and ask questions about day-to-day ethical challenges we face as ED nurses. It is also not my intention for this column to become a series of theoretical ethical papers that put forward this or that theory on how to make good ethical choices. A brief review of papers on nursing ethics showed an overwhelming volume of such papers. Frankly, I wondered what most of what was written had to do with where I live, or to use an old expression, ‘‘With where the rubber meets the road.’’ I believe that the Journal would like practical papers that ED nurses can use to help them problem solve the situations that are encountered on a daily basis. This is where all of you come in. I need you to submit articles based on your own ED experiences. They can be articles that provide case presentations of ethical challenges you have faced. They can be articles in which you ask for suggestions regarding how to approach a situation ethically. They can be articles regarding concerns you have about specific challenges to ED nursing ethics. There are a wide range of options. I see an opportunity here to have a
JOURNAL OF EMERGENCY NURSING
33:2
April 2007
LETTERS
very down to earth and practical column that really helps each of us think, yet is focused on what is the right thing (that’s what ethics is all about) to do in a given situation. You can be brand new to nursing practice, and be facing new challenges, including the challenge of how to respond to the ‘‘experienced nurse’’ in your midst who thinks that the old way is the only way. You can be an ‘‘experienced nurse’’ who is concerned with the training and upbringing of our new young nurses, or who can share your years of experience in facing ethical challenges in difficult situations. You can be a thinker who sees a potential problem, and you may just want to raise ED nurses’ consciousness so that it doesn’t become a real problem. Or you can be a group of ED nurses who share a common vision you would like to share with all of us. This is an open opportunity for all of us, but I cannot do it by myself. So as you are working, as you are dialoguing with colleagues (much as I did when I sent our letter to the Editor), as you are struggling with a problem, think about writing it up as an article, as a case presentation, or as a request for assistance. We can all use your insights to help us see some things more clearly. I have an unfortunate work schedule in which half my life is nights and half is days. During the night half, I primarily use my E-mail address at my primary job: [email protected]. During the day half I use my home E-mail address: [email protected]. Please, when sending articles to me, send them to both addresses. That way I will get material in a very timely manner. I am able to open and read Microsoft Word documents, Corel WordPerfect documents, and Adobe PDF documents, so work with whichever format you are comfortable with. Our initial plan is to publish articles twice a year. When you send something to me, I will get back to you as promptly as I am able to let you know if I can use what you send. If you are unsure, send me a proposal, and we can talk back and forth via E-mail about your ideas. I thank you all in advance for your help in making this column successful.—Dave Reynolds, ED, RN, CEN, Legacy Emanuel Hospital, 2801 N Gantenbein Ave, Portland, OR 97227; E-mail: [email protected] and [email protected] doi: 10.1016/j.jen.2007.01.004
April 2007
33:2
JOURNAL OF EMERGENCY NURSING
101