Our Readers Respond

Letters to the Editor – March 2007

Personal experience with “Last breath”

I found the article “Last breath: The ethics of pharmacologic paralysis” in the January issue to be very interesting. I used to think it would be scary to die from a lack of breath, until I had an asthma attack at home and had to call the ambulance.

While waiting for the ambulance, I went from being scared to feeling tired. I thought that if I went to sleep, I might never wake up, and my thoughts turned to what my family would be left to face.

I support allowing neuromuscular blockers to wear off before a patient is disconnected from the ventilator for two reasons. First, dying from a lack of oxygen may not be as uncomfortable as most of us imagine. It would be more frightening to “endure the agony of suffocation in silence and isolation” with no ability to breathe on your own. And second, allowing neuro­­muscular blockers to wear off first could give a patient more time with the family before death.
Darla Widnall, RN
Ormond Beach, FL

Showcase all nursing’s roles
Please consider the many nurses that work in community settings as you develop your excellent publication. School nurses, public health nurses, and nurses in home health and other community settings are all interested in keeping abreast of current nursing issues.
We need to recognize the commonalities in our profession. We can expand the circle in a way that showcases all nursing opportunities and celebrates the many ways that nurses make a difference.
Susan Sullivan, MSN, RN, PHN
Santa Ana, CA

Response from the Editor-in-Chief
You’re right. Nursing is a diversified profession that covers many specialty areas. Thank you for reminding us to feature issues important to all practice settings.
Pamela F. Cipriano, PhD, RN, FAAN


A long time coming
I am a new nurse, and I want to let you know how much I enjoy reading American Nurse Today and how informative it is. I’ve discussed the journal with my more experienced colleagues, and they all agree that they haven’t seen a journal like this in a long time.
Jennifer Macal, RN
Okemos, MI

Clarifying ethical communication
I read with interest the article, “When patient privacy endangers staff” by Leah Curtin in the January issue. I have worked in the acute mental health field for close to 25 years, starting as a mental health tech and now working as a shift nursing supervisor.
I appreciate the need for HIPAA (Health Information Portability and Accountability Act) regulations. How­ever, if I have information about a patient, and I don’t share it with the current provider, and someone gets hurt, who is at fault?
We are all trying to do the best for our patients, and sharing information is part of that effort. To believe that every patient gives you complete, truthful, accurate data is to put yourself in harm’s way. The harm may not come today or tomorrow, but someday, it will.
Thank you for not relegating a behavioral science–psych nursing topic to the back pages, as other general nursing journals do.
L.E., BSN
New York, NY

Author’s response
Thank you for your letter. I agree with you that patient assaults are important and deserve to be addressed before they can happen. But in this case, information regarding the patient’s history of assaults was available to the intake nurse. It was in the patient’s records and was documented in the court order. Further information was not needed.
HIPAA doesn’t forbid the communication of relevant information among caregivers. Indeed, a patient’s history of assaults is the most important predictor of future assaults on caregivers and other patients.
Communicating information to those who will care for the patient is appropriate and necessary. Such communication is unethical only when it is done in a prejudicial or demeaning manner.
Calling every hospital that has ever—or could ever have—admitted this patient, as this intake nurse did, is just going on a fishing expedition. And that is unethical.
Leah Curtin, DSc(h), RN, FAAN

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