CNU Library Blog

Title: Ethical Case Studies for Advanced Practice Nurses: Solving Dilemmas in Everyday Practice

Authors: Amber L. Vermeesch, Patricia H. Cox, Inga M. Giske, Katherine M. Roberts.

Publication Information: Indianapolis, IN : Sigma. 2023.

Location: Academic eBook Collection.

Description: Healthcare delivery can present ethical conflicts and dilemmas for advanced practice registered nurses (APRNs)—nurses who already have a myriad of responsibilities in caring for patients. Ethical Case Studies for Advanced Practice Nurses improves APRNs'agility to resolve ethical quandaries encountered in primary care, hospital-based, higher education, and administration beyond community settings. Through case studies examining various types of ethical conflicts, the authors empower APRNs and students with the critical knowledge and skills they need to handle even the most complex dilemmas in their practice. By applying a set of criteria and framework, this book guides APRNs to use critical thinking to make ethically sound decisions.

TABLE OF CONTENTS

• Case Study #1: Defensive Medicine
• Case Study #2: STI Confidentiality
• Case Study #3: Substance Use in Pregnancy
• Case Study #4: HPV Vaccine Refusal
• Case Study #5: Abortion
• Case Study #6: Prostate Cancer Screening with Prostate-Specific Antigen
• Case Study #7: Administration of Long-Acting Injectable Antipsychotics
• Case Study #8: Depression Screening in Adolescents
• Case Study #9: Treatment of Resistant Anxiety
• Case Study #10: COVID-19 Vaccine in Adolescence
• Case Study #11: Medical Emancipation Versus Confidentiality in Transgender and Gender-Nonconforming People
• Case Study #12: Childhood Obesity
• Case Study #13: Dementia and Stopping Driving
• Case Study #14: When to Transition to Palliative Care
• Case Study #15: Prescription Refill Dilemma for Patient and Spouse in Financial Straits
• Case Study #16: CRNA Labor and Delivery Epidural Pain Management With a Language Barrier
• Case Study #17: Violence, Suicide, and Family Dynamics With Medical Complexity
• Case Study #18: Psychiatric Acute Concerns and Fall Risks
• Case Study #19: Telehealth
• Case Study #20: Guiding a School of Nursing Through COVID-19 Focusing on Clinical Placements
• Case Study #21: Emergency Department Closure Decision-Making: Health System and Community Impact
• Case Study #22: Ethical Dilemmas in School of Nursing Leadership Pre-COVID-19

Title: Graphic Medicine Manifesto.

Published: 2015. 

Available: as an eBook in Academic eBook Collection.

 

Description: "This inaugural volume in the graphic medicine series establishes the principles of graphic medicine and begins to map the field. The volume combines scholarly essays by members of the editorial team with previously unpublished visual narratives by Ian Williams and MK Czerwiec, and it includes arresting visual work from a wide range of graphic medicine practitioners. The book's first section, featuring essays by Scott Smith and Susan Squier, argues that as a new area of scholarship, research on graphic medicine has the potential to challenge the conventional boundaries of academic disciplines, raise questions about their foundations, and reinvigorate literary scholarship—and the notion of the literary text—for a broader audience. The second section, incorporating essays by Michael Green and Kimberly Myers, demonstrates that graphic medicine narratives can engage members of the health professions with literary and visual representations and symbolic practices that offer patients, family members, physicians, and other caregivers new ways to experience and work with the complex challenges of the medical experience. The final section, by Ian Williams and MK Czerwiec, focuses on the practice of creating graphic narratives, iconography, drawing as a social practice, and the nature of comics as visual rhetoric. A conclusion (in comics form) testifies to the diverse and growing graphic medicine community. Two valuable bibliographies guide readers to comics and scholarly works relevant to the field."

Article-linking websites online can help you find relevant articles from one article's DOI. Scroll through these slides to learn more about LitMaps, Citation Gecko, and Connected Papers.

Academic research is an ongoing conversation between authors. by Sadie Davenport

Happy birthday to Dr. Leopold Auenbrugger! 

In the mid-1700s, in a hospital in Vienna, Austria, Auenbrugger found that by placing his ear to his patient's chest and lightly tapping, he could tell the density of organs within the body. By sensing if an organ or region feels hollow or dense, a doctor can detect blood clots, air pockets, masses, and other irregular conditions within the body. 

It wasn't until Dr. Rene Laennec developed the stethoscope in 1812 that other doctors used percussion to detect ailments in the body. 

Learn more about the medical applications of percussion in the video and links below! 

Read more: 

• Medline Plus: Percussion
• Science Direct article: "Percussion and physical diagnosis: Separating myth from science"
• SciHi Blog: Leopold Auenbrugger (This blog post has lots of cool pictures and interesting sources to read)
• Wikipedia: Leopold Auenbrugger 
• Wikipedia: Rene Laennec

SOAP notes allow doctors to communicate important information about a patient's well-being quickly and effectively. These notes are intended to help medical professionals in their daily routine, but can also help health professionals SOAP stands for:

• Subjective (patient's perspective) 
• Objective (results, measurements) 
• Assessment (your summary of patient's condition) 
• Plan (to manage patient's condition) 

The resources below describe in more detail what the patient's perspective may include, important results and measurements to report, what a proper assessment includes, and what may constitute the plan going forward. 

Here are some resources for writing SOAP notes: 

• Gomella and Haist’s Clinician’s Pocket Reference, 12e: Chapter 7, Chartwork (on Access Medicine)
• Huppert’s Notes: Pathophysiology and Clinical Pearls for Internal Medicine, Appendix 1: Practical Skills for Learners (on Access Medicine)
• Wolters Kluwer: What are SOAP notes? (Wolters Kluwer is a well-known health sciences database company and publisher!) 
• StatPearls: SOAP notes (on the National Library of Medicine website)
• Purdue Owl: SOAP Notes (includes what a SOAP note is and examples)

Title: What Patients Teach: The Everyday Ethics of Health Care.

By: Larry R. Churchill; Joseph B. Fanning; David Schenck. Oxford University Press. 2013.

Available in our Academic eBook Collection. 

Description: "Being a patient is a unique interpersonal experience but it is also a universal human experience. The relationships formed when we are patients can also teach some of life's most important lessons, and these relationships provide a special window into ethics, especially the ethics of healthcare professionals. This book answers two basic questions: As patients see it, what things allow relationships with healthcare providers to become therapeutic? What can this teach us about healthcare ethics? This volume presents detailed descriptions and analyses of 50 interviews with 58 patients, representing a wide spectrum of illnesses and clinician specialties. The authors argue that the structure, rhythm, and horizon of routine patient care are ultimately grounded in patient vulnerability and clinician responsiveness. From the short interview segments, the longer vignettes and the full patient stories presented here emerge the neglected dimensions of healthcare and healthcare ethics. What becomes visible is an ethics of everyday interdependence, with mutual responsibilities that follow from this moral symbiosis. Both professional expressions of healthcare ethics and the field of bioethics need to be informed and reformed by this distinctive, more patient-centered, turn in how we understand both patient care as a whole and the ethics of care more specifically. The final chapters present revised codes of ethics for health professionals, as well as the implications for medical and health professions education." 

On this day in 1960, for the first time, Dr. Belding Scribner (Scrib) inserted a shunt into a man's arm to connect an artery to a dialysis machine. The operation was successful and enabled the man, Clyde Shields, to survive on dialysis for over a decade. This shunt (shown in the images below) was the last piece of technology needed to provide long-term dialysis for patients with failing kidneys. The impact of this successful procedure was immediate -- kidney failure was no longer a death sentence. 

Left: A diagram naming parts of the original 1960 shunt. Middle: The shunt inserted into Clyde Shields's arm in 1960. Right: Dr. Belding Scribner. 

How it works: The shunt consists of two extension tubes, a stabilizer, and a "U tube" (which takes on a U-shape closer to the patient's elbow). When dialysis is needed, the "U tube" is removed and the dialysis machine connected in its place. (The original 1966 article below explains how this shunt works in more detail.)

Today: Now there are more options for dialysis. Patients may undergo surgery to have a fistula or graft in their arm, or a catheter in their neck, all of which improve access to the bloodstream for dialysis. At-home dialysis is also possible. The patient education webpages listed below offer general overviews of dialysis, including its types, steps, effects, risks, and outlooks. 

Read more: 

• Cleveland Clinic: Dialysis (patient education)
• Fresenius Medical Care: The History of Dialysis (patient education)
• Kansas Health System: Dialysis Shunt Graft Catheter (patient education)
• New York Times: Dr. Belding H. Scribner, Medical Pioneer, Is Dead at 82 (brief biography) 
• Pubmed: The 50th anniversary of long-term hemodialysis: University of Washington Hospital, March 9th, 1960 (free article)
• Oxford Academic: History of vascular access for haemodialysis (free article)
• Routine Use of the Scribner Shunt for Haemodialysis (ORIGINAL ARTICLE 1966)