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Archive for the ‘conscience’ Category

In most stories about conscience clauses and nurses, the nurse involved is the one appealing to conscience-clause legislation to justify non-participation in some medical procedure.

But that’s not always the case.

See this story, from CNBC: Idaho board: No action in Walgreens complaint

The Idaho Board of Pharmacy says it has no basis to start proceedings against Walgreen Co. in a complaint that alleged one of the drug store chain’s pharmacists in Nampa improperly refused to fill a prescription.

A nurse practitioner from Planned Parenthood of the Great Northwest contended the pharmacist abused the state’s 2010 conscience law in November after balking at filling a prescription for a drug that helps control bleeding after childbirth or abortions….

This I think is a little-discussed aspect of “conscience clauses” or “conscience laws”: they can be a focal point for disagreement between members of different professions. Also, while conscience clauses may sometimes help nurses avoid participation in procedures that go against deeply-held values, in other cases such clauses are going to frustrate nurses’ attempts to help patients obtain the services of other health professionals.

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In a recent article from the Chronicle of Higher Education, a “ghost writer” talks about the proliferation of students having papers and assignments written by others. The writer mentions nursing students in particular as a frequent client of his services. Here’s the story: The Shadow Scholar: The man who writes your students’ papers tells his story

With respect to America’s nurses, fear not. Our lives are in capable hands — just hands that can’t write a lick. Nursing students account for one of my company’s biggest customer bases. I’ve written case-management plans, reports on nursing ethics, and essays on why nurse practitioners are lighting the way to the future of medicine. I’ve even written pharmaceutical-treatment courses, for patients who I hope were hypothetical….

The ghost writer mentions the fact that these nurses “can’t write a lick”. It is, however, much more than that. Asking someone else to write your paper for you necessarily means you will not learn what it is you’re supposed to learn form the assignment, which is a far more serious consequence.

I’ve been teaching nursing students for many years now and the topics of plagiarism and cheating is one that comes up again and again. Here are a few things I try to communicate to my students: From the moment that they walk in the door on the first day of university in a nursing degree program, the expectations of them are much higher than the expectations of a student in a non-professional program, like a history or political science major. Nursing students are evolving professionals with clear responsibilities for the lives and well being of others, from the moment that they set foot in a patient care area. When a history major has someone else write her paper on the outcomes of civil wars in the sixteenth century, there are two results: First, she is quite clearly cheating. Second, she’ll know little to nothing about the civil wars in the sixteenth century, if asked later, since someone else did her research and wrote her paper. However, when a nursing student has someone else write his paper on the pathophysiology of cancer, those same two things happen but with more serious implications. Yes, the nursing student, like the history student, has cheated. But the nursing student will end up knowing little to nothing about the pathophysiology of cancer, something a nurse should know.

I realize that, sometimes, the demands we put on what are often very young nursing students struggling to manage heavy academic workloads, shifts in their clinical placements, and personal commitments, can be overwhelming. Students in all kinds of professional programs balance very intense programs, clinical placements and multiple responsibilities. And yes, the demands are extreme at times. as are the demands of nursing work, across all settings. But to cite overwhelming demands as a valid excuse for cheating is to diminish the very real importance of learning positive, constructive and responsible ways of dealing with stress and overwork, something nurses and nursing students must be encouraged to do.

The public has always put a great deal of trust in nurses. Time and time again, in surveys of the public, nurses rate very high in terms of degree of public trust. This trust forms the basis of the therapeutic relationship that nurses are able to form with patients and families. The public doesn’t want nurses who cheat or who get others to do their work for them. Instead, they want nurses who they can trust to both deliver safe and knowledgeable care in the most routine situations and also in life-and-death circumstances.

The public expects that if a nurse has a degree and has, by virtue of that degree, claimed to study how drugs interact and how intravenous therapy should be delivered, he’ll actually know this and be able to apply this knowledge to the care of others. If nursing students are, as the ghost writer here suggests many are, paying for their papers to be written by others, they are not only cheating themselves but also the patients who expect a high level of both professionalism and knowledge from nurses.

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