Crises in the operating room are common, but caregivers often fail to save the patient because they do not recall the necessary steps quickly enough. An experiment at Brigham and Women's Hospital suggests that surgeons, nurses, and other staff can vastly improve their handling of these critical situations by reviewing checklists, an approach used by pilots during airplane mishaps. When checklists were available to surgical teams, they missed just 6 percent of live-saving steps, compared with 23 percent when the tool was not available, according to results published online Wednesday in the New England Journal of Medicine.
Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal. "Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.
A nurse who refused to wear a surgical mask after receiving an exemption from a mandatory flu vaccination was fired for violating her hospital's policy. Carla Brock, a board-certified holistic nurse who has worked 11 years at Cox South Hospital here, said she is speaking out because she believes her hospital's new requirement to wear a mask if a staffer opts out of the flu vaccine amounts to a scarlet letter. CoxHealth, which owns four hospitals in southwest Missouri and northwest Arkansas, says it simply is putting the patient first.
In a move expected to shake up health care labor battles statewide, the powerful California Nurses Association announced Thursday that it will affiliate with the National Union of Healthcare Workers in fights with major health systems over wages, benefits and patient care issues. CNA also agreed to use its 85,000 members and considerable resources to help NUHW in its campaign to defeat a large rival, the Service Employees International Union-United Healthcare Workers West, in an upcoming election for the right to represent 43,500 Kaiser Permanente service and technical workers.
Thousands of registered nurses will walk off the job Christmas Eve at nine San Francisco Bay Area hospitals, where administrators and a nurses union are locked in a lingering dispute, a union official said Saturday. Nurses and X-ray technicians represented by the California Nurses Association will begin a one-day strike on the morning of Dec. 24 at seven hospitals operated by Sutter Health and at two San Jose hospitals affiliated with the Hospital Corporation of America, said union spokesman Chuck Idelson. Union officials say the strike?the eighth by the association since September 2011?was not called over a salary dispute, but comes as the union and the hospitals remain at odds over staffing levels, health benefits and sick days.
There is already a shortage of doctors in many parts of the United States. The expansion of health care coverage to millions of uninsured Americans under the Affordable Care Act will make that shortage even worse. Expanding medical schools and residency programs could help in the long run. But a sensible solution to this crisis—particularly to address the short supply of primary care doctors—is to rely much more on nurse practitioners, physician assistants, pharmacists, community members and even the patients themselves to do many of the routine tasks traditionally reserved for doctors.