The Legal Issue (32:1) provides a broad spectrum of topics for the reader. The Perinatal section includes 2 extended columns; the Legal Issues and Risk Management column, authored by guest columnist Kathleen Rice Simpson, sheds light on "Emerging Trends in Perinatal Quality and Risk With Recommendations for Patient Safety, whereas the Expert Perinatal column, "Transitions in Care: Risk, Recovery, and Best Practices," takes a deep dive into handoffs. There is also a Special Editorial by Chez, "The Arrest of the University of Utah Nurse Was Wrong! The Legal and Ethical Issues Discussed and Lessons Learned," exploring an unusual situation where patient advocacy was at odds with law enforcement.
"Marijuana-Perinatal and Legal Issues With Use During Pregnancy" is covered by Krening and Hanson. Legal for medical and/or recreational use in 29 states, yet still illegal at the federal level, marijuana use in the perinatal period presents complex ethical, legal, and medical/nursing issues. With little evidence to inform standards of care, there is a risk of policy and guideline development based on opinion versus science. Recommendations and considerations for clinical practice in caring for pregnant women and newborns exposed to cannabis are explored.
Drummond reports on a common labor medication with "Oxytocin: Tachysystole, Fetal Oxygenation, Patient Safety." Insights into dosage, administration, and pharmacokinetics of oxytocin are coupled with key points of physiology related to fetal oxygenation during labor. From both legal and safety perspectives, clinicians must be aware of common errors in oxytocin management.
A perennial hot topic in liability is documentation, especially in electronic fetal monitoring. Cypher elucidates the role of checklists, decision analysis, and technology in "Electronic Fetal Monitoring Documentation: Connecting Points for Quality Care and Communication." Essential to evaluating perinatal care from both quality and legal perspectives, this article provides a synopsis of the role of current documentation tools and approaches. Documentation is also crucial to deposition testimony, which is considered by this editor in "Litigation in Perinatal Care: The Deposition Process." Clinicians can improve defensibility and decrease anxiety related to testifying at deposition or trial by understanding the goals of the plaintiff's attorney. Plaintiff's strategies (including the reptile theory style of questioning) are reviewed, and tips for avoiding common errors at deposition are offered for consideration.
In this issue, the neonatal section features articles that address important topics pertaining to legal and ethical issues relevant to nurses caring for newborns and their families. Kathy Ahern reports on the experience of whistle-blowers and the trauma that is often associated with this activity. Carol Keohane and colleagues report on how partnering with a medical malpractice insurer can improve patient safety and decrease risk, specifically as it pertains to the use of therapeutic hypothermia in the setting of neonatal encephalopathy. The final 2 articles report on the nursing care needs of infants in drug withdrawal, as submitted by Jessica Smith and colleagues, and overall care issues following birth from the newborn's perspective, as submitted by Kim Francis and Lori Pugsley. Our columnists, Sara Rostas and Joan Smith, have each provided a thought-provoking column for our consideration and reflection. Sara discusses the ethical considerations of a neonatal intensive care unit pharmacist, and Joan, along with Suzzi Harper, discusses the skill of artful disclosure. Finally, Terese Verklan provides parting thoughts on the generosity of strangers following Hurricane Harvey, reminding us to be grateful for the kindnesses of others and to extend these kindnesses ourselves.
As always, thank you for reading The Journal of Perinatal & Neonatal Nursing (JPNN). Please reach out to us with any thoughts or suggestions for the journal. We wish you the best in 2018, and welcome your feedback on future topics and issues you want to read about in JPNN.
-Lisa A. Miller, CNM, JD
Perinatal Guest Editor
-Katherine Gregory, PhD, RN
Neonatal Editor