These top stories from 2005 will continue to hold our attention.
The fate of the jailed Bulgarian nurses and physician accused of purposely infecting hundreds of Libyan children with HIV is still undecided; a verdict was expected as we went to press. Despite testimony from scores of international experts on behalf of the defendants-and a letter sent to Libyan leader Muammar el-Qaddafi from 114 Nobel laureates, who said that scientific evidence had not been presented-the trial plods along in what many believe is an attempt to deflect blame for the infections away from the Libyan health care system's negligent hygiene practices.
A new trend: the criminalization of medical error. In some cases, nurses are facing felony negligence and homicide charges and possible jail time for errors leading to patient deaths. Nursing and hospital organizations are following such cases closely and generally are supportive of the nurses. The Institute for Safe Medication Practices is also protesting the felony charge filed against Julie Thao, a Wisconsin nurse accused of administering the wrong drug by the wrong route, causing a pregnant teen's death. Safety experts say that if professionals fear coming forward when errors are made, efforts to improve patient safety will be undermined, and the public may perceive an error to be the fault of a single person rather than a negligent system.
The nursing shortage continues, but not because of insufficient interest in nursing as a career. The National League for Nursing and the American Association of Colleges of Nursing report that thousands of qualified nursing school applicants are turned away because of faculty shortages.
The National Labor Relations Board ruling in October 2006 that charge nurses (excluding those who periodically "rotate" into performing charge duties) are supervisors and therefore ineligible to join unions could decimate union rolls, according to labor leaders. Most nursing union leaders-including representatives from the United American Nurses/AFL-CIO, the Nurse Alliance of the Service Employees International Union, and the California Nurses Association who spoke with AJN-are optimistic that hospitals will not interpret the ruling in a way that will disrupt patient care. But they also say they will protect members from any attempts to undermine nurses' ability to speak up about unsafe care, which studies have correlated with the protection granted by union representation.
Nurses continue to be undervalued. Evidence supporting nursing's impact on outcomes has largely been ignored, yet measures such as the use of rapid response teams have been widely adopted (the efficacy of these teams, according to a commentary published October 4, 2006, in the Journal of the American Medical Association, is not supported by research).
NPs are faring better as primary care providers, with Wal-Mart, Winn-Dixie, Publix Super Markets, CVS drugstores, and others establishing NP-run walk-in clinics in their stores.
Maureen Shawn Kennedy, MA, RN
news director