MDs Take DNR Orders Too Far

A study published in the Journal of the American Geriatric Society found that the presence of a do-not-resuscitate (DNR) order may affect the overall level of care a doctor provides for a patient. Researchers Dr. Mary Catherine Beach of Johns Hopkins University School of Medicine and Dr. R. Sean Morrison of Mt. Sinai School of Medicine, found that MDs were more apt to withhold from patients treatments not covered by a DNR order, ranging from complex therapies, such as an ICU transfer, to simpler interventions, such as blood transfusions. The researchers said, "Patients with DNR orders are often quite ill, and physicians may assume that because these patients already have chosen to have one life-prolonging treatment withheld, they would wish to have other life-prolonging treatments withheld, if given the choice. Yet patients may reasonably wish only to avoid CPR."-Journal of the American Geriatric Society, December 2002 as quoted in Illinois Nurses for Life News, winter/spring 2003

Death Without Indignity

In a Journal of Medical Ethics article, Peter Allmark says, "Dignity is largely something that someone brings to his death," not something that health care providers can confer. He claims that dignity is something that attaches to people because of their personal qualities. Specifically, someone can be considered to be living with dignity if they live well. But when a person is dying, all that health care professionals can do is contribute to death without indignity. This involves ensuring the person does not experience serious pain, respecting their autonomy and encouraging them to use their ability to think and to decide about their own life and death.-Journal of Medical Ethics, August 2002

Retirees Back at the Bedside

RNs are sitting down on the job, and their patients love it!! At Centegra Health System (CHS) in McHenry County, Illinois, retired nurses are returning to the part of their profession they loved most-pulling up chairs and spending time with patients and their families. CHS's six alumni nurses are paid for their work supporting a healing environment. They typically spend ninety minutes or more assessing or discharging patients, as well as providing education for patients and family members. The RNs provide no treatments; their most important job is therapeutic listening, without time constraints, in the capacity of professional support nurses. And busy staff nurses welcome the help. Patients benefit from more attention from their less-stressed primary nurses, as well as from the personal attention of alumni nurses.-Nursing Spectrum, December 2, 2002

Can Good Vibes Ease Pain?

Nurses at the Ella Milbanks Foshay Cancer Center in Jupiter, Florida, feel they have a sound approach to pain management-musically sound, that is. Based on a program used by the National Institutes of Health in Bethesda, Maryland, Foshay nurses have experimented with an innovative technology called vibroacoustic music that uses music felt by the body, as well as heard. The nursing staff found they could attain a significant reduction in pain and anxiety among patients with the Somatron(R) clinical motorized recliner; it is now a standard offering at Foshay. The vibrations are solely the result of musical sound that creates a complex pattern, rather than a single vibration like that produced by a massage chair. Vibroacoustic therapy seems to trigger the body's relaxation response, thereby reducing physical tension and anxiety-and apparently illness symptoms and pain, as well. For more information, e-mail George Patrick at [email protected] or Chris Brewer at [email protected] Spectrum, February 10, 2003

NCFI Calls for Papers

"Challenged to Care," Nurses Christian Fellowship International's 16th quadrennial conference, will be held in Seoul, South Korea, July 4-9, 2004. The aim of the conference is to equip nurses to be a Christian voice and presence in today's world. You are invited to submit an abstract of a paper to be considered for presentation during the seminar sessions on four afternoons during the conference. General themes are: Care for the Caregiver, Social and Political Impact, Paradigm Shift in Nursing and Celebrating Diversity. For topic ideas related to these themes or for information about submitting abstracts, or attending the conference, check the NCFI website, http://www.intervarsity.org/ncf/temp/ncfi/conference.htm.

Forgiveness Is Good for You

Your mother, your minister and your best friend may have extolled the virtue of forgiveness. But maybe it's time to discuss it with your health care provider. Researchers now believe that letting go of grudges may fortify the heart and the immune system. "When you're stuck in a grudge, you're isolated in your own suffering," says Fred Luskin, PhD, author of Forgive for Good and director of the Stanford Forgiveness Project. "The long-term damage to the cardiovascular system from bitterness and resentment is clearly established." After giving 260 volunteers nine hours of training in forgiveness, Luskin found that forgiveness lowered their stress, boosted their feelings of self-confidence and helped them feel a greater sense of community with other people. His subjects also reported fewer headaches, backaches and upset stomachs. - Mary Duenwald, Ladies Home Journal, May 2003

SARS Updates

Reports on cases of severe acute respiratory syndrome are available at the Centers for Disease Control and Prevention (CDC)'s site, http://www.cdc.gov/travel/other/acute_resp_syn_multi.htm. A table of suspected cases of SARS is updated weekdays at

http://www.cdc.gov/od/oc/media/sars.htm. General information about the syndrome can be found at http://www.cdc.gov/ncidod/sars, including guidelines and recommendations for clinicians, case definition, specimen collections and isolation and infection control. The CDC provides emergency travel advisory information about the disease for those who are traveling outside of the U.S.-Nurseweek, April 28, 2003

Nurse Authors Needed

Editor JoEllyne Howerton is requesting short, true, personal experience stories, along the lines of Chicken Soup for the Soul anecdotes, only faith-based, for the "Amazing Grace" book series. The target audience is medical professionals of various stripes. Stories may be fifty to 3,000 words and should be inspiring (perhaps funny) and leave the reader with hope and peace. For submission guidelines, contact Howerton at [email protected] or 541/607-8286.

PulseBeats compiled by

Melodee Yohe

consulting editor