Thursday, December 21, 2006

Federation of Medical Women of Canada condemns Libyan Action

Ottawa - December 21, 2006 The Federation of Medical Women of Canada joins other Canadian National Medical Organizations in expressing their outrage against a Libyan court decision to sentence a Palestinian doctor and five Bulgarian nurses to death.

Members of the Federation were distressed to learn that the court did not investigate conditions at the Benghazi hospital where the physician and nurses worked. As well, the scientific evidence that the children had contracted HIV prior to these health professionals working there was disregarded.

“Our members working on behalf of Medical Women’s International Association have traveled to Africa to assist in projects related to HIV. These health care workers are our colleagues and we will not stand for scientific ignorance with respect to HIV-AIDS,” says President, Dr. Gail Beck, “We urge all Canadians, and especially health care professionals to ask Foreign Minister Peter MacKay to vigorously take up this issue with the Libyan Ambassador to Canada.” Mr. MacKay can be reached

For Further Information:
Dr. Gail Beck, President

ext. 6288

Andrée Poirier, Executive Coordinator

From: Federation of Medical Women of Canada
Fédération des femmes médecins du Canada

780 prom Echo drive, Ottawa, Ontario, K1S 5R7
Tel: (613) 569-5881 or/ou 877-771-3777;
Fax/Téléc: (613) 569-4432 or/ou 877-772-5777


Wednesday, December 20, 2006

Interdisciplinarity and leadership. Whewww

What constitutes leadership in research units? Leading a group of researchers is a very different proposition than leading in healthcare organizations, and the product is different. How do research leaders attract researchers to work in their units particularly under circumstances when the unit does not pay the salaries of the unit members? What is the relationship between leader and unit members? How does the agenda for research get developed and what is the role of the leader in setting the agenda? Are there some leadership styles that are more effective in research units than others and how do effective leaders figure this out?

Interdisciplinarity has become the watchword for research funding in Canada; however, it may not be as dominant in other countries. What is the interdisciplinary constitution of research units, how was that reached, and what are the advantages and disadvantages? Is there a difference in attracting nurse researchers and non-nurse researchers to nurse-led research units?

Read the whole article here.

Dorothy Pringle PhD
Editor in Chief
Canadian Journal of Nursing Leadership

House of Healing, House of Disrespect: A Kantian Perspective on Disrespectful Behaviour among Hospital Workers

Respect toward patients is one of the most fundamental and central tenets guiding both modern bioethical practice and the everyday behaviour of all healthcare professionals. However, similar courtesy and respect is often breached in day-to-day interactions between hospital workers. Many examples are relatively minor, while egregious examples such as gender discrimination and physical abuse do occur. The more egregious transgressions may be handled by formal processes, even legal proceedings. However, the innumerable smaller examples of disrespectful behaviour are ubiquitous and insidious in their erosion of a productive collaborative approach to patient care and other aspects of functioning within the institution.

Tuesday, December 19, 2006

Nursing Practice Models: Time for Change

The organization of nursing care in acute care hospitals is increasingly challenging. The traditional models of primary, team and functional nursing, or even total patient care and combinations thereof, are insufficient in today's complex healthcare environments. Patient units in acute care are now characterized by extremely ill patients who require high levels of technical and assessment skills on the part of nurses; significant numbers of novice nurses who do not have these skills but must be integrated into these units; student nurses who require mentoring from experienced nurses; lack of continuity in patient assignments; short lengths of stay on any given unit, hindering nurses' ability to develop relationships and to negotiate patient participation in care decisions; 12-hour shifts that test nurses' energy and enthusiasm; lack of technology to support nurse-to-nurse and interprofessional communication within and across shifts; and increased pressure for evidence-based and outcomes-oriented practice so that individuals and cohorts of patients achieve the highest possible outcomes of care. And these are just a few of the pressures confronting the average unit.

Dorothy Pringle, PhD
Editor-in-Chief, Canadian Journal of Nursing Leadership

[full article is available by clicking on the title above]

Wednesday, December 13, 2006

The sad state of home care nursing

Where are the research reports that involve home care?

Home care is the sector touted, in every report on the future of healthcare in Canada, as fundamental to the future of the system, a sector that must grow in order to manage the increased complexity that the system will generate.

Given the present and envisioned future of home care, the sector should be a beehive of research activity, and we should have a research report or a report of an innovation in virtually every issue of this journal. The development of leaders is critical for this sector to respond to the enormous opportunities and challenges facing it.

Because home care is not covered by the Canada Health Act, different provinces use a variety of funding and delivery models. The Canadian Home Care Human Resources Study (2003) reports that between 8,600 and 9,700 registered nurses (depending on who is counting) are employed in home care; 29% of them work for private, for-profit agencies. Many receive no fringe benefits such as vacation, sick leave or pensions, and their salaries are lower than those of nurses working in other sectors (Canadian Home Care Human Resources Study 2003).

Home care nursing has a long and proud history in Canada. It needs great leadership to stimulate the development of innovations and research to put information into the hands of decision-makers.

Read the complete editorial here:

Dorothy Pringle, PhD
Editor-in-Chief, Canadian Journal of Nursing Leadership

Tips to navigate healthcare

"Tell the doctor why you are taking notes! You will discover that note-taking is a major theme of this book, yet we had never considered the doctor's interpretation of the patient taking notes. Since we have interviewed several physicians, we now know it is good practice to explain to the doctor up front why you are doing this. The doctor may think that you are creating a record in case he or she messes up. Explain clearly that you may need to go somewhere else and it may be helpful to have a record of what this visit yields."

This "tip" comes from "Navigating Canada's Health Care" a new book by Michael Decter and Francesca Grosso. They have including some good tax advice. So read this before you design your tax return.

And why ask the doctor? Take advice from Erma Bombeck: "Seize the moment. Remember all those women on the 'Titanic' who waved off the dessert cart."

Give us some humorous advice. Share the moment

Monday, December 11, 2006

. . . the effect on patients of knowing nurses only by their first names

I have a number of questions about the effect on patients of knowing nurses only by their first names. First, does it matter, and if it does, how is mattering manifest? Are patients as comfortable providing personal details or seeking information from Sue as they are from Sue Smith? Are they more comfortable? Do patients hold different expectations of nurses when they know only their first name, as opposed to knowing their full name? Is it appropriate in some patient care environments but not others? Second, what is behind this trend to using first names only in nursing? Is it a safety issue? Has it anything to do with nurses' status within the healthcare team? Was it planned, or did it just happen? Finally, are we compromising any aspect of our professionalism by using our first names only? Do we know the answers to these questions? Should we?

Dorothy Pringle, PhD and editor in chief of the Canadian Journal of Nursing Leadership.

Canada needs to invest $300 per Canadian for new information technology if we are to reduce ‘wait times’ in our healthcare system

The Commonwealth Fund asked 6,000 primary care doctors in seven industrialized countries about their use of information technologies (IT) to support primary care. Canada did not fare well. In fact, only 23 percent of Canadian doctors said they use electronic medical records (EMRs), compared with overwhelming majorities of doctors in the Netherlands (98%), New Zealand (92%), the U.K. (89%), and Australia (79%).

Right now, few of Canada’s family physicians are able to electronically order tests and prescriptions, access patient test results and hospital records on-line, or share health records electronically with other clinicians outside their practice. Canada has the lowest usage of computerized alerts on dangerous drug interactions and automated reminders for follow-up or preventive care. Other countries moved to address this sooner and we’re clearly lagging behind.

A staggering 68 percent of specialists receive no patient information for referred patients on their first visit. Patients with chronic illness regularly visit emergency rooms in hospitals that have no record of their medications or medical history. In addition, the lack of an integrated electronic health record significantly impedes the capacity of physicians to work in integrated multi-disciplinary teams. Unproductive appointments, repeat tests, unnecessary hospitalizations and uncoordinated care – the cycle of inefficiency ripples through the system, impacting access to services and wait times. Much worse, anywhere between 9,000 and 24,000 Canadians die each year from health system errors, much of it caused by preventable adverse drug events.

We must strengthen our commitment and accelerate the pace of implementation if we are to play catch-up with other countries who commenced their investment some 15 years ago.

This is the clear message from our healthcare community – from the Patient Safety Institute to the Canadian Medical Association to countless clinical bodies and hospital associations – and now reinforced in the Commonwealth Fund study. Echoing this sentiment, the Health Council of Canada recently stated that if we don’t modernize the management of patient information, all other activities for health care renewal will stall. Given that one of our key renewal efforts underway today is to improve wait-times and patient access to timely care, we clearly need to accelerate our efforts to tackle this national priority.

In addition to finishing what Infoway and its partners have started, our renewed commitment must provide a secure, comprehensive electronic health record for every Canadian, introduce electronic records in physician offices and computerized prescribing in hospitals. Our approach must also empower patients (and in particular, chronic-care patients) by giving them the tools to promote self-care and to access wait-times information on-line.

It is estimated that a one-time investment of about $300 per Canadian will be needed to fully implement the necessary systems. This investment will provide estimated savings and benefits to Canada’s health care system of approximately $6 billion each year once fully implemented. However, in terms of the lives that can be saved, the service improvements that will be delivered and patient empowerment, the benefits are priceless.

This material taken from an editorial commentary by:

Brian Postl, MD was Canada’s Federal Advisor on Wait Times and CEO of the Winnipeg Regional Health Authority. He is also a member of the Board of Directors at Canada Health Infoway.

Richard Alvarez is the CEO of Canada Health Infoway, a not-for-profit corporation responsible for accelerating the introduction of electronic health record systems to all Canadians.