AJN, American Journal of Nursing:
As a certified wound, ostomy, and continence nurse and educator, I read this article with perhaps a different eye than other nurses. In the article's sidebar, "The Dilemma of Intervention," author Kayser-Jones writes, "I have discussed the question of intervention with numerous people … [and] have concluded that it is more important for me to be able to continue to collect and report data that could have a wide impact than to try to improve care on a case-by-case basis." She describes ways in which she intervened, yet failed to do the most important thing of all: report this breach of nursing care to the state ombudsman, Medicare, or other regulatory organizations. In all research, the primary rule is beneficence or "do no harm." These authors seem to have considered themselves researchers first and RNs second.
They cite the American Nurses Association's Code of Ethics for Nurses with Interpretive Statements as it relates to the actions of the nurses at this facility, but what about the researchers' duty to protect participants in their study? The article says "Good care is everyone's business." Was it not their business to intervene? The authors of this article failed to protect this patient.
It is one thing to be involved in data collection away from the bedside, when participants are merely numbers on a page. It's quite another to visit the patient 30 times and be aware of multiple problems related to his care and not act.
Tracey J. Siegel, MSN, RN, CWOCN, CNE
Old Bridge, NJ