The Conversation Project

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At the Business Meeting at INANE 2015, Kathleen Ahern Gould, Editor of Dimensions of Critical Care Nursing, presented information on The Conversation Project. She suggested that perhaps INANE Editors could use the power of their journals and editorial pages to spread the word about this important project. There was agreement from the audience that this is an important project. Kathleen has taken the lead to get this INANE Initiative off the ground.

The first step is a page here at the INANE website, which has been created. The page has, at the moment, two resources:

  • An Editorial written by Kathleen that was published in the December issue of her journal
  • A white paper from the Institute on Healthcare Improvement about the overall project and its conceptual framework

The next step is to collect editorials or articles as they are published in our respective journals. We will add links and citations to published pieces as they are received. You may send information via the Contact Form at this website, or you can write to Kathleen directly.

Thanks in advance for your support of this important project!

Things Publishers Do

In our discussions – both online and at our conferences, INANE participants have nurtured a strong position regarding best editorial and publishing practices (see in particular our project launched at the 2014 conference in Maine, focusing on “Open Access, Editorial Standards and Predatory Publishing”  One of the resources that has influenced our work on this issue is the Scholarly Kitchen series of “Things Publishers Do.”  Today the chefs have provided the 2016 update of this list, which is now a list of 96 items!  It well worth reading, and noticing the enhancements as well as the additions to the list!

Kent Anderson UPDATED — 96 Things Publishers Do (2016 Edition)

Cuba Information Meetings Underway!

Yesterday Leslie and I launched our series of information meetings to share a report of our recent trip to Cuba!  We shared some slides summarizing our trip, and had a great discussion focusing on what can happen on a January 2017 INANE delegation to Cuba. We have three more of these video meetings planned – if you are interested in learning more, please sign up for one of the meetings to learn more! Let us know if you are interested but cannot join in one of these meetings, and we will make sure you are in the loop about the potential for this trip. If you missed Leslie’s post just after we returned, check it out to catch up on for early summary report.

If we find that there is sufficient interest to proceed with planning, we will let the staff at MEDICC know that we want to move forward with planning.  We will then send out lots of information to everyone and will do all we can to make this a meaningful INANE event to strengthen our editorial connections with nursing and healthcare in Cuba!

Use this form to let us know which meeting you would like to attend:

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INANE in Cuba? It Could Happen!

Cuba Day 2 004Brainstorming the INANE/Cuba Collaborative Educational Exchange

Last year, shortly after President Obama announced an easing of the decades-long embargo with Cuba, I had the crazy idea that perhaps INANE could have an upcoming conference in this country. I contacted Peggy Chinn and Joyce Fitzpatrick and the three of us had several meetings during winter/spring 2015 to discuss this possibility, but didn’t make much headway in terms of concrete information or actual planning.

We had a lucky break when I learned of MEDICC, a non-profit organization that sponsors health/medical educational exchanges to Cuba and has done so for close to 20 years. We got even luckier when we found out that the MEDICC offices are just a few blocks from Peggy’s home and she connected with their educational staff member, Elizabeth Sayre. Our third break came when we learned there was a trip to Cuba planned for December 6-12, 2015 and space was available. Peggy and I applied to join the group and were accepted to go.

Our specific objective for the trip was to determine if it was feasible for INANE to travel to Cuba for a conference. To facilitate this, we asked the MEDICC staff to include conversations with nurses and editors as part of the agenda for the exchange, and they did. This was very helpful for us to learn more and also make contact with particular people, complete with names and email addresses. We have already been in touch with them since we have returned home.

IMG_1495Peggy and I thoroughly enjoyed the format of our trip, with activities planned for each morning and afternoon, based on the interests and requests of all the travelers. Activities included visits to various sites and meetings with selected staff to learn more, usually in the format of a brief presentation (usually in Spanish, with an excellent English interpreter) followed by time for questions, answers, and discussion (“the exchange”). Our visits included a consultorio (family doctor/nurse office), a polyclinic (a regional clinic offering many outpatient services), a diabetes center, the Pedro Kouri Institute for Tropical Medicine, the Institute for International Collaboration, an organic farm, and the Latin American Medical School (ELAM). We also had specific exchanges with editors, publishers, nurses, and researchers.

Throughout all of this, INANE was on our minds. We came to understand that Cuba is a unique and complex country and this complexity would make planning and hosting our “traditional” August conference in Cuba a daunting task. For example, the language (Spanish) limits independent exploration and requires an interpreter for anyone who does not speak the language, as the majority of Cubans we met do not speak English.  The very limited resources and logistical challenges affect the visitor experience almost every moment. Added to this is the fact that it would probably be uncomfortably hot in August. And—creature comforts such as shopping, restaurants, and hygienic facilities—are not at a standard that some INANE members would expect. That said, people in Cuba are eager to reach out and the nurses and editors we met would be very interested in meeting and collaborating with INANE members, so we did not want to abandon the idea of a conference completely.

As we pondered this, we had a lightbulb moment when the idea for an alternative educational event hit us—having an exchange for 20 people, not 100, that would follow the format of a MEDICC exchange. We also realized that such a format might achieve the INANE goal of having an international reach far more effectively than what we have done to date and perhaps could become a model for future events in countries that might be inaccessible for our large conference.

With that in mind, we came up with the INANE/Cuba Collaborative Educational Exchange. To make this happen, we could partner with MEDICC to plan the trip. This would help with the logistics of arranging visas, charter flights, hotel reservations and so on—something that we think would be very difficult for our usual all-volunteer planning committee to do on its own. MEDICC also makes all arrangements for transportation to and from the sites, lunches for the group, and the translator, tour guide, driver, and a MEDICC representative to facilitate the experience. For our recent trip, all of these things were provided; we were on our own for dinner 5 of 7 nights, and had Saturday afternoon free.

MEDICC would work with us to customize the agenda for the various meetings and exchanges to meet the needs of our group and make arrangements for all the presenters. We also envision educational programming created by INANE participants, to share among ourselves and select Cuban guests (ie, editors and nursing faculty). Having experienced a MEDICC trip, Peggy and I were both very satisfied with the planning and implementation, and we would be comfortable partnering with them for INANE.

Having an INANE event in this format, with a smaller group, would also address some of the problems we realized: cooler weather in winter, and with a small group, better availability for hotel and restaurant reservations. As for shopping—well, let’s just say that if shopping is your priority, Cuba is probably not the ideal country for you to visit!  The emphasis in visiting Cuba is really educational, which is one of the categories for visitors from the US entering Cuba to receive a travel visa.

IMG_1505Peggy has already met with Elizabeth at MEDICC and they have availability for an exchange on January 15-22, 2017—so maybe this crazy idea really isn’t that farfetched!  MEDICC has already requested hotel accommodations for a block of 20 rooms (not yet confirmed), and the date has not yet been claimed by any other group.

Thus we are proposing to start the process of exploring this opportunity!  Our next steps are to determine interest in this idea among our INANE members and see if we could muster a group of 18-20 to participate in this exchange. To do this, we will have several video Zoom meetings (zoom.us)—interested people would only need to attend one meeting but we have scheduled four (see below) to try to maximize attendance knowing people’s busy schedules. The meeting will start with a Powerpoint with pictures and an overview of our recent trip, followed by questions and a discussion to brainstorm ideas of what we’d like to do for an INANE/Cuba Collaborative Educational Exchange. When the meetings are finished, we’ll move forward with planning next steps, if the consensus from the group is that this exchange is a realistic idea.

That’s the plan for the moment. I am working on the Powerpoint. The meetings are scheduled for:

  • Wednesday January 6, 8 am EST
  • Saturday January 16, 10 am EST
  • Monday January 18, 2 pm EST
  • Monday January 18, 5 pm EST

We can add additional meetings as needed. Please note that we are casting a wide net—all INANE members (editors, publishers, others) are invited to join the meetings and consider being part of this exchange.

Peggy and I look forward to meeting with INANE colleagues and discussing this possibility. If you have questions before the meeting, please feel free to leave a comment below, or send a message to us using the contact form.

Use this form to let us know which meeting you would like to attend:

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COPE “Best Practices” Principles Updated

Earlier this week, COPE (the Committee on Publication Ethics) announced an update of the Principles of Transparency and Best Practice in Scholarly Publishing.  These principles are central to the INANE initiative to promote best editorial standards in nursing journals and inform readers of nursing journals about the emergence of predatory publishers.  The principles also inform the vetting process that we use when we receive a request for inclusion in the Nursing Journals Directory.

The Principles were first posted on the COPE website in January, 2014, and this second version was just posted on June 22, 2015.  These principles are intended to guide and strengthen the practices of all scholarly publishing.  Consistent with the spirit and the process used by COPE and other organizations, for our Journals Directory we use our vetting criteria to first work with editors and publishers to address any concerns that have been raised.

Thank you to all the Editors who have published editorial addressing these issues!  You can see the growing list of these editorials here.

Principles_of_Transparency_and_Best_Practice_in_Scholarly_Publishing___Committee_on_Publication_Ethics__COPE

The Eighth International Congress on Peer Review and Biomedical Publication

The Eighth International Congress on Peer Review and Biomedical Publication will be held in Chicago, IL on September 10-12, 2017. This advance notice gives interested researchers plenty of time to develop and implement studies related to peer review and publication for possible presentation at the conference. This article in JAMA has suggestions for possible research topics that would be of interest to the audience.

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Shawn’s Poster

I attended the Seventh Congress in 2013. Other INANE members who were there included Suzie Kardong-Edgren, Shawn Kennedy, Francie Likis, Sarah Martin, and Charon Pierson. It was an interesting conference although a little doctor-centric. It would be nice to have a few INANE editors up at the podium! Kudos to Shawn (along with Jane Barnsteiner and John Daly) who did present a poster.

Here a chance to get something organized for the conference. If anyone is interested and has an idea and needs a research partner, I’d love to chat!

Leslie

Reminder! Your Journal(s) and INANE

For everyone who is a nursing journal editor or publisher, remember that INANE offers two important features that help give your journal visibility!search

One important feature is our initiative on Editorial Standards and Predatory Practices in journal publishing. The project involves the publication of editorials addressing these issues in as many nursing journals as possible!  We launched this project at our 2014 annual conference in Portland, Maine, and our list of editorials is growing almost daily!  We believe that we are the first group of journal editors to formally address this issue publicly, so it is a very important project that reaches beyond the limits of nursing alone!  Visit the list frequently to be inspired about the work that we are doing, and use our online form to send us the details about your journal’s editorials as soon as this becomes available!

The other important feature that helps provide visibility for your journal is our Nursing Journals Directory, co-sponsored with Nurse Author & Editor. The Directory is managed by Leslie Nicoll (co-manager of the INANE web site), Charon Pierson (COPE Council Member and in charge of our vetting process), and Peggy Chinn (co-manager of the INANE web site).

If your journal is already listed, take a moment to check the information we have posted to make sure it is up-to-date.  Let us know of any changes that are needed — keeping this Directory current is a high priority, so we make changes of any type that happen to come to our attention.  But we need everyone’s help to make sure that changes do come our way!  So let us know any time anything changes with the journals you work with!

If your journal is not already listed, get the process started!  Information about the vetting process is on our main Directory Page, and you can use the handy online form to send in your request for a listing!

Announcing the Nursing Editors History Project

Peggy Chinn and I are very excited to announce a new initiative that we have developed and will be leading: the Nursing Editors History Project. We have created a website which is here: NEHP. That site has all the details but in a nutshell–Peggy and I realized that there is no central repository or database of nursing editors. As everyone on this list knows, editors play a crucial role in the creation and dissemination of nursing knowledge. Our leadership is so significant that we created an award to recognize this! But, while archives exist that electronically store the articles that have been published in journals, but many of these archives do not include information on editors, publishers, and other key people. As time moves on, much of this information, which right now only exists only in the form of memories, is being lost. Thus we had the brainstorm of the NEHP.

As with everything that is INANE-related, this is a grassroots project. We have created the website and a form for collecting data about journals. The form has been gently pilot-tested but will likely need revision–we welcome your feedback! As we receive information, we will update the site, revise our processes, and keep everyone involved. We need your input to be successful. 

The website is our initial vision. It includes a database of journals and a listing of editors, past and present. We have links to the information that is submitted and will be linking back to the Directory of Nursing Journals at the INANE site. Our goal is to have a comprehensive resource that documents our editorial history, which can serve as a resource to inform the future. 

We invite all INANE members to join us in this initiative. Please share your journal information and history through our submission form. If you have information on other journals, particularly those that are no longer published, we are interested in that, too. There is a contact form at the website that makes it easy to get in touch with us. We welcome ideas and suggestions on the project in general–this is what will inspire us to make this project grow! Last, we have a page for donations. If you truly believe in what we have envisioned, financial support, even modest donations, will go a long way to supporting the sustainability of this project. 

Thank you for taking the time to read this message and visit the NEHP website. We look forward to hearing from you and receiving your journal information for our database.

INANE initiative on predatory publishers is well underway!

Our initiative “Open Access, Editorial Standards and Predatory Publishing,” launched predatory-word-cloud2during the 2014 conference in Portland, Maine is now becoming a significant and visible “presence” in our nursing literature.  The project began with an article created by a collaborative of nursing journal editors who were present for Jeffrey Beall’s presentation on this topic, and published in the September 2014 issue of Nurse Author & Editor. The Nurse Author & Editor article provided a foundation for all nursing journal editors to use in preparing their own editorials to inform and educate their readers about editorial standards, the hazards that have emerged in the publishing industry to erode confidence in scholarly publishing, and what to watch for in order to protect the integrity of nursing literature.

Now, editorials are appearing in nursing journals that contribute to this initiative!  We are tracking these as they appear and posting them on our “Editorials Published” page. We are including original editorials, reprints of the September 2014 Nurse Author & Editor article, journal blogs, and editorials that we find in journals of other health professions. If your eidtorial is not yet listed, please send us the information so that we can include it!  Go to our handy electronic form (scroll down on the page to see the form), and send in your information as soon as it is available!

Truth in Reporting: Straight Talk for The Good Nurse

NB: The following resources grew out of the INANE presentation by Charles Graeber and Diana Mason at INANE 2014 in Portland, ME. Faculty, editors, and other interested colleagues are free to use these resources, with proper credit to Charles Graeber, author of The Good Nurse, Diana J. Mason, PhD, RN, FAAN Co-Director, Center for Health, Media & Policy, Rudin Professor of Nursing, and INANE 2014.
~~
PART I: Editorial Notes Outline:

Takeaways:

  • In the book “The Good Nurse,” eight years of investigative journalism uncovers the shocking story of a serial killer nurse, and the hospital administrators who passed him on, hospital to hospital, for 16 years. It also highlights the attempts of several brave whistleblower “good nurses” to stop Cullen along the way.
  • Serial Killer Charles Cullen is in prison for what he did. Many of the administrators who passed him on got promoted.
  • New Health care employee reporting laws, designed to stop another serial killer like Charles Cullen, in fact treat truly “good nurses” like criminals.
  • Meanwhile it’s still business as usual for the health care executives.
  • We should know the truth and demand common sense laws that respect nurses, protect patients, and don’t force executives to choose between protecting their institution from lawsuits, and protecting patients from harm.

PART 2:

TALKING POINTS RE: LESSONS FROM THE GOOD NURSE

  • The book details how nurse Charles Cullen was able to selectively or randomly kill an admitted 40 patients, though expert estimates of the real number of Cullen’s victims to be closer to 400, making him the most prolific serial killer in United States history.
  • But as lurid as these details are, more troubling are the descriptions of how Cullen was able to go from hospital to hospital in Pennsylvania and New Jersey–often facilities with stellar reputations, including Magnet designation—without being reported to the police, the state boards of nursing, and state departments of health (until a coworker reported her suspicions to police, against the expressed wishes of her hospital’s administration and lawyers).
  • The book describes situations in which top executives and administrators stymied detectives’ investigations into the suspicious deaths, including misleading them about the medication system and record-keeping.
  • When Cullen’s actions (serious repeated nurse practice issues, delivery of non-proscribed meds, bizarre behavior, patient complaints) were uncovered by hospital authorities, he was either removed from the schedule, fired or allowed to resign. But never was he stopped.
  • Example: At one hospital, Cullen was the only suspect in a rash of insulin overdoses. He was removed from the schedule, and so applied for a job at another hospital, where he commenced overdosing patients. At another hospital, Cullen was caught red-handed by his fellow nurses, stashing empty vials of deadly paralytic drugs which he had used for murder during his shift. Outside council was brought in, and Cullen was allowed to resign, rather than be fired, so that he could receive a neutral recommendation.Cullen quickly found a new job, and began killing again.
  • Instead of opening themselves to outside scrutiny- at the risk of reputation, donor money and massive lawsuits- the hospitals, intentionally or otherwise, operated in a manner which protected the institution, but put their patients at risk.
  • When Cullen’s suspicious behavior was brought to the attention of the authorities by a whistle-blowing nurse, the hospital drove the nurse whistle-blower out of the state, and later, counter-sued families of patients who were suspected dying at Cullen’s hand, and have tried to intimidate the book’s author.
  • None of the hospital executives and administrators were held accountable for their actions or their failure to report Cullen in a timely fashion, if at all; several, including a risk management administrator who obstructed a police investigation, were promoted.
  • There has never been a criminal investigation into the actions of these administrators, but it’s not too late; nurse leaders and patient advocates can still demand the truth. (Somerset County NJ Police detectives also called for a Grand Jury).
  • New Jersey and Pennsylvania quickly passed broad laws (see below) in the wake of Cullen’s prosecution and life jail sentence, but there appears to be little enforcement of these laws requiring hospitals to report a dismissed employee.While ineffective at inspiring change at a corporate level, they appear to be overloading the nursing board review process, and can brand the career of an inexperienced nurse who makes a simple mistake.
  • Questions that this book raises include:
  1. How do we prevent another Cullen from going undiscovered in our midst?
  2. What policies and procedures are needed to ensure that health care organizations take the proper and ethical actions that are needed to prevent employees from continuing to do harm to patients?
  3. How do we tell nurses to blow the whistle on unsafe practices when their employers skirt doing so, even when required by law to report these?
  4. What are the local and national conversations that need to happen around institutional priorities (patient welfare versus financial health of the institution) accountability for patient safety in health care?
  5. What are the ethical dilemmas that nurse administrators face when becoming aware of potential criminal activity with their facilities, but are told by executive leadership that they must not investigate further, nor report it? How does this nurse weigh the legal requirement for reporting unsafe practitioners versus the institution’s interest in maintaining its fiscal health by preventing the information from becoming public?
  6. Exercise> CASE STUDIES: Students form groups to report and present case studies related to the practice and ethical issues raised.

PART 3:

A Closer Look: Systemic Issues Uncovered in The Good Nurse: The Enabling Patterns of Dysfunction

The investigation revealed several factors which contributed to perpetuating Cullen’s nursing/murder career for 16 years and 9 different health care facilities.

  • Hospitals were slow to react, understandably fearful of lawsuits, and repeatedly chose laborious and ineffective internal investigations, rather than outside attention from regulatory agencies and detectives. During these investigations, Cullen continued working, and killing patients.
  • Cullen exploited the space between the business of health care and the care itself.  In moving Cullen out of their employ and back into the job pool, many of the hospital administrators who dealt with the “Cullen problem” did their job as business people, but not their duty as patient advocates.
  • The trend toward outsourcing and use of staffing agencies increasingly allowed hospitals to treat nurses as disposable employees, and discouraged recognition or ownership of the Cullen problem.
  • Nurses who voiced concerns with Cullen’s behavior were marginalized, ignored or dismissed. Those who spoke up said they did so at the risk of their jobs. The whistle blowers identified in the book not only left the hospitals at which they had worked, and also the state.
  • Information flow was guarded, making problem solving slow, if impossible.
  • Outside investigators, who usually lacked familiarity with the healthcare setting and terms of art, were not given full information and didn’t even know what to ask for.
  • Family members of Cullen’s victims were sometimes not told of overdose levels of drugs found in their loved one’s bodies, and thus did not request autopsy.
  • Outside agencies, in the rare instances they were contacted regarding Cullen-related incidents, did not communicate with each other, or across state lines.
  • Penalties for non-reportage of sentinel events were rare and minimal, especially compared to  the perception that potential lawsuits would result from admitting to the problem.

The Good Nurse” is available in hardbook, paperback, and e-book versions, anywhere that fine books are sold.