Clinical Appraisal

What it takes to be a nurse scientist-in-training and a practicing clinician at the bedside requires a level of emotional maturity I think is likely entirely unique. I have immense respect for your work, and no one should ever make you feel as if you are a lesser researcher or scholar because of your clinical practice. Relationships with patients is why we do what we do.

Dr. Briere's recent publication can be read, here: https://www.mdpi.com/2072-6643/16/3/362

Don't become an evangelist for Capital S- Science. Instead, be open to the idea that you may not know what you think you know based on singular studies that have never been replicated, and may have results which actually fail the false discovery test.

How often should you expect the clinical research in your field to change your practice? If we assume Price's Law holds in health research regarding the validity of non-Null findings, we should expect a small fraction of published research to provide 'true' results. And amongst them, a smaller and smaller number will harbor all the 'large' effects.

Jackie Nikpour joins the podcast to discuss her crucial work in the space of primary healthcare and share her thoughts on what it means for RNs to work at the top of their license in primary healthcare in the U.S.

Dr. Pamela J. Grace joins the podcast for an episode dedicated to a discussion about how nurses can 'do right' by their patients.

Don't devalue new nurses' experiences and assume that, just because you've been in practice a long time it means your practice patterns are based on truisms. The way you've learned to do something and the fact that it's 'worked for you,' doesn't mean it's inherently true. Oftentimes, when studied, we learn what we thought we knew was true... isn't.

The burden of proof to demonstrate efficacy of biomedical tools (namely, drugs or surgery) is on biomedical scientists and physician-investigators. We are too quick, as a society, to assume their science is particularly good, just because it's popular, they're confident in what they do, and what they do appears impressive. Eminence is trumped by evidence every time, and some things that were hitherto dearly held beliefs by medical scientists as true have been crumbling down around them over the last fifteen years. Some biomedical findings are true and stand the test of time. Most don't.

It is easier to differentiate nursing from other health disciplines when you realize that the framework from which you're practicing not only implies unique processes but leads to distinct, if overlapping, outcomes, and that it's not all about tactics and techniques. Techniques and tactics, while similar, are grounded and applied from distinct frameworks of knowing and unique strategies, in service of often different goals.

I've recently made the case that I don't believe the NP is practicing nursing anymore, but that they're now medical providers. This is my attempt to buttress the opposing argument, rather that they are simply extending nursing thinking into a legislatively expansive domain of care provision.

Nursing is unique and we mustn't forget all the ways in which this is true. Medicine is almost always treated as 'the standard' against which other disciplines of healthcare are measured. But why should that be? What right has it earned to maintain that position beyond historical power hierarchies? Certainly contemporary evidence doesn't support that stance. You are an expert nurse. You are not a lower order version of medicine's implementation arm without prescriptive or diagnostic authority. And you're certainly not the punching bag for a medically-centered hospital system. You are an autonomous professional. Embody that and remember who you are and from where you came.

"Don't quantify your qualitative data." Except when you do it without realizing it... Also, sidebar, yay for 100 episodes of the pod.

While qualitative research has challenges, quantitative methodology faces numerous challenges of its own. In the end, what can we really learn about human experience from either form of research? Only that which lies either on the margins, or that which can be captured in an overly simplified model.

In this episode, I speak with a well-respected PICU colleague of mine and bedside nursing expert, Michelle Boivin, BSN, RN, about how she has managed to maintain her bedside practice for over 20 years.

https://about.me/ianlane/ https://youtube.com/@clinicalappraisal

https://about.me/ianlane/ https://youtube.com/@clinicalappraisal

https://about.me/ianlane/ https://youtube.com/@clinicalappraisal

According to the fan-favorite 30-year celebratory piece she wrote in Nursing Science Quarterly in 2017, Dr. Jacqueline Fawcett, Ph.D., RN, FAAN implies that: because the 'medical model' doesn't exist as a conceptual model (from what Dr. Fawcett could find from a brief, non-systematic review), medicine, per se, does not have discipline-specific knowledge and, therefore, isn't a discipline but rather is a 'trade.' Ergo, "medical model" doesn't really exist at all. This is all predicated on faulty reasoning, illogical leaps and poor empirical and philosophical work on the part of Dr. Fawcett. The fact that no one on the Editorial side of this publication didn't reject this just speaks to the fact that because Dr. Fawcett is a 'Living Legend," no one wishes to challenge her. This needed to be challenged, and is one of the sorts of pieces that does more harm to our profession publicly than it helps. This serves merely to alienate us from the rest of contemporary healthcare, at a time when our field continues to dwindle and our resources follow suit. https://youtube.com/@clinicalappraisal https://about.me/ianlane/

An interesting RCT examining nasogastric tube securement devices versus standard taping methods on accidental dislodgment. https://about.me/ianlane/ https://youtube.com/@clinicalappraisal

What else is there to say. https://about.me/ianlane/ https://www.youtube.com/@clinicalappraisal/videos https://www.buymeacoffee.com/ianalaneRN https://www.paypal.com/paypalme/clinicalappraisal