EVER BEEN NAKED?

by Effah Bin Newd, RN

Of course you have? We all have. But that is not what this post is about. The topic here is EBN. EVIDENCE-BASED NURSING; the sound-byte, catch phrase from our prestigious nursing “Think-Tank” universities. Those are the places where redundant nursing research studies are done that effect the way you practice bedside nursing by academic nurses that haven’t been at the bedside for centuries. Without this research you wouldn’t have a clue how to do your job at the bedside (please acknowledge the sarcasm implied). Don’t even get me started on the paperwork generated … I digress as I side track.

Back to EBN.

Please don’t misunderstand me, I was all for evidence based nursing in the beginning. I mean it too! I like to think my nursing practice was based on sound, tried, and true principles. I had no problem using whatever catch phrase the old girl’s came up with at those institutions of higher learning and thought. “Evidence-Based Nursing” sounds professional, even “educated” like smart people talk. And if I get tired of writing it out I can just use the abbreviation “EBN” and everyone in the “Smart People’s Club” knows what I am talking about (even if I don’t currently pay club dues).

But I did have a problem with all this research stuff. A trust problem. I had been in nursing a long time and experienced a lot. (I know, I know! Nurses are never given credit for their experience. You have to have paperwork proving you paid a ton of money, took a bunch of courses, passed them, and got a diploma to hang on your “Wall of Shame (as we called it in the military)” as proof. “On-the-job experience” and acquired expertise is never considered part of the equation and never certifiable. Whenever you change hospitals you are placed on the bottom of their totem pole and have to prove yourself all over again.)

This was my beef. It started when I read an article about “thalidomide” prescribed to pregnant women in the late 1950s and early 1960s (long before I became a nurse). It was prescribed as an off label use to prevent “morning sickness” which prevented pregnant women from getting rest and sleep because they were puking all night. Thalidomide was branded as an over the counter sleep aid safe even for pregnant women. It turned out not to be so safe causing severe deformities in the developing fetus. It affected over 10,000 newborns between 1956 and 1962. Doctors told their patients it was safe and so did the drug manufacturer. It was a nightmare for mothers and their newborns (but a medical malpractice gold mine for lawyers).

Throughout medical history there are more human guinea pig stories. Recall how they used to bleed patients in the old days. A doctor damn near bled George Washington to death. Nothing personal or political, it was merely the “standard of care” at the time.

Another example are the inhumane experiments the Nazi doctors carried out in the name of medical research and science. (As far as I know none of these Nazi doctors or their research findings are employed by today’s drug companies but the way things are going you wonder!)

Lets look at current medical research. How about that doctor at St. Luc’s Hospital in Montreal Canada back in the early 1990s. Dr. Roger Poisson falsified breast cancer research just so he could get published and also be eligible for more grant/research money. More recently, in Korea, Professor Woo-Suk Hwang, once thought to lead the field in stem cell research, falsified a mountain of his data.

Duke University had to pay a 112 million dollar fine for it’s research “misconduct”.

What about drug companies? The drug Vioxx was made by Merck. They pulled it off the market but not before thousands were affected. Turns out the drug company suppressed information and patients suffered.

In 2007, or there about, the drug Zyprexa was under investigation for illegal practices in marketing after they had 30 billion dollars in sales. They ended up paying 1.2 billion dollars in fines. The drug is still on the market and still being prescribed under a generic form called olanzapine. A major side effect is profound weight gain (up to 30 kg … 66 pounds) and diabetes.

For awhile there was controversy surrounding the heart drug Natrecor and drug eluding stents. The Natrecor issues were “resolved” and the stents are believed to cause a higher incidence of blood clots down the road.

What’s my point? All these examples involved medications and treatments that supposedly underwent mountains of research, studies, passed strict FDA guidelines and who knows what other “safety” standards in place. Your trusted doctor believed the data he/she was told and prescribed to you and what happened???? The medicine is some cases was just as bad or worse than the disease.

No one seems to really know what these drugs do or how they actually work. Is this blind trust? Are consumers nothing more than experimental guinea pigs? When drug companies make 30 billion dollars in sales and are only fined 1.2 million dollars the profits make the fine look like a mild admonishment and no deterrent at all.

This brings me back to Evidence-Based Nursing research. I ask: “Do I know the researcher? Are they honest? Where did they get their funding? Were their results objective or did they take money from a company and get results the company “paid” for? Are they living within their means? Do they have lots of debt? Are they abusing or addicted to drugs, alcohol, or gambling? Do they floss their teeth?“

What I am getting at is that I don’t know these researchers from the man in the moon. In today’s greedy, “alternative truth” world it is INSANE to blindly trust anyone, let alone some unknown researcher trying to make a name for himself. To trust drug companies, when you know their bottom line is profit where monetary fines are easily accommodated and not a deterrent, is equally crazy. You have to trust someone (or else they call you paranoid …. dear God, not that!) so you trust your doctor. But what if he is fooled also (or getting kickbacks …. dear God, not that!)

It is all just downright scary.

When they asked me to base my practice on “Evidence-Based Research” I was weary. The scams in research created a trust issue for me. I had to go with tried and true years of experience and gut intuition. When you hang around nursing long enough you develop that “sixth sense” and you listen to it. I relied on it. I refused to blindly accept research.

The internet is full of examples. Google “falsified medical research” or “healthcare research scams”.

I don’t trust people or companies in healthcare today and I was in health care. We are “snakeoil salesmen” with magic elixirs and promote (false?) hope for profit. It is a business. Medicine doesn’t have a cure for everything but it does have a treatment for everything. It comes with a hefty price tag, can compound your suffering, make you go deep in debt, make you lose everything you earned over a lifetime, and in the end you are still sick. And broke.

That is the naked truth.