Interdisciplinary Perspective Needed

The article, “Evaluation and Management of Hereditary Hemophilia in the Emergency Department,” by Nguyen and Takenaka appearing in the September 2009 issue of the Journal of Emergency Nursing did not meet the potential of the subject and the manuscript to add to emergency nursing knowledge.1 While the article succinctly relayed the differential diagnosis and medical care of patients with hemophilia, key nursing decisions and judgments were notably absent from the article. For example, the case presentation overlooked the triage nurse's findings and decisions. Deeper scholarly nursing exploration at the beginning of resuscitation would have been beneficial. The monitoring and trending of assessment by nurses, nursing decisions to interrupt diagnostic testing, provision of family care, and lessons learned from acute changes in a patient's condition or failure to rescue would have been of great assistance to ED nurse knowledge, and yet they are notably ignored by the authors.

The silence and neglect of nursing care, judgment, and decision making is common in reports of collaborative efforts.2 Interdisciplinary team collaboration is the key to reducing medical errors and enhancing patient safety.3, 4 The Institute of Medicine has directed health system leaders and educators to spotlight collaboration and interdisciplinary care.5 If full interdisciplinary collaboration is the focus of safe practice, shouldn't it also be the focus of our published works? While the authors' submission of medical knowledge in a nursing journal should be embraced as a beginning step, I am writing to call for more compelling interdisciplinary efforts that clearly incorporate nursing judgment and care from authors, Journal editors, and reviewers. Viable manuscripts that embrace a cohesive interdisciplinary focus will not only add to our collaborative knowledge but serve as an academic example for use in shared practice and patient safety initiatives.