Opinion: If I Were Grading This Paper They Would Get An F

Opinion

As a nurse educator, I read Bloomberg Press’s recent “investigative journalism” with great concern. The reporting paints the profession of Advanced Practice Nursing with a broad brush and implies concerns regarding its safety and efficacy.

Unfortunately, the authors of these stories may need to consider a refresher on objective investigative journalism.

All healthcare providers must critically analyze research to determine what is in the best interest of our patients and our community. They are educated in fundamental research evaluation principles to ensure they can decide what evidence should guide clinical practice. When we look at research, rules are followed to ensure that conclusions drawn from an investigation are accurate, unbiased, and demonstrate the best evidence.

The first rule is that all inquiry must include a broad and comprehensive search for the best evidence. Clinical conclusions should be developed around a large and diverse body of evidence.

The second rule is an understanding that not all evidence is the same. It is essential that evidence that guides practice should be unbiased, follow a proven process that finds truth, and not be designed to reach a pre-determined conclusion. This includes recognizing that opinion or isolated observations may be tainted by individual agendas and should be utilized with extreme caution.

Another important rule is the understanding that extraordinary claims require extraordinary evidence. If an author is to make decisive claims in a paper, they must have more than sufficient evidence to demonstrate the validity of their conclusion.

The foundation of this process is the understanding that inquiry should be objective, comprehensive, and open to contradictory data. The objective of all inquiry is to find truth! Any investigation conducted to prove a point is inherently marketing.

A recent series of articles and blog posts in Bloomberg media claims to investigate advanced practice nurses’ education, preparation, and safety. The reporting makes a series of generalizations that nurse practitioners are not adequately educated and may threaten public safety.

The reporter draws their provocative conclusions from a singular research study. To accentuate their claims, the authors provide details of isolated incidences of unfortunate medical errors involving advanced practice nurses.

The reporters who developed this series of reports violated the rule of inquiry by ignoring over 50 comprehensive research studies demonstrating that Advanced Practice Nurses are safe and effective healthcare providers. The author relies solely on one limited research study that included nurses who practice outside the United States. This isolated study has also drawn concern from researchers because of how the study was conducted.

To manipulate the readers’ sentiments, the author sensationalizes a series of errors associated with advanced practice nurses. The author implies that these incidents are isolated to Advanced Practice Nurses and are representative of the profession. The reporting ignores all extenuating circumstances that might have led to the error and ignores extensive research by the Institute of Medicine (IOM) that concludes that medical errors are primarily associated with problems in the healthcare delivery system, not the individual.

Reading this Bloomberg series, it becomes evident that the authors demonstrate a complete disregard for objectivity and balance. The reporting is intended to be provocative and manipulate the reader without any intention of balance.

What is most concerning for me is the potential of this series to harm patients, particularly the most vulnerable populations. Advanced Practice Nurses are increasingly becoming healthcare providers across the healthcare spectrum. Data has demonstrated that APRNs are often the sole source of healthcare for poor and vulnerable populations. Advanced Practice Nurses have successfully filled a void in healthcare delivery and improved patient healthcare outcomes. Irresponsible reporting that implies Advanced Practice Nurses are unsafe has the potential to harm the relationships these healthcare providers have built with their patients.

Bloomberg and other media outlets should present balanced and objective reporting that accurately discusses the preparation and safety of APRNs. Bloomberg reports that this reporting is the beginning of a series of stories. I hope they learn from their mistakes and present objective and factual reporting in the future.