Complete Issue PDF - University of Alberta Health Sciences Journal

e defined as making judgments about asituation using reflection, and integratinganalysis, evaluation, and inference withknowledge. According to Profetto-McGrath,critical thinking is a necessary componentfor the professional nurse to exerciseevidence-based practice. 1 Due to the threatof zombies and the characters’ isolation inthe mall, it is not possible for Ana to employevidence-based practice by consulting withexperts. Furthermore, there is insufficienttime for properly researched evidence to begenerated and examined. 5 In the literaturereviewing critical thinking skills andevidence based-practice, the professionalnurse would ideally have opportunity toaccess such resources. Nevertheless, in thefilm, Ana uses the best evidence she hasavailable to her in the given situation toguide her practice.In her triage center, Ana finds that one ofher patient’s conditions is deterioratingquickly. She observes and astutelycomments that the patient is cold, and thatshe has never seen such a bad infectionwithout an accompanying fever. Within acouple of minutes, the patient dies. Anaassesses the patient for a pulse, checksthe patient’s breathing, and determinesthat the patient is dead. Ana’s knowledge,assessment skills, and observations in thisscene compare to those of a professionalnurse. A few moments later, the deceasedpatient rises and begins to attack Ana. AfterAna defends herself and kills her formerpatient (now a zombie), Ana evaluates theinformation available, uses inference andprevious knowledge of her interactions withthe zombies, and determines the mechanismof the zombie infection. She determinesthat the zombie infection is spread throughbites. The critical thinking skills employed bythe main character are comparable to thoseexpected of a professional nurse, and areoutlined in peer-reviewed nursing literature.Thus, this film portrays the role of the nursepositively, as comparable to roles outlined inprofessional literature.Professional Nursing Values andEthicsThe film takes place during acommunicable-disease outbreak spreadby zombie bites. The Canadian NursingAssociation (CNA) states that: “During anatural or human-made disaster, includinga communicable disease outbreak,nurses have a duty to provide care usingappropriate safety precautions.” 4 Throughoutthe film, Ana abides by these regulations,using the resources she has available to her.Her actions in this respect are comparableto those expected of a professional nurseaccording to the CNA. 4After discovering the mechanism oftransmission of the zombie infection in hertriage center, Ana tells the group that Frank,one of her fellow survivors, has been bittenand should be quarantined immediately.Another character tells the group he thinksit is too dangerous to keep Frank alive.Our heroine immediately identifies andchallenges the ethics of this situation: “Whatare we talking about here? Are we talkingabout killing him?” 1 Though this situationis not taking place within a formal nursingenvironment or practice, it addresses anumber of nursing values and ethicalresponsibilities.Upon review of the Code of Ethics forRegistered Nurses, I believe that Anais encountering an ethical dilemma.Throughout the career of a professionalnurse, ethical dilemmas and questionsare encountered where the nurse has adifficult choice to make between two equallycompelling courses of action. Ana is facedwith this situation in the film. If Frank iskilled, it will be demoralizing and traumatic,especially for his daughter, who is withhim. However, if Frank is not killed, he willmost likely become a zombie and attack theremaining survivors.Ana’s character is humanizing for theaudience because she reminds us of thisethical dilemma. A professional nursehas specific nursing values and ethicalresponsibilities to uphold. Of the eightvalues outlined in the Code of Ethicsfor Registered Nurses, Ana maintainsfour values that pertain specifically tothis situation: 1) Safe, Compassionate,Competent Ethical Care, 2) InformedDecision Making, 3) Preserving Dignity and4) Promoting Justice. 4 She provides safe,compassionate, competent and ethical carefor all of the survivors—to the best of herability—within her limited environment.She discusses the ethical dilemma regardingFrank’s zombie bite with Frank and thegroup, thereby recognizing, respecting andpromoting Frank’s right to be informedand to make a decision. She recognizesand respects Frank’s intrinsic worth byreminding the group that he has a daughterwho cares for him. And lastly, Ana upholdsprinciples of justice by safeguarding humanrights as much as possible within the givensituation, and promotes the public good forthe group of survivors.Autonomous Role of the NurseAt the very beginning of the film, theaudience is able to see what life is like forAna before the chaotic zombie infectionspreads. Ana interacts with a physician,another health care professional, in theemergency department. The physiciandismisses Ana’s statement that it is the endof her shift and asks her to find a patientwho has been admitted to the hospital.Here, the audience briefly witnesses theheroine in a subservient role in relation tothe physician.This situation relates to the autonomy of thenursing profession. In this particular scenein the film, Ana does not embody the roleof an autonomous professional. However,in clinical settings, nurses do not report tophysicians, as the film portrays. 1 Nursesreport to their supervisor who is usually anurse, not a doctor. This misperception isan ongoing challenge within popular mediasources. As previously discussed, nurseshave their own code of ethics as outlined bythe CNA. 4 Nursing is a distinct autonomousprofession that is regulated and governedby experienced nurses, many of whom holdgraduate level degrees. 6In order to address the discrepancy betweenthe media perception of the autonomy ofnursing and the truly autonomous natureof the profession, nurses must advocate fortheir profession and effectively communicatewith members of the media to demonstrateaccurate representations, and for pride inthe profession of nursing. 2 The image androle of the nurse will continue to evolvein a positive direction when practicingprofessional nurses are actively involvedin a relationship with the media. McNallysuggests that these efforts should begin atan undergraduate level. 6As the film progresses, the audience beginsto see that Ana is capable of practicingautonomously, and that she is most certainlynot subservient to other characters. Rather,Ana carries a leadership role in manyinstances throughout the film, such asindependently setting up a triage centerfor those who are injured and encouraginggroup cohesion to battle attacking zombies.Ana’s autonomous role begins in the filmonce the zombie catastrophe begins.Context of the FilmOverall, the film Dawn of the Dead presentsa positive image of the nurse. I do, however,question the context in which this positiveimage is portrayed. This popular mediaportrayal of the nurse differs from what isfound in the professional nursing literature,as the nurse in this film is acting withina fictional world overrun by zombies. Isthe opportunity for the public to viewMUSAUniversity of Alberta Health Sciences Journal • April 2012 • Volume 7 • Issue 1 29