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JOURNAL OF NEAR-DEATH STUDIES
Joesten initially installed the holders without the cards for a trial
run, to identify any unanticipated problems. Shortly thereafter, the
research associate found that all the holders from CCU had been
removed and were piled up at the nurses' station, as one of the nurses,
not knowing the purpose of the holders, had taken it upon herself to
remove them all. Up to that point, we had purposely avoided discuss-
ing any details of the study with the nursing staff, thinking that the
less said, the better, regarding protection of the double-blind criteria.
We had expected that questions might be directed to the head nurse or
the research associate, who had been coached to explain that the
holders involved an ongoing study but to plead ignorance regarding
any specifics. But we had not counted on the authoritative initiative of
this nurse, and the need for an inservice meeting became apparent.
Consequently, Joesten attended the next CCU nurses' staff meeting,
and asked that the holders be left undisturbed. There he learned from
the nurses that patients almost invariably asked about the holders.
Joesten suggested that the nurses explain to inquisitive patients as
briefly as possible that the holders involved ongoing research, that the
nurses did not know any details about the study, and that the patients
could assume that the holders did not concern them unless they were
otherwise notified.
Having dealt with the unanticipated "nurse factor," we were foiled
again by the laws of physics. The tabs intended to adhere the metal
brackets to the walls would not stick for long to the semigloss painted
walls. All holders had to be reinstalled using screws, a method we'd
hoped to avoid because of the more costly repair once the study was
ended and the holders removed.
Holders were then secured and cards were installed. We had antici-
pated keeping the cards out of visual range, but had not anticipated
the reach of inquisitive visitors. The holder material, flimsy poster
board, allowed holders to be bent down and read, thus, cards viewed.
Whenever it appeared that someone had tampered with a card, it was
changed to one from a different box. This presented a continuing threat
to the double-blind criteria and, thus, to the validity of the study. It
also complicated the research procedures by requiring the ongoing
vigilance of the research associate, a nuisance we had not anticipated.
Results
Contrary to the CCU director's estimate, the first three months
passed without a single cardiac resuscitation. In the fourth month, a
male patient was resuscitated. His physician approved the interview
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