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Journal of Nursing



  • Do nurses really understand Advanced Health Care Directives?
    Maureen Kroning RN MSN EdD
    As a Nursing Supervisor, I have witnessed many problems associated with patients Advanced Health Care Directives (AHCD). On many occasions, patients are asked about AHCD when their medical condition worsens, leaving education of AHCD lacking and often put to the family to make end-of-life decisions. Both nurses and patients have verbalized not understanding AHCD. At the local hospital not only have many nurses acknowledged not understanding their role and responsibility about AHCD, but they also do not really have a good understanding themselves of what AHCD are; therefore, they do not feel comfortable educating patients and families about this vital healthcare issue. Research shows that providing AHCD education is effective in changing not only the treatment preferences of patients, but their attitudes toward end-of-life health care (AHRQ, 2003). There was an eminent need to look into this problem at the local community hospital.
    Tags: health, nurse
  • Funding Health Care as a Basic Human Right
    Jennifer Bergen, Jay Fultz, Sally Kessie, and Angela Osburn
    The United States of America is a nation known and heralded worldwide for its democracy, freedom, and wealth. Through our commerce, we have become a prosperous nation. Through our commonalities we stand united. Through our shared citizenship, we establish our community. Through our voices, we are heard. So why is it, our nation has been divided against the idea of health care being funded as a basic human right? U.S. Senator, Ted Kennedy, once said,
  • Literature Review: Safe Nurse Staffing
    Shana Camphor
    The purpose of this literature review is to exam nurse staffing and staffing related issue and its impact on the healthcare world. Safe nurse staffing poses substantial issues at the clinical level including its tremendous impact on patient mortality, patient satisfaction, increased incidence of medical errors, and nurse dissatisfaction and burnout.
    Tags: health, nurse
  • Doing More with Less: Are We Compromising Patient Care?
    Anita Schilling
    I came bustling into the Medical-Surgical unit at the hospital where I work as scheduled. It was the third 12-hour shift I was working, so I was really looking forward to getting the shift over with and enjoying the upcoming four days off. I was expecting to come onto the floor to find the usual nurses on the unit.
  • Moral Distress in Nursing and Available Support Systems
    Brynne Underhill and Jennifer Finkle
    Moral distress is a key issue facing nursing today; it affects the way nurses care for their patients and the number of nurses who stay in the profession (Gutierrez, 2005; Hamric & Blackhall, 2007).
  • Multidisciplinary Rounds In Various Hospital Settings
    Venice Ababat, Jeremias Asis, Michelle Bonus, Chloe DePonte, David Pham
    This paper focuses on the use of multidisciplinary rounds in various hospital settings with an emphasis on intensive care units. A comprehensive literature review on the studies that focused on the use of multidisciplinary rounds will be incorporated and referenced. Topics to be discussed in regard to application of multidisciplinary rounds are benefits, barriers, gaps in current literature, and recommendations for baccalaureate level nursing.
  • “What is it with you?”
    Kathleen Beyerman
    “I’ve got a fainter here!” I call over my sister’s head to the flight attendant. My sister is sitting in the aisle seat, I am in the middle, and my new patient is sitting by the window. He has just announced to me that he doesn’t feel well and thinks he may faint
    Tags: health, nurse
  • Nurse/Patient Communication Twenty Suggestions for Improvement
    John R. Thurston, Ph.D.
    From time to time, physicians are taken to task by fellow physicians and many others for a variety of shortcomings in the practice of their profession. Common among the listed faults is a lack of effective communication with their patients.
  • Basics on Inpatient Blood Sugar Control
    Lenore Hernandez RN, MSN, CDE, APRN-BCADM, CNS
    Controlling inpatient blood sugars is challenging and complex. Inpatient blood sugars can be affected by a multitude a variables. Some of the variables are nutritional intake, inflammation, stress and steroids. Research indicates more than 50% of Americans could have diabetes or pre-diabetes by the year 2020. Healthcare costs for this population both inpatient and outpatient is enormous and growing. Many of these patients will require hospitalization. Inpatient diabetes treatment can be complex but the outcome enhancement is great. Improving inpatient blood sugar control decreases both complications and mortality. Controlling the blood sugars of this growing patient population is well worth the investment of time and resources.
  • Health Promotion and Disease Prevention
    Renee Van Sickle
    The United States falls behind in healthy outcomes when compared to other countries.
  • Implication of Foreign-Educated Nurses on United States Nursing Collegiality
    Dr. Judy Williams, Ph.D., RNC
    The United States (U.S.) has repeatedly experienced a shortage of qualified registered nurses, a situation, which is capable of deteriorating further in view of the U.S. aging population (Clark, Stewart, & Clark, 2006).
  • Electronic Medical Record: How its Use Facilitated an Increase in the Number of Patients with Diabetes to Achieve the Target Measurement of Having at Least 2 HbA1c Tests Performed in a 12 Month Period.
    Tracy Colburn, RN, Author
    We are in the midst of an unprecedented era, the convergence of technology and medicine. Even stories of failures are not true failures because of all we stand to learn from the experience of others. Technology has enabled those in the field of medicine to move forward with their own improvement projects
  • College of DuPage Opens Hospital Simulation Lab for Nursing Program
    Brian Kleemann
    College of DuPage Nursing students are now learning how to respond to a wide variety of patient care experiences in the new Hospital Simulation Lab.
  • Stem Cell Research is Our Future of Cures
    Lisa Smith RN, BSN
    People have the power to change the world. The donation embryos are a step in the right direction for resources to continue research to help society in the future. It is not the intent to clone but to cure. Life is a gift that we should keep giving with this great opportunity.
  • The Reality of Diabetes in Rural Mexico: A Nursing Student Perspective
    Hillary E. Handler Suzanne M. Le Markita A. Balfour Maria de la Luz Bonilla Sebastiana del Rosario Gargantua Aguila Karen A. Monsen
    Students from six universities in Canada, Mexico, and the USA participated in a service learning exchange. In order to understand the needs of diabetes patients in rural Mexico three students from Canada and the USA trudged in the heat through the rough terrain to their homes. We used Omaha System signs/symptoms to collect interview data. The standardized language of the questionnaire allowed us to be aware of the interaction between traditional medical beliefs and the western medical model. Some of these challenges include maintaining the traditional family roles, controlling blood glucose levels without the appropriate medical equipment, and economic barriers. One patient was responsible for both caring for her eight young children and working in the fields to put food on the table. Additionally, she was in a constant hypoglycemic state causing her to faint in the fields. We also visited a visually impaired man that was distraught because he needed to rely on others for help in a machismo society. He said “While living in New York City, I was a victim of a robbery. I was so afraid because I thought I was going to die and as a result I got diabetes.” Though some may find this comment strange, it is a common theory among the rural population in Mexico. We will always remember the many Mexican speculate that eating bread absorbs the scare and thus prevents diabetes. This experience gave us a glimpse of the harsh reality that these people face everyday coping with diabetes.
  • Closing the Donut Hole: Who Will Pay?
    Kathy Hepner, RN, BSN
    The dark black hole in the Medicare Part-D prescription plan called the donut hole is finding the light, or is it? Health care reform has promised to close the donut hole for Medicare recipients completely by the year 2020 (Gionfriddo, 2010). The Consumer Report on Health (2012) confirms medication costs continue to rise with no end in sight. Who will pay the gap between what is currently covered and the predicted added coverage with Health Care Reform? According to the Center for Medicare and Medicaid Services (CMS, 2011) the Medicare trust fund is currently running in a deficit. Reducing the burden of our Medicare population, with associated out-of-pocket expenses for prescription drugs, cannot be achieved by a system already running in a deficit. As we start to unravel the mystery behind closing the donut hole, can we identify who will pay?
  • Withdrawal in the Pediatric Cardiac Population
    Joyce D. Vamja
    Oftentimes patients admitted to the Pediatric Cardiac Intensive Care Unit are placed on narcotic and/or benzodiazepine intravenous infusions after surgery, especially if prolonged intubation is expected. It is generally assumed that after a period of 5 days on continuous infusions or administration of around the clock opioid/benzodiazepine administration, the patient should be monitored for signs of withdrawal.
  • Promoting the Sexual Health of Older People
    Patricia MacGabbann
    This paper examines the issue of sexual health and older people. It identifies sexual health in this population group as a component of health that is often overlooked. As a practitioner of Gerontological Nursing, the author seeks to determine why this is and what can be done about promoting sexual health for this population group. Initially health promotion and sexuality are defined before outlining the rationale for the choice of this topic. Incorporated into the discussion is the acknowledgement that this is an area requiring significant development for all older people, regardless of sexual orientation, that in fact the need for health promotion for older gay and lesbian people may be a more pressing issue overall. Having outlined the need for health promotion, a number of strategies are introduced. Relatively little research into this specific issue has been conducted thus health promotion strategies in more broad terms are discussed.
  • Sally’s Eyes
    Jen Hoover
    She was only 36 years old but Sally was dying. She spent a lot of her life in the hospital which lead her to have a complicated medical and surgical history. This hospital admission had already been five months long when I came along.
  • A Needed Change in Nursing
    Teressa Smith
    National nursing licensure promotes more effective licensing than does state licensure by alleviating the ever-present nursing shortage and promoting mobility among the nursing workforce. Some of the many benefits of a national nursing licensure include improved patient access to quality nursing care, enhanced discipline and information sharing among the states, physical and electronic provision of care by competent nurses, and convenience of employers to more mobile and competent nurses.
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