Clinical Topics - Surgery

Fostering Sound Relationships in Nursing Education Through Faculty and Student Mentoring

Fostering Sound Relationships in Nursing Education Through Faculty and Student Mentoring

Tags: ethical principles ethics mentorship nursing ethics nursing faculty nursing students perioperative stress students violence

This article will provide a brief review of the literature on the benefits of effective mentoring such as improvement in the confidence level of novice nursing faculty members that leads to success as a teacher. This article will also provide an overview of some types of mentoring programs currently available. Further, this article will examine the importance of mentoring as it relates to enhancing the student-faculty relationship. Lastly, this article will examine ethical standards and the faculty member's role in promoting a just culture between the student, their peers, and the faculty member in the learning environment.

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What Can We Do to Promote Professional Socialization in Nursing?

What Can We Do to Promote Professional Socialization in Nursing?

Tags: clinical mentoring nursing faculty perioperative professional socialization student nurse transitioning working together

Transitioning to a new work setting is challenging for many nurses regardless of the time spent in practice. Promoting professional socialization, through mentoring and precepting, helps to facilitate a smooth transition. Effective mentoring, using role play, reflective exercises, and debriefing, provides the transitioning nurse the opportunity to self-actualize his or her potential in the new work environment. The use of Benner’s Novice to Expert Theory and Duchscher's Stages of Transition Theory as a basis for mentorship enhances safety and quality in the provision of care.

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Perioperative Fasting Guidelines as it relates to ERAS Protocol: Exploring Existing Modalities

Perioperative Fasting Guidelines as it relates to ERAS Protocol: Exploring Existing Modalities

Tags: anesthesia carbohydrate-rich drinks ERAS protocol NPO perioperative Perioperative fasting

For the longest time, any procedure requiring anesthesia was accompanied with perioperative instructions mandating a fast from midnight until the surgery. However, anyone that’s lived long enough has learned to understand that just because something has been done for a long time, it doesn’t mean it should be done for the rest of time. With technological advances and improvements in research, medical practices and patient instructions should evolve. Here, we’ll explore the rationale behind the old modality as it pertains to preoperative care and instructions, what’s changed in research and technology, and finally, what new modalities should be learned, taught, and implemented.

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A Husband's Difficult Decision

A Husband's Difficult Decision

Tags: bedside reporting end of life family Family Presence PACU sepsis

A husband's difficult decision regarding his critically ill wife and DNR status

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A Review of the Treatment for Postoperative Nausea and Vomiting

A Review of the Treatment for Postoperative Nausea and Vomiting

Tags: anesthesia health care professionals nausea PACU post-op risk factors treatment options vomiting

Common treatments reviewed for the treatment of postoperative nausea and vomiting, mostly in the PACU phase of care.

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Regional anesthesia; A quick introduction

Regional anesthesia; A quick introduction

Tags: anesthesia bsn professional rn Regional anesthesia

This article offers a small introduction and overview regarding regional anesthesia. You have nerves that run all through your body. Nerves provide a pathway for impulses to communicate between the brain and other parts of your body. Not only do your nerves tell your muscles to move, they tell your brain when something is painful.

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Recovering from Tragedy and Surgery

Recovering from Tragedy and Surgery

Tags: PACU support surgery tragedy

A story of a patient recovering from surgery and a tragic event.

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Medical Equipment

Medical Equipment

Tags: equipment oxygen PACU Post Anesthesia Care Unit T&R Transport and Relief

This article is about receiving a patient postop who required oxygen. The respiratory therapist had disconnected the oxygen and placed onto the beside portable O2 tank to administer a nebulizer treatment. After nebulizer treatment was completed the oxygen was not moved back to the wall and tank went empty. The patients oxygen dropped.

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Multimodal Analgesia:  Ways to Take Away the Pain

Multimodal Analgesia: Ways to Take Away the Pain

Tags: analgesia anesthesia multimodal pain management Regional anesthesia

This article addresses ways to use multimodal analgesia such as opioids, anti-inflammatories, regional anesthesia, etc to achieve greater pain control in patients.

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The Importance of Educating in Real-Time

The Importance of Educating in Real-Time

Tags: acute care critical thinking educating nursing education patient care patient safety perioperative teaching

Working in the acute care hospital, provides many opportunities to learn. As healthcare workers, we must recognize and act quickly on any situation that puts a patient at risk. A recent situation occurred in the hospital that required both the need to act and to provide education in real-time.

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Young and Healthy in the PACU

Young and Healthy in the PACU

Tags: anesthesia Healthy PACU

Some patients in the post anesthesia care unit (PACU) are young and or very healthy. These qualities sometimes give the impression that there will not be complications from surgery or anesthesia. This is not always the case. These patients may be overlooked for experiencing complications because they are healthy. I have seen a number of patients who have no health problems experience side effects from anesthesia and surgery.

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When

When "Old Dogs" go Back to School

Tags: Bachelor's degree education family nursing leadership PACU stress

I went back to college at the age of 62. Being an "old dog", I was not computer savvy, so taking classes mostly on-line was quite challenging. I believe that my trials and triumphs evidenced in this article, will encourage nurses, especially older nurses, to go back to school for their BSN.

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Patients First

Patients First

Tags: communication PACU patients

A brief article about a patient that inspired me.

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Anesthesia Awareness for Perioperative Nurses

Anesthesia Awareness for Perioperative Nurses

Tags: anesthesia awake awareness perioperative

Anesthesia awareness definition is an unexpected recall of events while under general anesthesia. The majority of the authors place the rate of anesthesia awareness to one patient out of every one thousand patients that experience some form of anesthesia awareness, however the exact mechanism of the pharmacological action of anesthetic is not clearly understood.

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Therapeutic Hypothermia Management

Therapeutic Hypothermia Management

Tags: cardiac cerebral ischemia critical care hemorrhage Hypothermia perioperative recommendations Subarachnoid Hemorrhage Therapeutic Hypothermia therapy traumatic brain injury treatment

The leading cause of death in North America is heart disease, resulting in 611,105 deaths in the last year. Cardiac arrest accounts for more than 300,000 heart disease related deaths. Patients that receive early quality chest compressions and defibrillation present with increased survival rate, however, the degree of brain dysfunction varies. The advancement in cardiopulmonary resuscitation after cardiac arrest and the use of therapeutic hypothermia have minimized brain injury and improved neurologic outcome. In 2002, two studies demonstrated the use of therapeutic hypothermia after cardiac arrest proving to lower mortality rate and have neuroprotective effect. This led the American Heart Association and the International Liaison Committee on Resuscitation to recommend the implementation of therapeutic hypothermia after the return of spontaneous circulation post-cardiac arrest. Mild hypothermia is also utilized in traumatic brain injury to control cerebral edema and to decrease intracranial pressure (ICP), cerebral ischemia, and subarachnoid hemorrhage (SAH). However, clinical effectiveness for subarachnoid hemorrhage is still questionable. This paper will focus on the recommendations for therapeutic hypothermia after cardiac arrest as well as a briefly discuss its use for clinical trials in traumatic brain injury, cerebral ischemia, and SAH.

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The Nursing Image: A Position Paper

The Nursing Image: A Position Paper

Tags: advocacy advocate Community Health Nursing ethics future of nursing media Nurse Education nursing ethics Perception perioperative Position Paper profession reflection

The nursing image connotes a healing caregiver at a patient’s bedside. Nursing as a highly skilled and education profession remains incongruent with media and advertising portrayal of the nursing image, in contrast to published reports as the most trusted profession for the past decade. Current public perceptions of the nursing image are sharply contrasted to that of how nursing prefers to be viewed. This purpose of this work is to edify two contrasting positions of the ethical constructs of the nursing image as well as present posits of the author.

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Medication Induced Bradycardia

Medication Induced Bradycardia

Tags: anesthesia bradycardia labetolol medicine PACU pain

In medicine there is never a playbook about how things are going to unfold and this is especially true when it comes to recovering from surgery and anesthesia. For example, sometimes as nurses we give medications to treat one symptom and unintentionally cause another.

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Not Just Another Day

Not Just Another Day

Tags: car accident death emergency room ER multiple injuries PACU saying goodbye

Brief story about helping someone say goodbye and knowing their loved one was cared for.

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Embracing Change

Embracing Change

Tags: critical care Emergency nurse ICU ICU Nurse nursing experiences surgical unit transition

Exemplar of my nursing experience of my transition from ER nurse to an ICU nurse.

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A Difficult Patient

A Difficult Patient

Tags: challenges difficult patient PACU

Article about managing a difficult patient in the PACU setting. In my nursing career, there are many different types of challenges. Job challenges, schedule challenges and patient related challenges. No matter what type of nursing I have encountered there are always difficult patients that test my nursing skills. Whether the demands are related to technical skill, assessment or cultural understanding, I enjoy that critical thinking that is required to rise to the occasion. As a seasoned nurse I feel that technical challenges have become easier to handle, while the social or cultural challenges have my increased interest. I continue to obtain as much education as I can to assist my nursing challenges.

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Receiving another patient helped save my other patient...

Receiving another patient helped save my other patient...

Tags: elderly experiences nursing nursing experiences PACU

I started my day in the Post Anesthesia Care Unit (PACU). I work the 7a-7p shift. It was just another routine day. I received an 84yr old female patient Mrs. R from the Main Operating Room (OR) who had undergone a Left Shoulder Replacement. Mrs. R received an interscalene block for pain in the OR and had general anesthesia. Since she was elderly and was not having good tidal volumes at the end of the case anesthesia decided to keep her on the ventilator a bit longer until she woke up more...

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What do they expect?  A comparison of student expectations and outcomes of undergraduate research experiences

What do they expect? A comparison of student expectations and outcomes of undergraduate research experiences

Tags: experiences nursing students perioperative research student student expectations student outcomes students

The big challenges facing nursing students today have permanent effects on us all as patients. Nursing students need to be able to value the relevance, authority, and utility of nursing research for patient care through embedding research learning in both academic and practice-based settings. Students can be supported in learning how to access, understand, and appraise the authority of research through weaving these skills into enquiry-based learning. Furthermore, encouraging students to undertake research- based practice change projects can support research utilization and development skills.

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Foley Catheters in Men and Women: Lubrication, Anesthesia, and Attitude:  A Randomized Trial

Foley Catheters in Men and Women: Lubrication, Anesthesia, and Attitude:  A Randomized Trial

Tags: anesthesia catheters comfort

Foley insertion in alert patients not in retention: males benefit from lidocaine jelly. All staff appear to underestimate discomfort.

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Spinal Block versus Epidural Block

Spinal Block versus Epidural Block

Tags: anesthesia Epidural epidural vs spinal block Regional anesthesia Spinal Block spinal block vs epidural

Spinal anesthesia, also called spinal analgesia, sub-arachnoid block (SAB) or intrathecal, is a form of regional anesthesia involving an injection of a local anesthetic into the cerebral spinal fluid with a fine needle. The term epidural is often short for epidural anesthesia, a form of regional anesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord.

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Basic Cardiac Assessments: Physical Examination, Electrocardiography, and Chest Radiography 

Basic Cardiac Assessments: Physical Examination, Electrocardiography, and Chest Radiography 

Tags: cardiac cardiac assessments chest radiology electrocardiography ICU physical examination risk factors surgical unit

The human heart is one of the major organs adversely affected by high blood pressure. Therefore, the registered nurse must provide a careful and thorough evaluation of the assessments needed via the cardiac structure and function (i.e., including visual signs, all non-and invasive cardiac medical devices), which is an obligatory part of the examination of the hypertensive patient.

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Clinical Nurse Leadership and Performance Improvement on Surgical Unit 

Clinical Nurse Leadership and Performance Improvement on Surgical Unit 

Tags: behavior clinical nurse leadership leadership skills performance surgical unit

There are many ways that nurses can prevent harm to their patients one method is to provide the necessary care that will promote only positive outcomes for their patients.

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Hiatal Hernia Defects and the uses of Mesh Versus Human Grafts

Hiatal Hernia Defects and the uses of Mesh Versus Human Grafts

Tags: Hiatal Hernia Medical Research Review surgery

The purpose of this Medical Research Review is to present results of current studies evaluating the postoperative results of Hiatal Hernia defects, with special emphasis on the recurrence rate and reflux after surgery comparing the use or not of mesh reinforcement.

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There Are No Simple Cases 

There Are No Simple Cases 

Tags: body case Code Blue nurse outcome PACU recovery simple study temperature

As a twenty year experienced recovery room nurse, I know that no case is ever the same. People are individuals. They react differently to medications. They metabolize drugs at different rates depending on age, body mass, body temperature, kidney and liver functions. Although everyone is different, I can basically expect a certain outcome in recovering people. But in saying this, you can always expect the unexpected.

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