ANS. Advances in nursing science
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Two notions of vulnerability dominate in the nursing literature. In one model, vulnerability is equated with susceptibility to particular harmful agents, conditions, or events at particular times and is considered something to be avoided or resisted. Another view regards vulnerability as the ever-present, common condition of all sentient beings and a condition of nurses' access to understanding patients' experiences. This article uses data from an ethnographic study conducted in two hospital emergency departments to illustrate tensions between these two stances toward vulnerability as they are reflected in emergency nurses' narratives.
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One invisible and silent phenomenon associated with the acquired immune deficiency syndrome (AIDS) epidemic is the return of mothers to care for their adult sons who are dying of the disease. This article presents an emergent fit of data from an interpretative study with 14 such mothers into Leonard's practices of mothering framework. Conceptualizing mothering as a practice rather than a technical skill provides a context for understanding nurture and care. The mothers' stories reveal moral content of mothering that is centrally important to cultural life, as well as implications for nursing practice.
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Historical Article
Creating critical care: the case of the Hospital of the University of Pennsylvania, 1950-1965.
This article examines the development of critical care nursing from 1950 to 1965 through the lens of a local story--the development of the critical care unit at the Hospital of the University of Pennsylvania (HUP) in Philadelphia, Pennsylvania. The methodology used is social history. ⋯ The study concludes that powerful social contextual factors, such as work force and economic issues, architectural changes, and an increasingly complex hospital population--rather than new technology--supported the development of critical care. The study also provides parallels to contemporary nurse work force issues.
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A pragmatic view of language and a critical study of discourse can advance nursing inquiry toward the study of racism, heterosexism, classism, and health. In critical language inquiry notions about humans, health and illness are seen as constructed in societal discourses. Critical language inquiry challenges nurse researchers to theorize not which research questions to ask, but how to ask research questions that broaden knowledge about the interconnections among language, discourse, health, and society. Critical discourse analysis, as a methodology, can be of significant utility in exploring the relationships among health, discourse, power, and society.
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The emergence of managed care raises new concerns about the ethics of health care financing and its impact on service delivery. The current outcry, however, fails to recognize that American health care financing has presented serious ethical dilemmas for at least 50 years. What follows is a historic overview of American health care financing, contrasted with current challenges. The intersection between ethics, economics, professionalism, and public authority is explicated, with a critical leader/advocate role for nurses presented.