Nursing forum
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Families struggle with the day-to-day worrying about behaviors of acting out at school and work, and the loss of normalcy that they used to have in their everyday lives. Families with a loved one with mental illness live in an almost constant state of uncertainty due to the unpredictability of the illness. ⋯ This article addresses the challenges inherent to the acute psychiatric admission process of a patient and family.
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Adequate pain control continues to be an enigma in the face of the Joint Commission (TJC) well-intended pain management standards. Notable in the pain standards is the mandate to make pain the fifth vital sign to increase pain visibility and awareness. ⋯ This article is a call for facilities to refocus on pain control. A need to evaluate current programs by facilities is evident. Studies show that Pain as the 5(th) Vital Sign and PRN effectiveness documentation are not effective and invariably have not met the goals of TJC pain standard--adequate and effective pain control.
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It is important for newly hired nurses to be supported throughout their first year of employment by nurse leaders on their team. Newly hired nurses struggle with application of new clinical skills and critical thinking skills as well as integrating into unit culture. ⋯ The newly hired nurses valued the time that they spent with the leadership team as it helped them to integrate into the unit and feel comfortable using the leaders as resources for patient care. The POEP proved to be a program that impacted not only relationships among the team, but it increased retention and quality of patient care as the nurses felt supported by the team, knowledgeable about the care they were delivering and confident in their ability to seek out resources. A program like the POEP could be adapted to various healthcare settings based on individual needs of the team.
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The purpose of this study was to examine how nurses' moral distress, education level, and critical reflective practice (CRP) related to their work engagement. The study is relevant to nursing, given registered nurse (RN) documented experiences of job-related distress and work dissatisfaction, and the nursing shortage crisis. A better understanding of factors that may enhance RN work engagement is needed. ⋯ Strategies to promote CRP and reduce moral distress are recommended, to promote RN work engagement. Additionally, further study on the role of education in nurses' work engagement is recommended.
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Dexmedetomidine is increasingly being used as a sedative for monitored anesthesia care (MAC) with regional anesthesia. This literature review critiques 12 studies that used dexmedetomidine as the primary anesthetic. Study designs include prospective, retrospective case studies and randomized double-blind and randomized single-blind studies. ⋯ Dexmedetomidine is an effective MAC anesthetic for specific procedures. Further research is needed to determine which specific procedures are appropriate for dexmedetomidine. Lastly, dexmedetomidine is more costly than current MAC anesthetics, making it difficult to justify its use.