British journal of nursing (Mark Allen Publishing)
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The decision to limit care for critically ill intensive care patients is not uncommon, and most deaths in the intensive care unit are now preceded by do not resuscitate (DNR) orders, which are regarded by some as a way to make death more humane and respect patient autonomy. When a patient receives a poor diagnosis the family needs to discuss the medical care and respect the patient's wishes. Many relatives hesitate to discuss these issues, because they wish to avoid discussing the idea of death or any serious change to the patient's condition. This article aims to address DNR orders and discuss the mechanisms available to achieve a good death for patients and their relatives, instead of enduring a distressing and undignified end.
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This case study details the healing of a chronic wound (20 years' duration) in a patient with dystrophic epidermolysis bullosa (EB). Many different dressings and creams had been used, and on occasions the wound began to heal but never progressed to closure. A honey impregnated dressing was used and the wound healed in 15 weeks. A brief overview of the dystrophic form of EB is given and some evidence for the efficacy of honey is presented.
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Work autonomy is an essential aspect of nurses' professional lives. The aim of this research was to study American nurses' work autonomy and, in particular, autonomy over patient care and unit operations decisions. Data were collected electronically during July of 2004. ⋯ Nurses were more autonomous about decisions relating to patient care than unit operations, and their total work autonomy was moderate. Correlations and stepwise regression analyses revealed that nurses' experience, education, and time commitments influenced their work autonomy. Findings suggest that nurses' work autonomy should be enhanced to reach its full potential and that nurse administrators should promote their nurses' work autonomy.