NursingConnections
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Laws are clear when it comes to reporting child abuse, elder abuse, or maltreatment of the disabeled; however, the fuzzy area of domestic violence, or injury to women by their husbands or intimates, puzzles the system ethically and legally. Experts are divided on the issue of mandatory reporting of domestic violence by health care professionals. As exemplified by the Florida law, the crux of the problem may be twofold. ⋯ This victim vulnerability creates ethical dilemmas in the emergency department, often the first outside contact after a violent incident. This paper examines the implications of reporting applied to emergency practice in the context of basic ethical standards. The application of mandatory reporting laws to competent adult victims presents questions related to nonmaleficence, beneficence, autonomy, confidentiality, and a variety of contextual issues that arise from these main ethical domains.
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Critically ill patients require continuous assessment of their need for sedation and pain management. The purpose of this study was to develop a consistent categorization of patient's symptoms and to identify actions that yield effective patient outcomes. Nurses in this study described patients with sedation problems as those who were disoriented or aggressively acting out, fearful and restless, or manifesting changes in orientation, memory loss, or mental status. ⋯ Nurses identified separate subjective and objective cues for patients' anxiety, agitation, and confusion. The most frequently identified nursing actions were assessment to differentiate between pain, anxiety, agitation, and confusion; personal reassurances, relaxation and other physical comfort techniques; administer prescribed medication; collaborate with a physician to identify cause; and give additional prescribed medication. Effective outcome measures included stable vital signs, normal oxygen saturation, progression with ventilator weaning if appropriate, return to normal level of orientation, and a quiet yet arousable state.
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Historical Article
"Blue baby" nursing: a forerunner of pediatric ICU nursing.