The Canadian nurse
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Our 1942 DC-3 struggled against head winds as it approached Somalia's capital, Mogadishu. The two-and-a-half-hour trip had stretched to four-and-a-half hours and we were getting anxious to reach our destination and embark on our mission. As a volunteer team of Canadian and American health care professionals, our mission was to deliver health care to Somalians dying of disease and malnutrition.
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As a health care professional, you are legally accountable for the nursing services you provide. This means you could be sued if a patient suffers harm while in your care, whether or not you were to blame.
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Nurses are beginning to realize that clients' deficits influence family members and, conversely, that family members play an important role in the development and resolution of these deficits. The authors attempted to find published literature describing a family nursing evaluation based upon Orem's conceptual framework. Previous nursing research has described how Orem's model is applied to nursing interventions with individual clients, but none has addressed the application of nursing interventions to multiperson units within a family situation. ⋯ This article reviews the three basic concepts found within Orem's conceptual framework: self-care; self-care deficit, and nursing systems. The authors also outline their theoretical assumptions for the use of this approach with family nursing interventions, based upon six functional dimensions of the family as described by Epstein et al. and Guttman. In addition, the article provides a concrete example of how nursing evaluation can be structured within this scheme of reference.
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Clothing is a powerful form of non-verbal communication, conveying socio-economic status, occupational role and even the authority and power vested in that role. The traditional hospital nursing uniform reflects its historic military and religious foundations, and, many would say, the servile rank of the wearer.
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Our experience has shown ketamine to be a safe and effective method of providing pain relief during specific procedures in burned children. It renders high doses of narcotics unnecessary and offers children the benefit of general anesthesia without the requirement of endotracheal intubation and a trip to the operating room. The response of parents and staff to the use of ketamine has been positive. ⋯ The literature does not answer such questions as: Which nursing measures reduce the incidence of emergent reactions? How many ketamine anesthetics can safely be administered to one individual? How does the frequency of administration relate to tolerance in a burn patient? Are there detrimental effects of frequent or long-term use? Clearly, an understanding of these questions is necessary to determine the safe boundaries of ketamine use in burn patients. Ketamine is not a panacea for the problem of pain in burned children. But it is one means of managing procedural pain, which is, after all, a significant clinical factor in treatment and recovery.