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The COVID 19 pandemic has had a tremendous impact on nursing and health care delivery systems. Recent research demonstrates a correlation between the stress of providing complex health care and the decline of nurse well-being. Investing in the well-being of nurses can benefit the entire health care system. Educational institutions can play a role in enhancing nurse well-being by incorporating holistic nursing education principles into the curriculum, including reflective practice methods to promote self-awareness and self-care. This may be challenging for some nursing programs, but the Power of Nursing course can help close this gap. This noncommercial course incorporates key elements of holistic nursing including authenticity, empathy, compassion, unconditional acceptance, and self-care; elements not always emphasized in a traditional curriculum. Power of Nursing, offered as an elective in nursing schools or part of nursing residency programs, provides attendees with tools and strategies to boost resilience, strengthen personal commitment to nursing, and increase well-being preparing them to thrive in any health care environment., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to understand the experience of female Hispanic nurses in formal leadership roles., Background: Research has identified that a diverse nursing leadership workforce is essential to providing optimal patient care. Little is known about the phenomenon of minority nurse leaders, particularly female Hispanic nurses in leadership roles., Methods: Ricoeur's hermeneutic phenomenology guided the interviews of 15 female Hispanic nurses in leadership roles., Results: Three themes were generated that described the environment in which leaders lived: family, culture, and healthcare organization. Four phenomenological themes were identified: weaving my life fabric, my inner dialogue, weight on my shoulders, and paving the way., Conclusion: The study findings highlight the importance of a diverse and inclusive nursing leadership workforce. By proactively addressing equal opportunities, reducing barriers to career advancement, and developing strategies to support and encourage minority nurses, organizations and communities can recruit and retain qualified underrepresented minority nurse leaders., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Professional nurses are leaving their current positions in acute care hospitals and, in some cases, the profession in greater numbers than ever. Nurse leaders must understand factors surrounding nurses' intent to leave to develop strategies to mitigate this phenomenon and retain nurses. This review of the literature seeks to synthesize studies on nurses' intent to leave. Themes include job satisfaction, resources and staffing impacting workloads, leadership, and burnout., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: Both authors have no conflicts of interest to disclose

Percutaneous endoscopic gastrostomy feeding tube placement is multifactorial and considered a lifesaving mechanism, which leads to a host of thoughts and feelings that affect the decision-making experience. As people live longer and the population ages, these decisions often involve the caregivers who have their own experience and therefore can result in caregiver burden and anxiety. A descriptive phenomenological study was conducted to describe and understand the caregiver's decision-making experience regarding percutaneous endoscopic gastrostomy feeding tube placement in community-dwelling adults. Edmund Husserl's philosophical underpinnings were utilized in conjunction with Colaizzi's (1978) method of data analysis to maintain the rigor of the study. Sixteen adult caregivers of patients from six rehabilitation and skilled nursing facilities were interviewed using a semistructured interview guide. The audio-recorded interviews were transcribed and thematic analysis was conducted. The study results yield four main themes: "Survival ... that was the determining factor"; "The doctor decided"; "More education ... just make sure they understand"; and "It makes me very scared." Implications for practice, policy, and future research are thoroughly discussed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Society of Gastroenterology Nurses and Associates.)

Competing Interests: The author has no conflicts of interest to disclose.

Purpose/aims: This study explored the feasibility of educating nurses on an emotionally sensitive topic using video. The aim was to educate nurses on how to assist individuals who have had an amputation of a limb in viewing themselves in the mirror., Design: One-group repeated-measures design with 2 time points (pretest and posttest at 1 month)., Methods: Nurses viewed a video in which 8 amputee actors described how and why nurses should support individuals' viewing of self in the mirror following amputation., Results: This video-based education was feasible, and recommendations were made for future research. Participants were engaged and shared insight into how this knowledge would change their nursing practice., Conclusions: A larger educational research study to test the effect of this education on improving nursing confidence and offering the mirror is recommended.

Purpose: To investigate inter- and intrarater reliability scoring the Infant Motor Profile (IMP)., Methods: A total of 20 infants at risk for motor developmental delay were assessed using the IMP. Six infants were born at term (gestational age: 38-42 weeks), and 14 infants were preterm (gestational age: 24-35 weeks). Videos were analyzed twice with an interval of 1 month by 4 assessors after 2 days of IMP training., Results: Spearman rank scores demonstrated strong interrater and intrarater reliability for total IMP scores (inter: r = 0.80-0.96; intra: r = 0.85-0.97) and the domain of performance (r = 0.95-0.99). Reliability for the domains of variation, variability, and fluency was satisfactory (inter: r = 0.15-0.85; intra: r = 0.30-0.92). The weakest agreement was found in the domain of symmetry (inter: r = 0.20-0.69; intra: r = 0.33-0.65)., Conclusion: Therapists naive to the IMP demonstrate good intra and interrater reliability (after 2 days of training) for most domains with the exception of symmetry.

Forensic nursing is a nursing specialty that provides services to a variety of patient populations who have experienced violence, including interpersonal violence, sudden or unexpected death, and motor vehicle collisions. However, many critical care nurses have received the background knowledge or practical skills required to provide the level of care required by many forensic patients. The purpose of this study was to determine whether differences in knowledge or practical competence exist between participants using 2 different learning modalities: medium fidelity simulation versus face-to-face lecture. Participants who were enrolled in an elective online forensic nursing science course were randomly assigned to an intervention or control group. The 18 intervention group participants were given three 2-hour forensic simulation sessions in the laboratory. The 17 control group participants attended 3 face-to-face lectures covering forensic science topics. All study participants also received the same forensic course content via the online Blackboard platform. No significant differences were found between the 2 groups in either knowledge or practical competency. The lack of results may have been heavily influenced by the small sample size, which resulted in insufficient power to detect possible differences.

Use of the mirror is an everyday phenomenon for most individuals. There seems to be limited evidence-based studies that address mirror viewing and the appropriate use of mirrors for patients with dementia. Using a case study, the purpose of this study is to begin a dialogue with the nursing community on practical nursing interventions and the need for research in this area.

Objectives: Electroconvulsive therapy (ECT) is an effective treatment of depression, but its mechanism of action still remains unknown. Some studies emphasize that epileptic seizures result in cerebral production of cytokines, including the cytokine network in association with the pathophysiology of depression. We hypothesized that depressed patients would show a dysregulated profile of peripheral cytokines before and after ECT treatment., Methods: Fifteen hospitalized subjects with major depressive disorder were recruited. Human cytokine array IV was used to determine the profile of cytokines in the serum during the course of ECT. Positive results of the cytokine assay were verified by reverse transcriptase-polymerase chain reaction. Depressive symptoms were evaluated before and after ECT series., Results: The signal intensity of eotaxin-3 and interleukin (IL)-5 changed statistically significantly between the first ECT and 24 hours after the last ECT. Furthermore, there were significant correlations between the signal intensities of eotaxin-3, bone morphogenetic protein 6, IL-5, and transforming growth factor-β and the severity of depression. The results of Cytoray assays were confirmed partly by reverse transcriptase-polymerase chain reaction. The changes of tumor necrosis factor β in pre-post comparison of ECT and the correlation of the Montgomery-Asberg Depression Scale score with tumor necrosis factor β, IL-5, and bone morphogenetic protein 6 expression could be verified. Only the relative signal intensity of IL-16 correlated significantly with the clinically as well as electroencephalographically measurable seizure duration., Conclusion: Electroconvulsive therapy treatment seems to change the expression of various cytokines in relation to changes of affective states such as mood. Therefore, cytokines might play a specific role within the treatment and pathogenesis of affective disorders.

Complementary and alternative medicine (CAM) is not generally associated with the complexity and intensity of critical care. Most CAM therapies involve slow, calming techniques that seem to be in direct contrast with the fast-paced, highly technical nature of critical care. However, patients in critical care often find themselves coping with the pain and stress of their illness exacerbated by the stress of the critical care environment. Complementary and alternative medicine-related research reveals that complementary therapies, such as Reiki, relieve pain and anxiety and reduce symptoms of stress such as elevated blood pressure and pulse rates. Patients and health care professionals alike have become increasingly interested in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Reiki is cost-effective, noninvasive, and can easily be incorporated into patient care. The purpose of this article is to examine the science of Reiki therapy and to explore Reiki as a valuable nursing intervention.

A vascular access for hemodialysis is the client's lifeline. It must be protected and used only for hemodialysis. Clients are knowledgeable about their vascular access and need to be listened to about its care. These clients' greatest fear is that their vascular access will be damaged and rendered nonfunctional. All health care personnel who come in contact with the vascular access and the client need to properly care for the vascular access with the goal of preserving its function. The purpose of this article is to explain the different types of vascular access for hemodialysis and how nurses can preserve and care for them. The vascular access and adjacent body areas need to be assessed regularly for circulatory, neurological, and muscular functions. Adequate perfusion helps to preserve the vascular access. Clients with end-stage renal disease will undergo many invasive procedures to establish and maintain a vascular access. Therefore, it is important to preserve the integrity of the existing vascular access as well as the surrounding vessels for future accesses. Nurses in acute care settings can assist to reduce the human and economic burden of vascular access.

The management of problem wounds by critical care nurses is a particular challenge in that their primary responsibilities revolve around emergent care and resuscitation of patients. However, with the identification of pressure wound development as a "never event" by Centers for Medicare & Medicaid Services and the escalating costs to more than $5 billion annually for treating chronic wounds in the US population, wound management has become a clinical imperative. The essence of nursing as a healing, caring profession should drive our efforts at reducing and/or eliminating any untoward complication that threatens the very being of our patients. Problem wounds represent such a challenge. This article examines wound management from both the science and art of nursing care. The science comprises advanced wound therapies including hyperbaric oxygen therapy, recombinant DNA growth factor therapy, human skin equivalents, V.A.C. Therapy, advanced support surfaces, and state-of-the-art dressings. The art of wound management resides in the development of a comprehensive wound center with both outpatient and inpatient capabilities including a hospital-based wound team of nursing specialists. The challenge of healing problem wounds requires a multidisciplinary approach, a dedication to measurable outcomes, and a passion for holistic, patient-centered interventions.

At our institution, high-dose i.v. dexmedetomidine is used to provide sedation for pediatric patients undergoing nonpainful radiological imaging studies. Some of these patients exhibit marked bradycardia (more than 20% deviation from the lowest age-adjusted normal values) while maintaining an arterial blood pressure within an acceptable normal range. We report on three cases wherein treatment of dexmedetomidine-induced bradycardia with i.v. glycopyrrolate (5.0 microg/kg) not only resulting in resolution of bradycardia but also resulting in an exaggerated increase of arterial blood pressure.

Routine coronary angiographic assessment of bypass graft patency does not allow quantification of bypass graft flow reserve. This study was designed to evaluate the use of cine-computed tomography (cine-CT) to determine relative bypass graft flow velocities and flow reserve. Saphenous vein grafts from the left innominate to the midleft circumflex coronary artery were placed in 5 dogs. The proximal portion of the left circumflex was then ligated. A 20-mHz Doppler probe to assess graft flow velocity, a cuff-type vascular occluder to provide variable graft occlusion, and an infusion line for selective drug administration were placed at the midgraft position. Electrocardiographically triggered scans were performed at levels of the aortic root and cardiac base following bolus inferior vena cava contrast administration. Continuous recordings of Doppler velocity and aortic pressure and intermittent measurements of cardiac output were obtained throughout the studies. Selective increases and decreases in coronary artery bypass graft flow velocity from control were performed using combinations of intragraft adenosine and/or variable graft occlusion. Simultaneous contrast clearance curves were generated from a region of interest in the ascending aorta and in the coronary artery bypass graft. Subsequent determinations of a parameter, delta PT (the time difference between peak opacification in the aorta and the bypass graft), were found to highly correlate with individual values of relative coronary bypass graft flow velocity (r = 0.74-0.97, n = 54). This study suggests that cine-computed tomography can be used to noninvasively quantify relative bypass graft flow velocities in individual dogs and eventually in patients.