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Current advances in technologies and treatments provide pet owners and veterinarians with more options for prolonging the life of beloved pets, but can simultaneously lead to ethical dilemmas relating to what is best for both animal and owner. Key tools for improving end-of-life outcomes include (1) sufficient training to understand the valid ethical approaches to determining when euthanasia is appropriate, (2) regular training in client communication skills, and (3) a standard end-of-life protocol that includes the use of quality of life assessment tools, euthanasia consent forms, and pet owner resources for coping with the loss of a pet. Using these tools will improve outcomes for animals and their owners and reduce the heavy burden of stress and burnout currently being experienced by the veterinary profession.

Several initiatives in the past 20 years have been implemented in Los Angeles County to improve service delivery across the mental health and substance abuse treatment systems, with the goal of increasing access to and coordination of services for individuals with co-occurring substance abuse and mental disorders. To examine the current status of service delivery to this population, a survey was conducted with administrators of mental health and substance abuse programs that provide services to dually diagnosed patients and with the treatment staff in those programs. Administrators (n = 15) and staff (n = 99) in substance abuse programs rated the accessibility and coordination of services to dually diagnosed patients significantly lower than the mental health administrators (n = 10) and staff (n = 136). Efforts to coordinate service delivery across the two systems need to address these divergent perceptions between staff in programs that are increasingly called upon to work together to jointly deliver services.

Smoking is the most preventable cause of death in our society. Tobacco use is responsible for nearly one in five deaths in the United States and the cause of premature death of approximately 2 million individuals in developed countries. Smoking accounts for at least 30% of all cancer deaths and is a major cause of heart disease, cerebrovascular disease, chronic bronchitis, and emphysema. The North Carolina Triangle Oncology Nursing Society applied for a competitive grant through the national Oncology Nursing Society and Cancer Care, Inc., in partnership with the Wellness Community and Bristol-Myers Squibb. The grant could be used for any lung cancer issue or project. Because North Carolina is deep in the tobacco belt, it was decided to focus on the largest group of new smokers in the United States, children and teens, for the project. Over 80% of adult smokers surveyed in 1991 had begun smoking by the age of 18. The oncology nurses wanted to focus on prevention, not cessation. Therefore, grade school children were the population selected for this project. This age group is impressionable and able to understand the negative consequences of smoking. This article outlines the content of the educational intervention and evaluation of the program.

This article examines mental health and substance abuse treatment providers' attitudes and beliefs regarding the relative values of academic knowledge and experiential knowledge. These two forms of “knowing” increasingly come into conflict as providers from the two service systems work together to provide services to individuals with co-occurring disorders. Data to address this issue were obtained from seven focus groups conducted with 48 substance abuse and mental health treatment providers and stakeholders in Los Angeles County. Findings suggest the tenuous role of experience-based knowledge within the emergent framework of dual diagnosis treatment and its emphasis on the professionalization of providers. The article raises concerns as to how differing, and often competing, treatment approaches affect the provision of care for this population and questions how these tensions will be resolved within efforts to increase collaboration between the two systems in providing services to dually diagnosed patients.

School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic assessment guidelines, and various treatment options to assure proper management of students with injuries to the ankle. The benefits of adhering to these guidelines are that students will receive better, cost-effective treatment and the nurse will make appropriate referral recommendations to parents and other school personnel.

This article focuses on the important role of the school nurse in promoting healthy lifestyle choices through networking, resource identification, and working with community partners. “Everyone Is Healthy at Northeast” was a health promotion program designed and presented in two ways: classroom lessons and a health fair. There were interactive health promotion classroom lessons on topics such as proper hand washing, the effects of tobacco, and keeping one’s heart healthy. These lessons were enhanced by community partners in delivering the healthy lifestyle message through a variety of teaching methods: music, interactive games, and hands-on visuals. The health promotion education program culminated in a schoolwide health fair that showcased the healthy lifestyle choice information at various stations. “Everyone Is Healthy at Northeast” was a success and promoted healthy lifestyle choices through creativity, collaboration, and support from the entire school community.

Every year, school nurses have the responsibility for developing and presenting a bloodborne pathogen presentation to the education and clerical staff of their buildings. Although the information is similar from year to year, the manner in which the information is presented can be altered. Teachers are using active learning strategies in a variety of learning environments, engaging students in the learning process by having them play an active role. With some planning, preparation, and imagination, active learning strategies can be incorporated into bloodborne pathogen presentations. The purpose of this article is to define active learning, describe how to develop a program using active learning strategies, and provide some examples of bloodborne pathogen presentations that have already been developed. Several sources are identified that can provide the school nurse with information regarding bloodborne pathogens. Information about how computers can be integrated into the bloodborne pathogen presentation is also presented.

Developing a national position on competencies for school nurses can directly in-fluence professional practice, which ultimately affects the well-being and academic success of students. Collaboration between national experts, such as school nurse educators and school nurse consultants, interested in moving this development forward is key. Closely aligning the work done by the Southern Regional Education Board Council on Collegiate Education for Nursing on entry-level competencies with the Standards of Professional School Nursing Practice provides a framework to carry the school nurse competency initiative forward. Continued competency development will provide guidance for the academic programs that design curricula to prepare school nurses and for the practice settings that hire school nurses.