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Comments on the problems concerning crowding in hospital emergency departments (ED) across the U.S. Association between ED crowding and nursing shortage; Effect of crowding on health services administration; Need to educate the public about when to go to ED.

Presents views on the nursing profession. Career options for nurses; Status of nurses as healthcare professionals; Advice for people who are considering a career change.

This article describes the risk factors and protective strategies associated with workplace violence perpetrated by patients and visitors against healthcare workers. Perpetrator risk factors for patients and visitors in healthcare settings include mental health disorders, drug or alcohol use, inability to deal with situational crises, possession of weapons, and being a victim of violence. Worker risk factors are gender, age, years of experience, hours worked, marital status, and previous workplace violence training. Setting and environmental risk factors for experiencing workplace violence include time of day and presence of security cameras. Protective strategies for combating the negative consequences of workplace violence include carrying a telephone, practicing self-defense, instructing perpetrators to stop being violent, self- and social support, and limiting interactions with potential or known perpetrators of violence. Workplace violence is a serious and growing problem that affects all healthcare professionals. Strategies are needed to prevent workplace violence and manage the negative consequences experienced by healthcare workers following violent events.

This study sought to determine parents' beliefs about children and gun safety. A survey was sent to 230 parents of elementary age children addressing their beliefs about firearm storage, firearm safety training for children, and whether or not their child would handle a gun. Findings are based on the 82 returned surveys. Parents believed safe firearm storage was important to protect children. Only 22% of parents reported having a firearm in their home. However, of those reporting a firearm in the home, 85% did not practice safe gun storage despite reporting they believed it was important. These findings are supported by other studies that have found that parents have unrealistic perceptions about how their child will respond when a firearm is encountered. The only predictor of parents' incorrect perceptions about firearm safety training was the item "children will be safe if taught." This parental misperception provides further evidence that parents have unrealistic attitudes about children and guns.

Background: The use of observational units (OUs) in pediatric emergency departments (EDs) has become an important adjunct to emergency care. An extended observation period (4 to 23 hours) in the ED has decreased both the number of admissions and prolonged use of acute ED beds. This serves to increase patient satisfaction as well as optimizing care. The use of OUs allows for the most appropriate allocation of resources. These units are typically located within the ED or immediately adjacent to it. The ED physicians are the gatekeepers of the unit and serve as the medical supervision for these patients. The Children's Hospital of Philadelphia developed an OU known in the hospital as the Emergency Department Extended Care Unit (EDECU) approximately 5 years ago. In order for the EDECU to function at its fullest potential, the ED at The Children's Hospital of Philadelphia has opted to use the ED nurse practitioners (NPs) to enhance the care for these patients., Objective: The NP has been an integral member of the ED for the past 10 years with primary roles in urgent care and in the follow-up program. As the ED expanded to include the EDECU, the role of the NP also developed to meet the needs of these patients. A review of the role development of the ED NP in observation medicine and the impact on patient and staff satisfaction as well as contributing to fiscally responsible care will be addressed., Methods: A retrospective review of the NP's role development in the evolution of the EDEDU., Results: Incorporation of the NP in the treatment team has provided efficient use of professional staff, comprehensive patient care, and increased patient satisfaction., Conclusions: The use of the EDECU has become an important part of the services offered in the ED at The Children's Hospital of Philadelphia. The integration of the NP in a pivotal role allows for optimal use of human resources, and provides efficient, cost-effective patient care in the ED.

Resuscitation documentation assists health care professionals in trending patient status, determining what treatments may be most effective, and determining where opportunities for improvement may exist. An overview of what is known about resuscitation documentation is provided in this article, as are implications for future research related to documentation of resuscitation events. Use of the Utstein guidelines in determining essential elements of resuscitation documentation is also presented.

Issues and Purpose: To determine the effects of feeding decisions on infant growth in the first 6 months of life., Design and Methods: Growth measurements were collected twice during the first 6 months of infancy as part of a larger investigation of infant feeding practices (N = 52)., Results: Infants who received solid foods before the age of 4 to 6 months weighed less than those who received solid foods after 4 to 6 months. There were no differences in growth measurements between formula-fed and breast-fed infants, although breast-fed infants weighed more at birth., Practice Implications: Emphasize the importance of feeding breast milk (preferably) or formula only for the first 6 months. Advise parents to withhold fruit juices until the infant is at least 6 months old.