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Aims and objectives: To explore the perceptions and experiences of perioperative nurses and Certified Registered Nurse Anaesthetists (CRNAs) in robotic‐assisted laparoscopic surgery (RALS). The objective was to identify the factors that affect nursing care of patients who undergo robotic‐assisted laparoscopic surgery (RALS). Background: The rapid introduction of technological innovations into the healthcare system has created new challenges for perioperative nurses. RALS affects the physical and interpersonal context of the surgical team's work and subsequent patient outcomes. Despite significant changes to the workflow for perioperative nurses and CRNAs, there is little research focusing on the nurses' experience and their challenges with RALS. Design: A qualitative descriptive study. Method: Semi‐structured interview questions guided data collection. A total of seventeen participants including six preoperative and postoperative nurses, seven intraoperative nurses, and four CRNAs in the United States were interviewed. The interviews were conducted between 26 April–24 June 2018. Data were analysed using thematic analysis, and the COREQ checklist was used to report data collection, analysis and the results. Results: Three major themes and two categories within each theme were identified: (a) surgical innovation: nurse perception and workflow; (b) interprofessional practice: teamwork and standards; and (c) outcome: patient outcomes and system outcomes. Conclusions: The findings indicate that RALS has the potential to improve patient outcomes when performed in a timely fashion by skilled surgeons, and efficient, well‐trained surgical teams. For patients to experience full benefits of RALS, patient characteristics, the underlying reason for surgery, and cost must be considered. Relevance to clinical practice: The results of this study highlight the necessity of promoting factors that improve the surgical team training and practice for RALS and will ultimately impact patient outcomes. [ABSTRACT FROM AUTHOR]

The aim of this hermeneutic phenomenological inquiry was to explore the lived experience of aging for late-midlife women via reflective journaling and a photo elicitation interview, and to demonstrate how the creation of a collage allows women to make meaning of the aging experience. Using van Manen's philosophical framework, four themes were discovered: Invisibility, Conflicted Self, Freedom, and Relationality. Invisibility was expressed by the women as disregard, not being seen by others, or overlooked in daily activities. Conflicted Self involved the conflict between the inner being and the outer physical body. Freedom related to the ability to let go of others' expectations and allow themselves to be the people they were in their own reality. Relationality was the interconnectedness the women felt with family, friends, and colleagues, and the changes in these relationships. The women's narratives and collages portrayed a holistic picture of aging, not confined to decline but rather a life of anticipation. INSET: COMPOSITE OF TODAY'S LATE-MIDLIFE WOMAN.... [ABSTRACT FROM AUTHOR]

This article presents a dynamic new model of health informatics. Within the model, the focus of health informatics changes from the provider to the consumer and incorporates the dynamic relationship of technological change to health care. Bioinformatics is the scientific discipline that is translated into care through the practice of health informatics. The loci of health informatics practices are the consumer (consumer informatics), the patient (clinical informatics), and the community (public health informatics). The continuum from individual to community interacts with and contributes to health care technology, which is represented as a constantly changing progressive wave.