The Journal of the New York State Nurses' Association最新文献

Political activism for healthcare workers is a crucial complement to clinical practice. Nurses are in a unique position to not only provide bedside care but also to advocate for change within the political arena and the community at large. Preparing professional nurses for community-based practice involving political activism and civic engagement requires developing and sustaining a philosophy that supports service learning and community partnerships. The concepts of service, community, collaboration, empowerment, and political activism are essential foundations. These ideas are inherent in educationally preparing nurses to meet the healthcare needs of individuals and communities. Many nursing students, however, seem either intimidated by or uninterested in the political aspects of professional nursing practice. The authors will describe an educational strategy embedded in a senior capstone course that involves an account of a senior nursing class's first experience in political involvement.

As the population ages, and healthcare costs continue to rise, innovative models to address these twin issues of cost-effective elder care continue to evolve. Looking to the community as the context for care requires new ways of thinking about how to develop and evaluate services. This paper describes the Neighborhood Health Advocate Program (NHAP), an innovative approach to supporting inner-city minority older adults to live in their homes, as well as testing a model for program evaluation based on an action research approach.

Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. She exhibited signs and symptoms of internal bleeding and was advised to have a blood transfusion and emergency surgery in an attempt to save her and the fetus. She refused to accept blood or blood products and rejected the surgery as well. Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient's autonomy and compromise standards of care or ignore the patient's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.

Heart failure (HF) patients are reported to have twice the risk of having cognitive deficits compared to the general population. Cognitive impairment in this population may cause non-compliance to prescribed self-care regimens and delay in seeking care that may potentially lead to frequent readmissions. Although cognitive deficit is common among people with HF, cognitive screening is not routinely performed due to lack of a simple screening tool and the misconception that cognitive changes are part of normal aging. Therefore, future research needs to focus on identifying a simple screening tool that nurses can use to screen for subtle changes in cognition including forgetfulness and delayed recall. Early identification of subtle cognitive changes has the potential to guide healthcare providers to formulate feasible strategies to understand and/or prevent a low cardiac output state before major cognitive impairment becomes evident.

Medication errors remain one of the most common causes of patient injuries in the United States, with detrimental outcomes including adverse reactions and even death. By developing a better understanding of why and how medication errors occur, preventative measures may be implemented including technological advances. In this literature review, potential methods of reducing medication errors were explored. Furthermore, technology tools available for medication orders and administration are described, including advantages and disadvantages of each system. It was found that technology can be an excellent aid in improving safety of medication administration. However, computer technology cannot replace human intellect and intuition. Nurses should be involved when implementing any new computerized system in order to obtain the most appropriate and user-friendly structure.

Changes in the causes of death and advances in medical technology are leading nurses today to become more involved with end-of-life care than previously. Yet, terminally ill patients and their families have reported dissatisfaction with end-of-life care. One reason for the dissatisfaction may be attitudes among nurses about end-of-life care and hospice referral. Attitudes about end of life affect nurses' ability to care for and communicate with patients and families facing these issues. For this reason, it is important to examine nurses' attitudes about end-of-life care, specifically hospice referral, to improve care to patients and families facing death.

The federal government challenges universities to promote health and prevent illness by creating awareness of health issues and encouraging healthy practices. Establishing a wellness program on campus is a means to provide excellence in health care for students and a way to reach out to faculty and the community at large. In this paper, the authors explicate the process of a multidisciplinary, collaborative effort in a university to develop a wellness program. Various data supported the need for the program. Using a model center, the design and implementation of the program are addressed, as well as the benefits of the wellness program.

In the late 1960s many foreign nurses arriving in New York City were unable to pass the New York State Board licensing examination. In this article, the author explains how a group of leaders and organizations proceeded systematically to address this problem through effective policy development. The process is presented from the establishment of a local program to meet the needs of this group of nurses to the creation of a national commission to oversee issues encountered by professionals seeking employment in the United States. Today, the Commission on Graduates of Foreign Nursing Schools is recognized worldwide as an authority on the education, registration, and licensure of nurses and other healthcare professionals.