Focus on critical care最新文献

These recommended strategies can be implemented in any geographic location. What strategies will you implement in your practice? Remember to share with others by word of mouth or publications which strategies were effective in your practice setting and geographic area. The nursing shortage is well documented; let us implement these strategies to help reduce the shortage before others do it for us. In this way nurses can determine their own destiny.

We have described how we revised our critical care orientation according to Gordon's FHPs. The process will require continuous review and revision. Research is necessary to determine the effectiveness of an orientation organized by a nursing framework in facilitating holistic nursing practice.

The number of patients who live with recurrent ventricular dysrhythmias is increasing as medical advances such as pharmacologic and electrical therapies decrease mortality rates in this population. As a result, nurses frequently encounter patients who are trying to learn to live with chronic aspects of recurrent life-threatening dysrhythmias. The findings of this study provide an important beginning description of strategies used by patients to address their concerns. The RVD patients in this study reported using a variety of strategies to manage their physiologic and psychosocial concerns. Their responses described a continuum of strategies to handle concerns that ranged from "compensate for the concern" to "unable to handle the concern." These findings suggest several implications for nursing. Careful assessment of all patients with RVD is appropriate to detect areas where patients perceive a need for additional strategies to manage their concerns, require support for existing self-reliance strategies, and need identification of additional nursing interventions. Individualized or group programs may be appropriate interventions to assist some patients. Strategies to support patients who report an inability to manage specific concerns need clarification. Ideally, as further research defines the processes patients with RVD use to manage their concerns, high-risk patients can be discovered and provided with interventions to promote their adjustment to living with life-threatening dysrhythmias.

In conclusion, this study describes coping mechanisms used by the nurse when caring for DNA patients. These coping mechanisms are of two types: caring for the patient and caring for the family. Coping mechanisms used when caring for the patient include spending minimal time, avoidance, depersonalization, being present at death, and grooming the patient. Coping mechanisms used when caring for the family include personalization of care and giving information to the family. An understanding of coping strategies used by nurses in caring for DNA patients may assist staff in recognizing and dealing with feelings associated with this stressful phenomenon.

The ICD has proved to be a valuable therapeutic adjunct for patients at risk for sudden cardiac death. Careful attention to details associated with patient and family teaching assures a smooth adaptation to what may seem an overwhelming circumstance for patients and family members.

ECG abnormalities are a frequent, potentially life-threatening complication of subarachnoid hemorrhage. Yet, the mechanism behind these ECG abnormalities is poorly understood. Nursing literature has given this phenomenon little attention. However, neurogenic ECG abnormalities have implications for critical care nursing practice and research. In this article the most frequently documented neurogenic ECG abnormalities occurring in patients with subarachnoid hemorrhage have been discussed. The proposed pathophysiologic mechanisms and nursing implications were also discussed. Patients with neurogenic ECG abnormalities require complex, multifaceted nursing assessment and intervention. Only with a better understanding of the phenomenon will the critical care nurse be able to meet the needs of these patients.