ABSTRACT
PURPOSE: To describe the rationale maternity patients use in determining whether to accept care by a male student nurse. Information about the activities that women are comfortable having male nursing students perform is inconsistent and the reasons for women's comfort or discomfort are unclear. Furthermore, little is known about what factors patients consider when assigned a male nursing student. Yet, knowledge of such factors can enhance understanding and guide the selection of students in maternity units. DESIGN: Focused ethnography using a purposive convenience sample of 32 women, aged 20 to 40 years, who spoke English, and who had given birth to normal newborns in one small community hospital in the mid-Atlantic region of the United States. Patients were excluded if they or their infants were in an unstable physical or mental condition. The study was conducted in 1995. METHODS: The women were interviewed using a semi-structured format. FINDINGS: Data from participants pertained to personal and contextual factors. Personal factors were perception of postpartum self and personal feelings. Contextual factors were student characteristics, establishment of relationships, nursing care activities, and partner viewpoint. CONCLUSIONS: Women during and after giving birth have definite thoughts about male student nurses caring for them. Nurse educators should consider these when assigning men. Educators should encourage professionalism and competence in their students.
Subject(s)
Mothers/psychology , Nurse-Patient Relations , Nurses, Male/psychology , Obstetric Nursing , Students, Nursing/psychology , Adult , Anthropology, Cultural , Female , Humans , Interview, Psychological/methods , Male , Mid-Atlantic Region , PregnancyABSTRACT
Iatrogenic subclavian artery pseudoaneurysms developed in two patients after inadvertent introducer sheath placement into the artery during attempted subclavian vein cannulation using Seldinger's technique. Such iatrogenic subclavian artery pseudoaneurysms are quite rare, but they may become more common with the increasing use of invasive monitoring and diagnostic techniques. Both cases involved patients in hypovolemic shock at the time of attempted subclavian vein cannulation. Their injuries were confirmed by preoperative arteriography, and primary arterial repair was successful in each. Based on our experience, we make the following recommendations: 1) subclavian vein cannulation with large-bore catheters should be avoided in hypovolemic patients; 2) suspected cases of iatrogenic arterial injury should be evaluated arteriographically; and 3) primary repair to prevent subsequent thrombosis, rupture, or embolization should be performed after confirmation of the injury.
