A review of the literature on how important water is to the world's elderly population.

AIM: This article reviews the literature on how important water is to the world's elderly population. BACKGROUND: Water is a finite resource, so we must preserve the water that we have. Physiological aspects and what water requirements our bodies maintain sum up this essential nutrient for life. Dehydration is a concern in the elderly. CONCLUSIONS: Five strategies related to water intake can promote health: (1) assess for symptoms which may indicate dehydration, (2) encourage ingestion of fluids and foods to maintain an optimal fluid level, (3) be alert to physical and clinical conditions affecting hydration in the elderly, (4) consider environmental factors which may affect body fluids, electrolytes and acid-base balance, and (5) encourage methods to increase fluid consumption.

A review of the literature on care of clients in pain who are culturally diverse.

AIM: This article reviews the literature on the care of clients from diverse cultures who are in pain and provides strategies for care. BACKGROUND: Pain is a critical concept for caring for clients and particularly for clients from another culture. Culture shapes the values, beliefs, norms, and practices of individuals, including the ways persons react to pain. Culture affects the assessment and management of pain. CONCLUSIONS: Seven strategies can assist in culturally appropriate assessment and management of pain: (1) utilize assessment tools to assist in measuring pain, (2) appreciate variations in affective response to pain, (3) be sensitive to variations in communication styles, (4) recognize that communication of pain may not be acceptable within a culture, (5) appreciate that the meaning of pain varies between cultures, (6) utilize knowledge of biological variations, and (7) develop personal awareness of values and beliefs which may affect responses to pain.

"The best thing about the hospitalization was that the nurses kept me well informed" Issues and strategies of client education.

The patient had been in an automobile accident and was recuperating from a brain concussion. He was scheduled for 24 h of evaluative procedures to rule out injuries which might require surgery. He had been on a back board for a possible spine injury, had a variety of X-rays, blood work, and an EKG, and had been given oxygen, medication by injection, and intravenous fluid and medication through a pump. A variety of health team members including nurses, physicians, and a surgeon had done assessments and taken a history to assist in the diagnostic process. "The best thing about the hospitalization was the nurses telling me what they are doing and why they are doing it! It was really reassuring to have the procedures explained and to know what is being done and why." "I didn't always know if they were going through the steps to help remind themselves what they were doing or to tell me what they were doing. In either case, it was helpful for me to have information on what was happening." "They answered my questions as best they could. When I asked the nurse adding an IV bag what was in it he said, "Potassium" and he explained that my level was 3.3 when the normal was 3.5 to 5.0. He said that since they didn't know my normal they were giving me potassium just in case I needed it. He knew just what he was talking about and the facts were reassuring." "When I asked him to explain what the injection was, he said it was "Tetanus." He said I could refuse it if I wanted to, that it would probably get sore. However, he said I did have open abrasions and if I had not had one in 10 years it would be a good idea. So understanding this reasoning, I was glad to get the shot." "Patient education is really important. When I was in the hospital 10 years ago I was not given all this information and it really helps! I really appreciate the different approach by the nurses. It is really reassuring."

Culturally competent care: emphasis on understanding the people of Afghanistan, Afghanistan Americans, and Islamic culture and religion.

Since the attacks in New York and Washington, DC, in September 2001, increased racial and religious animosity has left Arabs, other Middle Easterners, Muslims, and those who bear physical resemblance to members of these groups, fearful. This article provides information about the people of Afghanistan, Afghanistan Americans, and Islamic culture and religion, which can greatly assist the nurse who is confronted with persons from diverse cultures during the provision of care. The Giger & Davidhizar Transcultural Assessment Model was first published in the International Nursing Review in 1990. This model is now used worldwide and provides an assessment model to assist in understanding cultural phenomena and individuals from different cultures.

The employee who seeks to benefit from being ill.

The presence of physical symptoms that do not correlate with a disease process are often frustrating to healthcare professionals, are difficult to diagnose and may consume an inordinate proportion of healthcare resources. However, proper and complete physical and psychological assessment and treatment is becoming increasingly possible and essential. Physical illness may occur concomitantly and sometimes as a result of psychological distress, which has displayed itself in a diagnosed mental illness. In other cases physical symptoms may be caused by unconscious dynamics, and the process becomes the primary presenting mental concern. In other cases the physical illness is part of a conscious process and motivated by the hope of gain. Differentiation between physical symptoms of unconscious and conscious origin is important in selecting the correct response. A manager must first of all be alert for physical symptoms that appear to be consciously motivated, as in a disorder called "malingering." The essential feature of malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding work or obtaining financial compensation. Managers may inadvertently encourage malingering in the workplace by inappropriate responses to employees who present a physical complaint that is consciously motivated for gain. When the manager can recognize this phenomenon as malingering, appropriate managerial intervention can cause this behavior to be controlled and even eliminated and thus enhance productivity.

Are managers wasting words on praise?

Praise can be a powerful form of affirmation and a motivator. However, praise also can be given in a way that negates its benefits. To avoid wasting words and maximize the benefits of praise, it must be offered in the right manner and at the right time.

Are you sure you want to be a manager?

Management has a substantial effect on organizational outcome and is critical for the organization in terms of obtaining long-term goals. Therefore, the selection of successful managers is crucial to attaining organizational objectives. However, a staff technologist who functions very successfully in his or her present role may not have the characteristics needed for successful management. Unfortunately, success in one's current, nonsupervisory position is usually the very attribute that is considered when a management position is offered. Because of this, there are many who fail miserably in the management role. These managers are ill-suited for the duties they must perform, unhappy in the position, disliked and seen as ineffectual by their subordinates and colleagues. It is essential that any individual who is offered a management position critically evaluate his or her abilities and personality before accepting the offer. For a candidate who is unsure of his or her abilities, tests are available that can assist in measuring attributes such as leadership behavior, power management, power orientation, conflict management, perceptions of organizational climate and the individual's "organizational fit" with the organization offering the position. These instruments should be used with caution because their reliability and validity in predicting management success depend on a wide variety of factors. Ultimately, it is the prospective manager's personal judgment that must be the final determinant of whether a management position is the best choice.

"How to get along with doctors and other health professionals".

All nurses will from time to time find themselves in negative interactions with doctors and other healthcare professionals. By using positive communication techniques the nurse can promote healthy interpersonal interactions and a positive atmosphere. By selecting responses rather than responding spontaneously difficult situations can be managed and a professional environment maintained.

The orthopedic patient's special need for wholistic caring.

The care of patients with musculoskeletal and subsequent orthopedic injuries is a challenging one for the nurse. Wholistic care involves much more than physical care although this is, in itself, a challenge. Care by staff, family, and friends who respond to the patient with orthopedic injuries must include attention to the complex adjustments that the patient is making psychologically to both present and future disabilities. The author's personal experience as an orthopedic patient was the impetus for this article.

When your client has had an accident.

Accident victims often experience difficulty finding meaning and logic in their accident. Confusion and depression are frequently emotions that will be felt until resolution occurs. In many cases other individuals assist in this struggle for resolution. The nurse often has opportunity to provide suggestions and support as the client struggles to find meaning.

Dealing with the "always sick" employee.

Somatoform disorders occasionally surface in employees and others who, ordinarily unknowingly, are reacting to the stresses in their lives. Somatization is a process by which individuals communicate psychological distress through physical symptoms, thus essentially making themselves ill. However, by learning to recognize the signs of possible somatic problems the manager can apply various strategies to decrease an employee's apparent physical problems and enhance job performance.

E-mail triage.

This article describes how hospital managers can use principles of triage when sending and receiving e-mail. It also discusses when e-mail should not be used, and when personal communication should occur.

Coping with a heightened level of stress.

Nurses are responsible for their own health. Knowledge about stress will increase ones repertoire of intervention possibilities. To really rev up your engine, address the energy drains, and incorporate simple life-style changes, like proper exercise, adequate nutrition, appropriate sleep, and a positive attitude. Take time for your spiritual life and emotional contentedness. Refueling your body will increase your day-to-day vigor and overall health.

Can stress make you lose your hair?

Many individuals are frightened by hair loss and are hesitant to speak about it. Many are unaware that stressors can causes hair loss and that hair care practices and habits can aggravate a hair loss situation. Intervention by the nurse in encouraging a person to have an adequate assessment and work-up can facilitate an accurate diagnosis. Supportive and appropriate therapy can then be arranged. The hair tells a story and can be associated with good health.