My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death.

AIM: The purpose of this study was to examine, on a national level, nursing students' perceptions after experiencing a patient death. BACKGROUND: Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in actual death situations. METHOD: A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey was sent to the membership of the National Student Nurses' Association. Of approximately 55,000 members, 2,480 responded to the survey. RESULTS: Experiencing a patient death as a student occurred for 41 percent of participants in the nationally representative sample. Of those who experienced a patient death, 64 percent did not receive any debriefing. CONCLUSION: Most nursing students did not feel prepared to care for a dying patient and the patient's family. Students need and want more education on end-of-life nursing care.

Nursing Students' Clinical Experience With Death: A Pilot Study.

Although debriefing in simulation settings is routine in nursing education, debriefing does not routinely take place in clinical settings with nursing students after a patient has died. This pilot study sought to explore nursing students' perceptions of their first experience with the death of a patient. Students reported emotional distress and feelings of inadequacy with regard to communicating with and supporting the family of the dying patient. Only half the students sampled reported debriefing by their clinical instructor or staff. Nurse educators must include debriefing and student support following a patient death in the clinical setting.

The nurse's role in primary care antidepressant medication adherence.

Depression remains one of the most common conditions seen in primary care settings. Antidepressant medications (ADMs) are considered standard treatment for moderate to severe depression, and in some instances, for minor depression. When ADM adherence is low, patients are at risk for treatment failure and poor quality of life. Nurses may be key in ensuring the success of ADM therapy; however, little is known about the interventions nurses use or the consequent patient outcomes. The objectives of this article were to identify studies in which nurses managed ADM adherence and to collect evidence about the efficacy of these interventions. A systematic literature review of clinical trial studies was conducted, which specifically included the role of the nurse. Nurse interventions identified were: patient care management, medication monitoring, depression education, and referrals to specialty providers. Nurses use a range of interventions to manage ADM adherence. In most studies, these approaches, including collaborative care, were efficacious.

Developing positive attitudes toward geriatric nursing among Millennials and Generation Xers.

Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults.With the understanding that younger adults see a need to balance work and play, a baccalaureate nursing program provides examples of ways to accomplish this through integration of courses, simulations, positive images of aging, and learning activities that enhance empathy for both frail and healthy older adults.

Factors associated with antidepressant medication adherence and adherence-enhancement programmes: a systematic literature review.

Medication adherence is critical to the efficacy of available treatment for depression in primary care settings. This review identifies factors associated with adherence and what is known about the effectiveness of adherence-enhancement programmes. A comprehensive systematic review of English language publications from January 2002 to October 2011 was conducted using the following databases: PUBMED/MEDLINE, PsycINFO and the Cochrane database. Twenty-one studies met the inclusion criteria for adherence-enhancement evaluations. Eleven of the studies evaluated demonstrated significantly positive effects on adherence; the remaining 10 reported mixed or no effects. Similar to previous literature reviews, factors shown to be associated with adherence were multifactorial and in this analysis were grouped as patient, condition and comorbidities, therapy or treatment, patient-provider relationship and healthcare system level. Adherence improved most notably in studies that included sustainable system and patient-targeted changes. Evaluating adherence-enhancement interventions is key to promoting successful approaches; however, a number of gaps exist between intervention and implementation: (1) the cost in resources and time to implement and sustain these programmes is unknown, (2) specific details about which subgroups of patients are best helped with such programmes is not clear, and (3) what specific processes or content are critical to programme success is still to be identified. There are sufficient data supporting the substantial need for planning and implementing adherence interventions despite reported mixed results. Primary care providers are often positioned to impact patients' adherence; however, practice constraints can limit their implementation.

Practical considerations in establishing sustainable international nursing experiences.

An understanding of global health and the development of cultural competence are important outcomes of today's baccalaureate nursing programs. Thoughtfully designed international experiences can provide excellent opportunities to achieve those outcomes. Based on 16 years of providing international experiences within a baccalaureate curriculum, components are identified that contribute to the development of a sustainable international program. Areas addressed in the article are evaluating the fit with university and college mission, establishing the program within the university operational structure, selecting faculty and students, developing sites, designing a course, and program evaluation.