ABSTRACT
PURPOSE: This clinical article explores how trauma-informed care (TIC) can be used by rehabilitation nurses with patients who have experienced pervasive adverse childhood experiences (ACEs). METHOD (INTERVENTION STRATEGIES): This clinical article gives suggestions for using the five guiding principles of TIC: safety, trustworthiness, choice, collaboration, and empowerment, as the best clinical practice. CONCLUSION: Implementing TIC promotes successful rehabilitation, improves patient outcomes, and reduces costs. For every $1 spent on TIC, $5 is saved in lifetime costs. CLINICAL RELEVANCE: ACEs cause physiological changes in the brain, leading to antisocial and risky behaviors, which may result in head injuries, spinal cord injuries, amputations, and multiple traumas with subsequent rehabilitation admissions, as well as obesity, and chronic illnesses. TIC is a cultural shift: We as providers must ask ourselves "What happened to this person?" instead of "What is wrong with this person?" Nurses are beginning to develop our literature and practice of TIC.
Subject(s)
Practice Guidelines as Topic , Rehabilitation Nursing/methods , Rehabilitation Nursing/standards , Wounds and Injuries/nursing , Humans , Life Change EventsSubject(s)
Drug Therapy/nursing , Geriatric Nursing , Polypharmacy , Aged , Comorbidity , Humans , Medication Adherence , Nurse-Patient Relations , Nursing AssessmentSubject(s)
Anemia, Sickle Cell/nursing , Emergency Nursing , Pain Management/nursing , Vascular Diseases/nursing , Acute Disease , Anemia, Sickle Cell/complications , Health Services Accessibility , Humans , Nurse-Patient Relations , Practice Guidelines as Topic , Severity of Illness Index , Vascular Diseases/etiologyABSTRACT
PROBLEM: The sequelae of a stroke can negatively affect sex and intimacy for survivors and their partners. PURPOSE: This clinical article offers practical evidence-based recommendations for nurses to use in advising couples who may be experiencing sexual problems due to decreased desire, erectile dysfunction, vaginal dryness, paraparesis, pain, spasticity, fatigue, aphasia, concrete thinking, emotional lability, shame, embarrassment, fear, depression, or neurogenic bladder. KEY FINDINGS AND CLINICAL RELEVANCE: Recent research and clinical articles show that intimacy and sexual concerns are often ignored by the rehabilitation team, yet research shows that couples want information to assist them to maintain their sexual relationships. Using the PLISSIT model to address sexual concerns, nurses can facilitate discussions to aid couples toward improved sexual function and quality of life.
Subject(s)
Sexual Behavior/psychology , Stroke/psychology , Survivors/psychology , Adaptation, Psychological , Aged , Aged, 80 and over , Aging/psychology , Female , Humans , Male , Middle Aged , Quality of Life/psychology , Rehabilitation Nursing/education , Rehabilitation Nursing/methodsABSTRACT
Hospital immobilization after a cardiac event can cause complications. The pathophysiology of complications, research concerning benefits of early ambulation, and recommendations from the American College of Sports Medicine are discussed.
Subject(s)
Cardiac Rehabilitation , Early Ambulation , Cardiovascular Surgical Procedures , Hospitalization , Humans , Myocardial Infarction/therapy , Postoperative CareABSTRACT
Giving family members the option of being present during resuscitation has been shown to be beneficial for both family and staff. However, only a small percentage of intensive care units have policies promoting family-witnessed resuscitation. This article reviews current research showing the benefits of family-witnessed resuscitation, outlines how to successfully integrate a family facilitator during resuscitation, and includes research that has been effective in changing the prevailing attitudes of staff. The authors also argue for the resuscitation team to practice ethical and cultural humility when involving family members so that all resuscitation efforts are a success, whether the patient lives or dies.
Subject(s)
Attitude of Health Personnel , Family/psychology , Resuscitation/psychology , Visitors to Patients/psychology , Dissent and Disputes , Humans , Professional-Family RelationsABSTRACT
Elective laparoscopic cholecystectomies are common outpatient surgical procedures. After briefly discussing cholecystectomy and its indications, best practices in phase I, phase II, and phase III recovery are discussed. Typical pharmaceutical regimens for controlling pain and postoperative nausea and vomiting are summarized. By implementing best practices, nurses can prevent and recognize complications. The criteria for discharge, extended recovery, and inpatient admission are discussed, along with the required patient discharge teaching using the teach-back technique, as well as patient and family teaching needs in the immediate postoperative period. Nurses can optimize the patient's surgical experience and promote safety by implementing best practices in all phases of recovery from laparoscopic cholecystectomy.
Subject(s)
Cholecystectomy, Laparoscopic , Postoperative Care , Education, Continuing , HumansABSTRACT
Death is common in the intensive care unit. Some patients are surrounded by family; others, with only nurses and physicians by their side. This article describes the experience of a critical care nurse caring for a patient in his last hours and in the hours after his death. These extraordinary measures left her with a sense of peace and pride in being an intensive care unit nurse.
