Spinal cord injury in the elderly.

Caring for patients who have sustained an SCI requires the nurse to be knowledgeable in the pathophysiology of the disorder, the sequelae following the injury, and the nursing care activities. Additional knowledge is required of the nurse when the patient with SCI is elderly. The nurse must be familiar with the changes in the body systems caused by aging, the alterations in the spine from aging, and how these changes impact the sequelae and nursing care activities.

Experiences of critical care nurses caring for unresponsive patients.

Grounded theory methodology was utilized to explore the experiences of critical care nurses caring for patients who were unable to respond due to a traumatic brain injury or receiving neuromuscular blocking agents. The registered nurses participating in the study worked in a neuroscience intensive care unit. Saturation of the categories was achieved with 16 interviews. The core category that emerged from the study is Giving the Patient a Chance. The subcategories of Learning about My Patient, Maintaining and Monitoring, Talking to My Patient, Working with Families, Struggling with Dilemmas and Personalizing the Experience all centered upon the focus of doing everything to help the patient attain the best possible outcome. Factors influencing each of the subcategories were identified such as the acuity of the patient, experience level of the nurse and the presence or absence of family members or significant others. These factors accounted for the variations in the nurses' experience. Several reasons accounting for the variations were determined. The study identified areas that need to be addressed in both general nursing education and nursing practice, such as instruction on talking to comatose patients, working with families and orientation information for nurses new to caring for these populations. Recommendations for improvement in these areas, as well as for future studies are discussed.