The nursing shortage in California: the public policy role of the California strategic Planning Committee For Nursing.

California is experiencing a nursing shortage resulting from multiple factors. The purpose of this article is to summarize nursing shortage issues in California and present the role of the California Strategic Planning Committee for Nursing (CSPCN) in addressing the issues from a public policy perspective. Reasons for the development of CSPCN as well as goals, objectives, and phases of work are presented. Selected findings from CSPCN's 1999 synthesis of data on the demand for and supply of nurses as well as resulting recommendations are summarized. The role of CSPCN in public policy initiatives is described.

Differences in fatigue by treatment methods in women with breast cancer.

PURPOSE/OBJECTIVES: To investigate the differences between various cancer therapies (radiation, hormonal, chemotherapy, and their combinations) and the specific dimensions of fatigue (affective meaning, behavioral/severity, cognitive/mood, and sensory). DESIGN: Descriptive, cross-sectional, mailed survey design. SAMPLE AND SETTING: Data were collected from women who were breast cancer survivors and members of a nonprofit educational organization in the North-east. Criteria for this study included no self-reported disease recurrence, and treatment was within 18 months prior to the mailed survey (N = 322). The typical participant was middle-aged (mean = 52.2; SD = 10.3), Caucasian (93%), postmenopausal (55%), and diagnosed with cancer 2.42 (SD = 2.6) years prior to the study. METHODS: Secondary data analysis from a study using the Piper Fatigue Scale. VARIABLES: Level of fatigue. FINDINGS: Significant differences were found by treatment in total fatigue scores (p < 0.03) and cognitive/mood scores (p < 0.05). Women who received combination therapy had the highest fatigue scores (mean = 4.8; SD = 2.0); those who received only radiation therapy had the lowest fatigue scores (mean = 2.7; SD = 2.0). CONCLUSIONS: Fatigue in breast cancer survivors varies by type of cancer therapy. Future studies are needed to investigate the relationships between fatigue and hormonal therapy, and they need to be designed to examine changes over time. IMPLICATIONS FOR NURSING PRACTICE: Study findings advance knowledge about fatigue in women with breast cancer and aid nurses in providing anticipatory guidance for women undergoing different treatment regimens.

Education and practice partnerships in California.

As the most populous state in the United States, California often serves as a bellwether of events to come. The following describes nursing work force issues in California, examples of how nurse educators are responding to health care system changes, and how practice colleagues are joining educators to prepare nurses for meeting the health needs of the people of California. The discussion begins with historical perspectives from the late 1980s to the present, the founding of the California Strategic Planning Committee for Nursing and its work, the Robert Wood Johnson Colleagues in Caring project for developing a master plan for nursing in California, and examples of existing programs in California that serve as models for preparing the best care providers to meet the health care needs of the population.

Quality-of-life issues in home care.

Quality-of-life issues in home care are complex. Nurses not only must help the family consider these factors for the patient at home, but also they must examine the effects of home care on the primary caregiver and the entire family. Nurses use a holistic view in assessment to diagnose the needs of the client and the caregiver. Physiologic, psychologic, cultural, spiritual, and sociologic aspects are all considered. Nurses have an important role in assisting clients and their families to maximize the benefits of home care. They can help them with the provision of care in the current situation and to plan for the future for appropriate levels of care as the client's condition changes. These actions will result in an optimum quality of life for the client and the client's family.

Home health care and geriatric nursing.

Future articles on home health care will discuss in depth many of the issues raised in this first section. After the proposals for health care reform are presented in detail to the nation, analyses of their effect on home health care and geriatric nursing will be reviewed by leaders in the field. Clinical practice changes and issues in home health care nursing will also be discussed as innovations, regulations, consumer demands, and funding sources take effect. Readers are encouraged to submit issues and ideas of interest to the Journal for experts to discuss in future articles.