Finding and keeping nurses: every hospital manager's challenge.

To reduce the impact of the nursing shortage, hospital administrators must do whatever is necessary to develop an environment where nurses want to work. Nurses have many choices in job selection, and they must be able to clearly perceive the benefits of working in one hospital over another. Hospital administrators who have a desire to be leaders in quality patient care must be innovative and creative in their attempt to recruit and retain nurses. The shortage of nurses is not only real but is probably permanent. The economics of the health care industry are not likely to change. The winners will be the nurses, as their overall quality of work life will improve.

Student success begins with the course guide.

Nursing faculty have seen enrollments increase over the past few years. Many of these students are from non-traditional applicant pools: minority groups, re-entry students, second career starters, males, and culturally diverse individuals. Greater numbers of nurses and nursing students from a broader population base represent a very positive trend for the nursing profession as a whole. This new trend can be credited as a result of extensive efforts beginning in the 1980's to ease the nursing shortage in the United States. Yet teaching students with such a wide variety of backgrounds can be quite a challenge for faculty. Many students have special learning needs that are addressed poorly in the traditional academic setting, but funding cuts and faculty shortages have limited opportunities for universities to provide special programs. Faculty must become more creative in their efforts to meet students' needs with fewer resources. One teaching/learning tool that is literally within the grasp of every course instructor, but is highly underrated and inefficiently prepared or used, is the course syllabus or guide. Adult learners of all populations benefit from a well organized course guide, and it remains one of the most basic and cost-effective instructional aids that any teacher can supply for a student.

Cystadenoma and cystadenocarcinoma of the pancreas.

Cystadenoma and cystadenocarcinoma comprise the majority of the true neoplastic cysts of the pancreas. Five cystadenomas and two cystadenocarcinomas of the pancreas were found in a review of the clinical records of the University of Minnesota Hospitals and the Minneapolis Veterans Administration Hospital. The report of these cases serves to review the clinical and pathological features of these neoplasms. These rare neoplastic cysts occur predominantly in women and are not associated with a history of trauma, alcoholism, or pancreatitis. They produce symptoms by compression of neighboring organs and are slow growing, often attaining large size. With complete excision the results of surgical treatment are usually good.

Diagnostic peritoneal lavage in evaluating acute abdominal pain.

A study was performed to determine the value of peritoneal lavage in the acute abdomen not related to trauma. Lavage was performed in 33 patients in the evaluation of abdominal pain of sufficient degree to warrant consideration for surgical intervention. Peritoneal lavage was truly positive or truly negative in 64% of the cases. It showed false negative results in 28% and false positive results in 8%. The lavage was most accurate in the evaluation of appendicitis, colonic disease, and intra abdominal bleeding. It was highly inaccurate in the evaluation of cholecystitis and peptic ulcer disease. It was concluded that the peritoneal lavage can be a useful adjunct in the evaluation of patients with abdominal pain and should be considered in difficult diagnostic problems but not routinely employed.

Results of routine preoperative sigmoidoscopy and barium enema on patients with inguinal hernia.

The diagnostic findings of history, physical examination, rectal examination, barium enema, and sigmoidoscopy in 684 patients with the initial complaint of inguinal hernia were examined. History and physical examination led to the diagnosis of four cancers of the colon and one villous adenoma. No significant new findings were made by sigmoidoscopy when symptoms elicited by history did not indicate some abnormality. A cost analysis of finding significant disease in these patients with inguinal hernias indicates that in-hospital evaluation by barium enema and sigmoidoscopy is probably not warranted.