Creating a positive surgical experience for patients.

Perioperative nurses strive to provide a positive surgical environment and, thus, a positive surgical experience for all patients. Blending traditional medicine with complementary therapies is one way to accomplish this task. This article presents a brief review of literature about traditional and complementary interventions used successfully in health care settings, along with a case study illustrating how one facility integrated these therapies into surgical patient care. The facility's goal was to increase patient satisfaction and create a positive surgical experience.

Hospital and parish (county) utilization of master's-prepared nurses in Louisiana.

Recent regulation in Louisiana involving advanced practice nursing, combined with new educational standards at the Master's level established by the Louisiana State Board of Nursing, prompted a statewide survey of hospitals and parish health units. The purpose of the survey was to determine whether and to what extent Master's-prepared nurses were being used in Louisiana and to identify the importance placed on role functions and activities generally associated with the advanced practice nurse (APN). The survey included open-ended questions concerning expectations about future hirings and perceptions of future roles and duties of the Master's-prepared nurse as well as suggestions to educators on what is needed to better prepare nursing students at the Master's level. Results from this exploratory survey provide information on APN utilization with implications for nursing educators and administrators as well as APNs.

Expert witness/legal consultant: the importance of data collection.

Claims resulting from medical negligence are increasing at an alarming rate, resulting in an increasing demand for nursing specialists who can act as a legal consultant or expert witness. This article reviews the role of the nurse as a legal consult and/or expert witness, emphasizes the importance of data collection, and offers a list of healthcare-related documents, records, materials, and other evidence to assist the consultant.

Acute intermittent porphyria: a nursing case study.

Nursing care for a patient with AIP can be challenging. AIP is a complex disease with various signs and symptoms and is often misdiagnosed. Recognition of the signs and symptoms of AIP could be life-saving. Ways to avoid exacerbations, as well as counseling regarding possible genetic transmission, are important aspects of the nursing care of individuals with AIP.

Nurse consultant and professional liability.

The expanded role of nurse consultant brings greater responsibility and risk of professional liability in a litigious society. The nurse consultant needs to be aware of the elements that constitute malpractice and be able to plan for the management of risks involved. When purchasing a liability policy, the nurse consultant must consider the practice setting, types of policies, components of the policy, cost, and means to obtain adequate coverage. Other strategies for protection include proper use of the consultant process, client communication, and individualized client contracts. A well-written contract serves as a legal document to delineate responsibilities and outcomes, provide a professional image, and protect against possible negative developments.

Surgical management of congenital tracheal stenosis.

Congenital tracheal stenosis is a rare and potentially lethal malformation. Although congenital tracheal stenosis carries a high mortality rate, advances in surgical treatment have increased the likelihood of survival, and these patients are seen with increasing frequency in intensive care units. The surgical options available are dilation, resection, and tracheoplasty. Because of the lack of a prosthetic replacement, resection is generally limited to lesions involving less then one third of the trachea. Tracheoplasty with a variety of graft materials has, in some cases, been successful in increasing the diameter of the stenotic trachea. Postoperative care involves maintaining paralysis and sedation until healing is established, with close attention to preventing complications. The needs of the family are addressed through teaching and support. A case of successful tracheal reconstruction, by use of an autologous cartilage graft, in a 14-day-old infant with severe stenosis from just below the vocal cords extending to the hilum is presented.

Calcium channel blockers: nursing care for hypertension.

Calcium channel blockers are gaining wider use in patients with cardiac disease, particularly hypertension and angina. The nurse must be aware of the actions, side effects, and interactions of these agents if they are to be administered safely.

Sexuality and the older woman.

The nurse has a responsibility to be informed of the sexual needs of older patients and the physiological changes due to aging. Through education of the patient, family and other health care personnel, the nurse can do much to change their knowledge about sexuality in the older woman (Steinke, 1988), and encourage a healthy perspective and sexuality.

The essentials of win--win negotiation for the clinical nurse specialist.

Clinical nurse specialists (CNSs) must negotiate conflicts daily as they come in contact with patients, families, and other professionals. To be a successful negotiator, the CNS must understand the process of reaching a satisfactory settlement of differences in a conflict situation. The process involves identifying the problem, collecting facts and analyzing the situation, deciding on goals, and identifying tactics. The use of role play, third party advice, and influence, as well as negotiation strategies is discussed along with a relevant case presentation.