ORL nursing: where we have been and where we are going.

In 1873, formal training for nurses in the United States began on the east coast with the formation of hospital-based schools (Schoor & Kennedy, 1999). Upon completion of the two to three year program, graduate nurses took positions in private homes as private duty nurses. Hospitals needed only a few supervisory nurses since student nurses provided most of the patient care. The popularity of private duty nursing continued for many years and was slowly replaced by hospital staff nursing in the 1930s. This article provides an overview of ORL nursing and the advent of certification in ORL specialty nursing.

Highlights from the Hill: it is an election year: shall I get involved?

Nurses are becoming players in the field of health policy and are increasingly involved in the political process at all levels: national, state and local. To become a "player" in the often intimidating world of politics may seem complicated and unapproachable. One of the easiest ways to show interest and to learn is by volunteering during an election year. There are many avenues that may be followed and this article offers an introduction as to what to do, how to do it, and why your actions will make a difference.

Caring for the Islamic patient.

The delivery of culturally sensitive care by perioperative nurses is an essential element of patient advocacy. To provide culturally astute care, nurses must familiarize themselves with the world's religious and ethnic groups. Islam is a worldwide religion and, like all religions, is practiced along a spectrum ranging from very conservative and traditional practices to the more liberal and contemporary ones. A person may accept some, all, or none, of the principles discussed in this manuscript. Additionally, the patient's country of origin plays an integral role in the planning of culturally competent care.

The 21st annual SOHN congress.

In a recent Presidential Perspectives column (see ORL-Head and Neck Nursing, Vol. 15, No. 3, Fall 1997, p. 4), Mary LeGrand described the impact that volunteerism can have on the success of an organization. The following article lends a prime example of how one SOHN member volunteers her services at both the local and national levels, donating her time and talents, reaping the rewards of her experiences, and ultimately sharing her thoughts in the following article.

How I do it--a trip to the seashore with Mr. Sun Bunny....

This clever teaching plan for healthy children can serve as a role model for nurses who are looking for creative ways to become involved in community-based activities.

Treatment of conductive hearing loss with ossicular chain reconstruction procedures.

Middle ear infections and ossicular disorders can cause conductive hearing loss. Ossicular disorders include fibrous unions in which scar tissue replaces the long process of the incus; disarticulations caused by previous surgical procedures or cholesteatomas; fixation from otosclerosis, cholesteatomas, or congenital malformations; and dislocations caused by trauma. Surgical reconstruction procedures, with the insertion of partial or total ossicular replacement prostheses, help restore conductive hearing. Patients who undergo these delicate procedures have significant hearing deficits and require sensitive, skilled perioperative nursing care.

Thyroplasty type I for unilateral vocal cord paralysis.

Unilateral vocal cord paralysis may occur with trauma, neoplasms, mechanical or central nervous system dysfunction, or following extensive aortic and mediastinal vascular surgery or thyroidectomy. Thyroplasty type I is a form of laryngeal framework surgery (ie, phonosurgery) used to treat unilateral vocal cord paralysis. A silicone implant is placed inside a surgically created window in the thyroid cartilage and pushes the paralyzed cord medially, allowing the moving cord to touch the paralyzed cord and close the opening. The procedure is performed under monitored local anesthesia with sedation so the patient can phonate during the procedure. Airway compromise is the main complication associated with this procedure.

Vestibular neurectomy. Midfossa approach for Menière's disease.

Surgical intervention and nursing management of the patient with Meniere's disease is a modern-day nursing challenge. It has allowed many patients to return to daily living and active employment with relief of symptoms and added feelings of well-being and self-worth.