Teaching Critical Care Nursing Online for RNs.

Registered nurses are choosing to further their educational careers by seeking a bachelor's of science degree online (RN-to-BSN). The impetus for choosing the online delivery method is related to the ability to sign into a Learning Management System during times that are advantageous to their hospital work schedules, family, and daily living activities. The RN-to-BSN online option degree requires a Critical Care/Advanced Health Care Course as part of their curriculum plan; therefore, the article presents an overall view of the critical care course, the theoretical underpinnings for progression to the online delivery method, and examples of a module required by the critical care course.

Meeting the needs of family members of ICU patients.

Health care professionals have begun to view family members as an integral part of the healing process and the well-being of patients in the intensive care unit. The needs of family members may be varied, and nurses must become attuned to the family members' needs and acquire skills to direct interventions toward identifying and meeting those needs. The aim of the research study was to explore and identify the perceptions of family members' needs and to ascertain if those needs were perceived as met or unmet by the family members of patients housed in the intensive care units. The hypothesis proposed that a gap exists between identified needs of family members visiting intensive care patients and their perceptions of needs as being met or unmet. Data analysis included quantitative and qualitative methods.

Concept analysis: compassion fatigue and effects upon critical care nurses.

Walker and Avant's method of concept analysis was used to delve into the initial understanding of compassion fatigue, a relatively new concept being explored with critical care nurses and other health care professionals. The term was originally used in 1992 involving research exploring burnout experienced by critical care nurses when a trend emerged where nurses appeared to have lost their "ability to nurture." The term has since been used synonymously with secondary traumatic stress disorder. Two important goals exist for this article: First, theoretically to conduct a concept analysis of compassion fatigue, thereby providing information for critical care nurses to understand the concept as a universal human experience. Second, from a caring perspective, identifying the effects related to critical care nurses provides an opportunity to address physical and somatic consequences of compassion fatigue that will ultimately become important to nursing practice, education, and research.

A discussion of family-centered care within the pediatric intensive care unit.

Every year, thousands of children are admitted to pediatric intensive care for treatment. Many of these admissions are for acute injuries, but children with chronic illnesses requiring repeated hospitalization are also on the rise. Hospitalization of a child is extremely stressful for both the patient and family. Historically, intensive care units had restrictive visitation hours and did not allow for sibling visitation or multiple family members. Parents and family members were not encouraged to participate in care when at the bedside. As the shift toward family-centered care continues, many hospitals are now changing visitation policies to allow for active family involvement in patient care. Parents are now encouraged to participate in care. Intensive care units are modifying layouts of the unit to facilitate visitors and provide sleeping spaces for parents when available. Families are considered part of the team instead of visitors, and are included in the decision making process. The purpose of this article is to promote discussion of family-centered care in the pediatric intensive care unit.

Perceived met and unmet needs of family members of patients in the pediatric intensive care unit.

Extensive research has been conducted over the years with a general focus on the family members of adult patients in the critical care setting. The resulting recognition of the profound impact that the family has on the patients' outcomes has led to greater focus on the direct assessment and identification of perceived met and unmet needs of family members. In contrast to the adult patients needs, this descriptive, exploratory pilot study consisted of 20 family members who had pediatric patients in the pediatric intensive care unit. Families completed a 2-part instrument: the Demographic Data Questionnaire and the Needs Met Inventory. Data were analyzed and reported the top 10 always met/usually met needs and the top 10 never met/sometimes met needs in order of importance during the first 24 to 36 hours after admission of the pediatric patient. The overall items under the subscale assurance ranked the highest as perceived needs always met/usually met. The overall items under the subscale support ranked the lowest as perceived needs never met/sometimes met.

Factors influencing treatment delays for acute myocardial infarction.

Previous studies have supported the fact that delaying medical attention when suffering an acute myocardial infarction may lead to complications such as cardiac dysrhythmias, congestive heart failure, pericarditis, and rupture of heart structures. Gender and culture are often associated with delayed treatment times, with socioeconomic status as a silent interwoven barrier in seeking treatment. Delaying treatment times for clients suffering an acute myocardial infarction potentially poses a disadvantage for receiving occlusion-eliminating therapies. The purpose of this article is to begin discussion of the effects of delayed treatment outcomes regarding gender, culture, and occlusion-eliminating therapies.

Perceived needs of critical care family members: a phenomenological discourse.

A phenomenological study with Heideggerian hermeneutic contextual analysis was used to illuminate the perceived needs of family members who were in the critical care waiting room. Family members freely expressed their perceptions of perceived needs, and thick descriptions supported 4 explicit needs expressed by all participants. These needs were seeking information, trusting the professionals, being a part of the care, and maintaining a positive outlook. The dialogues of the participants were presented to develop awareness and stimulate conversation regarding the needs of family members in the critical care waiting room who are an integral part of the healing process of patients in the critical care unit.

Unmet needs of family members in the medical intensive care waiting room.

The descriptive, exploratory study consisted of 30 adult family members who completed a 2-part instrument: the Demographics Data Questionnaire and the Needs Met Inventory. Data were analyzed using descriptive and inferential statistics. The top 10 always met/usually met needs and the top 10 never met/sometimes met needs were reported in the order of importance during the first 24 to 36 hours after admission of a patient to the medical intensive care unit (MICU). The items under the subscale of information ranked highest as needs met. Unmet needs were to talk about negative feelings such as guilt and anger; to talk about the possibility of the patient's death; to have explanations of the environment before going into the MICU for the first time; to visit anytime; to talk to the same nurse every day; to have explanations given that are understandable; to feel there is hope; to have good food available in the hospital; to be assured it is alright to leave the hospital for a while; and to feel accepted by the staff.

Bioethical issues concerning death: death, dying, and end-of-life rights.

Ethical issues about death, dying, and a person's right to make end-of-life decisions have become one of the most legally complex and culturally sensitive areas to emerge in our time. Sensitive issues associated with a terminally ill individual's right to make end-of-life decisions and the disposition of those who are unable to make such decisions for themselves will keep healthcare professionals, medical ethicists, counselors, families, lawyers, judges, and legislators busy for years to come. Americans find it difficult to deal with end-of-life issues and would rather focus on what more can be done to save a life.

Critical care family members' satisfaction with bereavement experiences.

Heideggerian hermeneutics is used to illuminate the dialogues of 23 participants who experienced the death of a family member in the critical care unit within the past year. Those constructs that were considered helpful and satisfying during the process of losing the family member included information from the hospital staff, support from the family, and unrestricted visits. Those that were considered unhelpful and dissatisfying during the process of losing the family member included inaccessibility of the physician, cause of death, inadequate treatment, uncaring staff, and not being present at time of death. Constructs that were considered helpful and satisfying in the time since death were family, friends, and clergy. Those that were considered unhelpful and dissatisfying since death included legal/financial problems, dealing with bureaucracies, dealing with other bereaved family members, funeral homes, and organ donation.

Family presence during CPR: new decisions in the twenty-first century.

At present, a great deal of controversy exists on whether family members should be allowed during the resuscitation of a loved one at a hospital. Literature reports that family presence is beneficial in some cases. However, other literature, in contrast, indicates this practice is not advantageous. This article discusses recent findings and explores pros and cons of family members' presence during cardiopulmonary resuscitation. Making this information available to health care personnel provides information for future dialogue.