The Nursing clinics of North America
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Nurs. Clin. North Am. · Mar 2010
ReviewThe effect of telephone nurse triage on the appropriate use of the emergency department.
One of the first encounters many people have with a health care institution occurs in the emergency department. If that area presents a poor picture to patients and their families, the whole institution can be seen as negative. How a tertiary care facility identified a way to improve the appropriate use of the emergency dept is the focus of this article.
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The withdrawal, withholding, or implementation of life-sustaining treatments such as artificial nutrition and hydration challenge nurses on a daily basis. To meet these challenges, nurses need the composite skills of moral and ethical discernment, practical wisdom and a knowledge base that justifies reasoning and actions that support patient and family decision making. Nurses' moral knowledge develops through experiential learning, didactic learning, and deliberation of ethical principles that merge with moral intuition, ethical codes, and moral theories. Only when a nurse becomes skilled and confident in gathering empiric and ethical knowledge can he or she fully act as a moral agent in assisting families faced with making highly emotional decisions regarding the provision, withholding, or withdrawal of artificial nutrition and hydration.
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Nurs. Clin. North Am. · Dec 2009
ReviewThoughtful nursing practice: reflections on nurse delegation decision-making.
This article discusses delegation challenges and legal and regulatory oversight associated with delegation in the clinical practice setting. The authors address moral and legal attributes of the roles and responsibilities of health care providers regarding delegating health care interventions. The article also explores guiding principles and rules of delegation within professional standards, national practice guidelines, and state nurse practice acts. Nurse experts provide thoughtful reflection on nursing models and the role of delegation, emphasizing the critical role of delegation in extending the role of the health care professional in patient care services.
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Culture has been defined as the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. A culture of nursing refers to the learned and transmitted lifeways, values, symbols, patterns, and normative practices of members of the nursing profession of a particular society. To serve the unique and diverse needs of patients in the United States, it is imperative that nurses understand the importance of cultural differences by valuing, incorporating, and examining their own health-related values and beliefs and those of their health care organizations, for only then can they support the principle of respect for persons and the ideal of transcultural care.
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Nurs. Clin. North Am. · Dec 2009
ReviewNursing, religiosity, and end-of-life care: interconnections and implications.
The influence of religious beliefs and practices at the end of life is underinvestigated. Given nursing's advocacy role and the intimate and personal nature of the dimensions of religiosity and the end of life, exploring the multidimensional interplay of religiosity and end-of-life care is a significant aspect of the nurse-patient relationship and must be better understood. The question that must be faced is whether nurses' own belief systems impinge on or influence patient care, especially for patients who are at the end of life. When nurses understand their own beliefs and respect the religious practices and needs of patients and their families, it deepens the humanistic dimensions of the nurse-patient relationship.