Nursing science quarterly
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Nursing science quarterly · Jan 2016
Nurse Practitioners: Knowledge, Skills, and Leadership for the End-of-Life Conversation in Intensive Care.
An impending policy change in Medicare will provide reimbursement for the end-of-life conversation. The rise in numbers of older adults who face serious illness coupled with advances in healthcare technology are increasing the need for providers to address end of life issues in the acute care setting. Doctoral-level nurse practitioners who specialize in acute care of older adults are poised to be leaders and facilitators of this conversation in a particularly challenging context-the intensive care unit. The focus of this article is the new end-of-life policy in relation to the particular contributions that adult gerontology acute care nurse practitioners offer in the acute care setting.
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Through the use of story, this article explores the notion of moving with mediocrity and excellence. Insights gleaned from the stories presented are identified for nursing and healthcare. Parse's humanbecoming community change model and family model are utilized as the perspectives for developing a deeper understanding of mediocrity and excellence.
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Living on the edge was explored employing the Parse research method. Ten participants living in the frontier of the American West were asked, "What is the experience of living on the edge?" The findings showed the structure of living on the edge as: Living on the edge is persevering with pioneering ventures amid perilous remoteness, as vacillating sentiments arise with diverse affiliations. Understanding the experience of living on the edge as it relates to health and quality of life is important for nursing practice and advances nursing science.