The role of the neonatal intensive care nurse in decision-making: Advocacy, involvement in ethical decisions and communication

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses’ perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal tertiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decision-making primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decision-making, where the view of all team members are considered

Eventos de vida estressantes entre idosos brasileiros residentes na comunidade Stressful life events in Brazilian community-dwelling elderly

Foram investigados eventos de vida estressantes em 544 idosos participantes do estudo PENSA, em Minas Gerais (74,6% de mulheres e 25,4% de homens; média de idade = 72,11; DP ± 8,29; sendo 42,1% de 60 a 69 anos; 39%, de 70 a 79 e 18,9%, 80 a 99). Os eventos compuseram as seguintes categorias: eventos relacionados à finitude (morte ou doença), problemas que afetam os descendentes, relacionados ao cuidado, eventos pontuais e bem-estar psicológico. Os homens relataram eventos pontuais (60-69), problemas dos descendentes (70-79), e finitude e bem-estar (> 80); as mulheres relataram eventos pontuais (60-69), problemas dos descendentes (60-79) e finitude (> 80). As mulheres consideraram os eventos como mais estressantes do que os homens. Resultados semelhantes têm sido relatados na literatura.<br>We examined stressful life events in 544 elderly participants of PENSA, in Minas Gerais (74.6% women and 25.4% men; age = 72.11; ± 8.29; 42.1% aged 60-69; 39% 70-79 and 18.9%, 80-99). Stressful life events were classified into categories related to: death and illness, problems affecting children, caregiving, turning points (transitions), and psychological well-being. Men reported turning points (60-69), problems affecting their children (70-79), death and illness and psychological well-being (> 80); women reported turning points (transitions) (60-69), problems affecting their children (60-79), and own death and illness (> 80). Women evaluated events as more stressful than men did. There are similar results in the literature