What is the experience of assisted dying for Dutch healthcare staff working in a hospice or chronic disease care centre?

What is the experience of assisted dying for Dutch healthcare staff working in a hospice or chronic disease care centre? Background: Assisted dying is a contemporary issue with worldwide interest. Debate has largely focused around individuals seeking the right-to-die. Lacking thus far has been consideration of the experience of clinical staff. This research was conducted at a chronic disease centre and a hospice in the Netherlands where permissive legislation was first enacted. Aim: The aim of this research was to explore and gain a deeper understanding of the assisted dying experience of Dutch healthcare staff to inform and broaden the global debate. Methods: This study provides the first application of a constructivist qualitative inquiry with three professional groups to analyse the care experience of 21 doctors, nurses and therapists practising in the Netherlands. Data from semi-structured interviews were analysed using thematic analysis to identify latent and semantic themes from which new insight was gained. Findings: Requests for an assisted death were received and processed by all staff groups. Large numbers were heard at the hospice where fifty percent of the patients wanted to discuss it. Requests required an assessment of seriousness, an exploration of patient fears and an evaluation of psychological status. Optimum palliative care had to be ensured. Such measures were found to resolve or delay the majority of requests. Assisted deaths challenged staff and were perceived as not normal. The administration of lethal drugs and post-death case scrutiny were stressful for doctors. After death debriefing and psychological support were valued by staff, but adjustment took some time. Doctors reported a recovery period in which they were unable to respond to further requests rising equity of access issues. The involvement of nurses and therapists, including activities previously unreported, safeguarded patients. The provision of assisted dying was perceived as significantly increasing workload, but this was not resented. Support for the provision of assisted dying was overwhelming, but this was unqualified in only a third of participants

Nurse Retention in Workplace Adversity

Practice Problem: Nurse turnover rate and lack of retention are issues that have an impact on safe patient care, patient mortality, quality outcomes, and patient experiences in the acute care units at the identified project setting. Turnover leads to excess labor utilization of overtime and increased hospital costs. PICOT: The PICOT question that guided this project was (P) In acute care hospital nurses, how do (I) nurse retention strategies (C) compared with no nurse retention strategies (O) reduce nurses’ intention to leave and increase job satisfaction over (T) eight weeks? Evidence: Twenty-one articles were reviewed that identified autonomy, recognition, acknowledgement, communication, and transformational leadership as nurse retention strategies, which contributed to a positive workplace environment and led to improved job satisfaction and nurse retention. Intervention: The intervention consisted of focused communication that included staff recognition and acknowledgement by the nurse leaders of each unit, which had a positive effect on the workplace environment and job satisfaction. Outcome: The results indicated a statistically insignificant change in job satisfaction and intent to stay yet did show a clinical significance. Conclusion: The benefit of the project was that there was a clinically significant change in behaviors including: verbal expressions of increased job satisfaction, notable positive attitudes and hopefulness, as well as staff resilience. Consistent leadership and a larger sample size may produce statistical significance in a future study

Proposal for Two Phonetic Characters

This is a proposal to add two phonetic characters to the international character encoding standard Unicode. The characters were published in Unicode Standard version 7.0 in June 2014

The Psychological Stress Evaluator: Yesterday\u27s Dream - Tomorrow\u27s Nightmare

This note will examine the manner in which the Psychological Stress Evaluator functions and explore the legal implications stemming from its use as a lie detector. More specifically, three issues which arise in connection with the use of the PSE will be discussed: first, the validity and reliability of the PSE; second, the admissibility of PSE test results in evidence; and third, the potential remedies for subjects of PSE tests who have occasion to object

Dr. Lois Hattery Tiffany (1924-2009): In Memoriam

Dr. Lois Hartery Tiffany, Distinguished Professor Emerita, Department of Ecology, Evolution and Organismal Biology, Iowa State University, Ames, Iowa, died on 6 September 2009. Dr. Tiffany was an outstanding mycologist and teacher. Held in high regard by the public as Iowa\u27s Mushroom Lady and known by many students, colleagues and friends as Dr. T., she was the matriarch of the Botany Department (now the Department of Ecology, Evolution and Organismal Biology) at Iowa State

Preventative Oral Health Services Provided by Nurses\u27 Aides to Nursing Home Residents

The purposes of this investigation were to identify: 1) what preventive oral health services were provided by nurses\u27 aides to nursing home residents, 2) how frequent preventive oral health services were performed by nurses\u27 aides, 3) who nurses\u27 aides reported abnormal or suspicious findings detected in the resident\u27s mouth, 4) what factors discouraged and encouraged nurses\u27 aides performance of oral health services, and 5) how nurses\u27 aides rated their oral health knowledge of services they performed. The study population was comprised of a random sample of 40 percent of nursing home facilities in southeastern Virginia. A 14-item questionnaire was administered to nurses\u27 aides employed at 11 (79 percent of sample) nursing home facilities. Data were analyzed using the Statistical Analysis System (SAS). Frequency distributions and percentages were tabulated for discrete, nominal, and ordinal scaled data. Results suggest that nurses\u27 aides employed in southeastern Virginia nursing facilities typically perform preventive oral health services such as toothbrushing, mouthrinsing, and denture cleaning procedures for nursing home residents. The majority of nurses\u27 aides indicated that patient cooperativeness was a major factor that encouraged or discouraged the performance of oral health services. Nurses\u27 aides typically reported suspicious and abnormal findings detected in residents\u27 mouths to the nurse in charge of shift. The majority of nurses\u27 aides rated their oral health knowledge of denture cleaning and toothbrushing as excellent. However, a large percentage of nurses\u27 aides rated their oral health knowledge of saliva substitutes and flossing as poor

Exercise as a Treatment for Fibromyalgia: A Scoping Review

Fibromyalgia is a chronic, disabling condition that is both challenging to manage and frustrating for the patient and primary care provider. The aim of this scoping review is to explore how nondrug treatments, such as exercise, can reduce pain and promote physical function in adults with fibromyalgia (FMS). The body of literature on exercise as a treatment for FMS has identified beneficial effects, but there is no standardized approach for prescribing an exercise regimen in primary care. We conclude with a synthesis of general recommendations for exercise approaches to support care for patients with FMS