Palliative and End-of-Life Care: Precepts and Ethics for the Orthopaedic Population

Since the emergence of reports such as the National Consensus Project for Quality Palliative Care (2013) and the National Association of Orthopaedic Nurses Palliative Care Consensus Document (2005), there continues to be a growing recognition of the multiple adverse effects of serious illness and chronic conditions, as well as the potential benefits of receiving palliative or end-of-life care. As modern technology expands its ability to support life, ethical dilemmas may be encountered in the provision of palliative or end-of-life care. Through integration of the precepts of palliative care and consideration of the relevant ethical principles, orthopaedic nurses may best meet their patients\u27 comprehensive needs at an exceedingly difficult time

The Rhetoric of Hospitality: Conditions of Death in America

The Right of Hospitality: Conditions of Death in America calls Western biomedicine’s approach to death into question. Death unifies all human experiences and is always possible, despite the human tendency to deny its existence and, instead, orient the self towards a futurity that is always out of reach. This project investigates the structures influencing how death in America occurs, and traces the roots of Western culture’s rejection of death to the execution by hemlock of Socrates’ immortalized in the Phaedo. Western biomedicine’s institutionalization of medicine requires that both patients and doctors enter into imbalanced hospitable relationships, and these pressures, along with the rejection of discourse about death, make for a difficult and dehumanizing end-of-life care system in America today. Case studies of contemporary experiences of death—including Oregon State’s Death with Dignity Act, Brittany Maynard’s end-of-life activism, and a patient’s dissatisfaction at the extension of his life—provide opportunities for teasing out the ethical issues surrounding end-of-life. Ultimately, the options presented to patients at end-of-life are not simply a matter of hospitality; they are a human rights issue. This issue promises to dramatically alter the experiences of the world’s rapidly growing number of humans kept alive by modern medicine, and if it is left uninvestigated, will force Americans into woefully insufficient end-of-life care

Clinical Observation Reflections from Students in an Interdisciplinary Palliative Care Course

The purpose of this study was to gain insight into how a brief clinical observation encounter contributed to students’ experiences in an interdisciplinary palliative care course. This course was required of all graduate nursing students and was available as an elective for medical and other healthcare professions students at a healthcare sciences university. The students were required to spend approximately 8 to 12 hours attending interdisciplinary team meetings or accompanying a team on rounds and patient visits. The students’ summary narratives of their observation experience were analyzed in this qualitative study that focused on six categories of feedback: (1) patients’ and families’ reactions, (2) communication issues with patients and families, (3) how the palliative care team speaks with the patient and family, (4) communication within the interdisciplinary team, (5) students’ reflections, and (6) students’ suffering. This study demonstrated that a clinical observation activity can be a valuable introduction to palliative care principles for healthcare students in an interdisciplinary course. Students benefited from gaining insight into family/practitioner communications regarding difficult issues, interdisciplinary roles and cooperation, and application of palliative care principles to clinical practice. Further research is required to identify appropriate interventions to deal with student distress resulting from such early career clinical encounters

How it Came to Be…Integrating Ignatian Philosophy and Pedagogical Paradigm into Marquette University’s Pre-Licensure Nursing Curriculum

This article describes the process that Marquette University’s College of Nursing used to revise its prelicensure nursing curriculum. More specifically, it explains how faculty discussions, with the Vice President of Mission & Ministry and a faculty member from the Department of Theology, which is centered on the philosophy of St. Ignatius of Loyola, and faculty participation in the Marquette Colleagues Program helped ameliorate the curricular change. The article also addresses how faculty selected the Ignatian Pedagogical Model as the framework for the revised curriculum; and the development of faculty and students for an enhanced understanding and application of Ignatian philosophy, spirituality and the IPP in the classroom and their daily life

An Online Educational Program Improves Pediatric Oncology Nurses’ Knowledge, Attitudes, and Spiritual Care Competence

This study evaluated the potential impact of an online spiritual care educational program on pediatric nurses’ attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. It was hypothesized that the intervention would increase nurses’ positive attitudes toward and knowledge of spiritual care and increase nurses’ level of perceived spiritual care competence. A positive correlation was expected between change in nurses’ perceived attitudes toward and knowledge of spiritual care and change in nurses’ perceived spiritual care competence. A prospective, longitudinal design was employed, and analyses included one-way repeated-measures analysis of variance, linear regression, and partial correlation. Statistically significant differences were found in nurses’ attitudes toward and knowledge of spiritual care and nurses’ perceived spiritual care competence. There was a positive relationship between change scores in nurses’ attitudes toward and knowledge of spiritual care and nurses’ spiritual care competence. Online spiritual care educational programs may exert a lasting impact on nurses’ attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. Additional studies are required to evaluate the direct effects of educational interventions patient outcomes

Policy Recommendations for Meeting the Grand Challenge to Build Financial Capability and Assets for All

This brief was created forSocial Innovation for America’s Renewal, a policy conference organized by the Center for Social Development in collaboration with the American Academy of Social Work & Social Welfare, which is leading theGrand Challenges for Social Work initiative to champion social progress. The conference site includes links to speeches, presentations, and a full list of the policy briefs

Financial Capability and Asset Building: Achievements, Challenges, and Next Steps

In the midst of a global pandemic that brought untold numbers of families to a financial precipice, experts came together to examine the role of social work in ensuring financial security and equity for all. This conference report details the most recent of five Financial Capability and Asset Building (FCAB) conferences held since 2015. The two-part virtual conference, held in September 2020 and February 2021, convened leaders in the academy and in the field to discuss achievements, challenges, and next steps in FCAB

Creation and Implementation of a Pediatric Advanced Practice Nurse Critical Care Fellowship Program

Advanced practice registered nurses (APRNs) who begin their careers in the pediatric intensive care unit (PICU) may be challenged in this practice environment. Inadequate prior experience as a staff nurse, limited opportunities for clinical placements in the PICU during graduate education, and being in a fast-paced, high-acuity practice environment without prior exposure to critically ill children are practice challenges in the PICU setting. The goal of postgraduate education training programs (fellowship programs) for the acute care pediatric nurse practitioner (ACPNP) is to prepare students to become beginner practitioners who can function effectively in the acute care setting within a few months of being hired, much like that of their physician counterparts who complete a fellowship. The health care environment continues to be influenced by trends in national health care reform, shifts in the models for physician training, and the Accreditation Council for Graduate Medical Education resident duty hour restrictions. These emerging trends have given health care organizations the opportunity to evaluate their current care delivery and training models. It is expected that the demand for APRNs with specialty training will increase. The aim of this article is to describe our experience in the creation and implementation of a critical care pediatric nurse practitioner (CCPNP) fellowship training program at a large midwestern U.S. tertiary care center. It is expected that the demand for APRNs with specialty training will increase. When this fellowship was created, there were no known fellowships available for pediatric nurse practitioners (PNPs) interested in pediatric critical care. To meet the needs of these providers, a focused training program is required to provide specific preparation and competencies to practice to the full extent of the provider\u27s license. A recent recommendation is for health care administrators to consider implementing fellowship training programs to assist nurse practitioners transitioning into specialty roles (Kells, Dunn, Melchiono, & Burke, 2015). We used several online search engines to identify pediatric health care institutions with active advanced practice provider postgraduate fellowships. Our search in June 2017 identified fellowship programs in primary care, pediatric hematology/oncology, palliative care, neuro-critical care, and urgent care/emergency department. To our knowledge, this fellowship program was the first of its kind and seeks to provide postgraduate specialty training and education focused on the unique requirements of critically ill children and their families to help fill a knowledge gap when entering practice in this highly specialized practice environment

Studies of wolf x coyote hybridization via artificial insemination

Following the production of western gray wolf (Canis lupus) x western coyote (Canis latrans) hybrids via artificial insemination (AI), the present article documents that the hybrids survived in captivity for at least 4 years and successfully bred with each other. It further reports that backcrossing one of the hybrids to a male gray wolf by AI also resulted in the birth of live pups that have survived for at least 10 months. All male hybrids (F1 and F2) produced sperm by about 10 months of age, and sperm quality of the F1 males fell within the fertile range for domestic dogs, but sperm motility and morphology, in particular, were low in F2 males at 10 months but improved in samples taken at 22 months of age. These studies are relevant to a long-standing controversy about the identity of the red wolf (Canis rufus), the existence of a proposed new species (Canis lycaon) of gray wolf, and to the role of hybridization in mammalian evolution

This Year in the MOVES Institute

in the Proceedings of IEEE Cyberworlds 2003, the International Conference on Cyberworlds, Singapore, 3 – 5 December 2003, pp. xxxiii-xl.An Invited Paper