Maintaining a professional approach to life.
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Psychiatric nursing graduate programs are in precipitous decline in the United States, leading many advanced practice psychiatric nurses to question the viability of their field. This article examines the current crisis in advanced practice psychiatric nursing education in the United States by identifying core concerns and exploring the reasons for these concerns. Suggestions for securing the future of this practice area are also discussed. These suggestions include identifying a more clearly focused role for advanced practice psychiatric nurses, development of realistic educational expectations, achievement of greater uniformity in curricula, and the establishment of a strong and rigorous process of accreditation.
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An important shift is taking place in the nursing area, where the old "head nurse" position is giving way to a new phenomenon--the nurse manager, an individual whose responsibility and authority are broader and more strategic. The nurse manager is becoming a key player in hospitals' efforts to satisfy patient needs, hold down costs and maximize efficiency; indeed, this "linchpin" manager is being given authority over budgeting, capital equipment expenditures, employee evaluations and patient care outcomes. But are the nurses now in hospitals up to the challenge? And are hospital executives prepared to make the human resources investment necessary to ensure the success of the new nurse managers?
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Robots and other new technologies relieve hospital pharmacists of such traditional tasks as counting pills, allowing them to more actively participate in direct patient care. While turf battles with clinicians are seemingly inevitable, bringing pharmacists onto patient floors can enhance medication safety and lower liability for hospitals.
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INTRODUCTION: Aircraft operations are a vital component of the transportation system in Alaska. Between 1990-2002, a total of 481 people died in Alaska in aviation accidents. The purpose of this study was to examine the practices and attitudes of Alaska commuter and air taxi operators and their pilots as they relate to company fatal accident rates. METHODS: A case-control analysis based on accident statistics was performed, grouping operators and their pilots into cases and controls, based on operator fatal accident rates, during January 1990 to June 2001. Responses from two aviation safety surveys-one of air carrier operators and one of active commercial pilots-were compared between cases and controls. RESULTS: The average case pilot had less career flight experience than control pilots and worked 13 h x d(-1) and 81 h x wk(-10; that is, 1 h x d(-1) and 10 h wk-1 more than controls. Case operators were less likely to consider pilot fatigue a problem when scheduling flights (p = 0.05) and more likely to depend financially on timely delivery of bypass mail (p = 0.04). Case pilots were three times as likely as controls to fly daily into unknown weather conditions. Nearly 90% of case pilots reported that they never flew when so fatigued that they wanted to decline the flight, compared with 64% of control pilots (p = 0.01). CONCLUSIONS: Pilots of high-risk operators differed from those working for the other operators, both in experience and working conditions. The combination of pilot inexperience and longer work hours and workweeks may contribute to Alaska's high aviation crash rate.
In 1997, a nursing care model task group was formed to develop a framework to guide the development of the nursing care delivery system in a newly merged hospital corporation. A collective group of experienced and motivated nurses in the renal program met to develop an integrated renal nursing professional practice model. In addition it was recognized that a city-wide model involving the two acute care renal centres would be advantageous. The challenge was to clearly articulate the professional roles and relationships of nurses and nurse practitioner/clinical nurse specialists in a constantly changing environment. This process provided the opportunity to identify key trends influencing renal care and possibilities for changing practice. Networking across the corporations was enhanced, partnerships were formed, and a sense of value for the work that was being undertaken developed. The group's endeavours resulted in an integrated nursing professional practice model that emphasizes accountability and continuity and places value on therapeutic relationships. Another strength of the model is the acknowledgement of the collaborative nature of the multidisciplinary team. After two years of development, the model was implemented. A city-wide Renal Nursing Professional Practice Council has been established in order to provide leadership in evaluating the model. This will include assessing the success of implementation, impact on patient/family care, and collaborative rewards experienced by staff. Future planning will address the potential need for a multidisciplinary focus within the practice council.