Nursing is no longer a submissive profession

It's an essay aiming to demystify nursing as a submissive profession. For doing so, a literature review on the profession history following its evolution up to the current practice was made. For some times, nursing and medicine went along in their historic development and nursing was featured in a dependence/submission picture due to the lack of scientism in its practice. But a lot has changed and for a long time nursing has its practice based on the scientific knowledge, being the care delivery systematization the     

Definition of futility no longer a purely medical decision

Efforts to come to grips with defining the conditions and boundaries of futile treatment continue to emerge in professional and lay discussions. One clear underlying premise that is taking hold is the idea that such definitions of futility are no longer the sole purview or responsibility of the medical establishment.     

Protocols in ambulatory care.

Protocols offer a mechanism for bringing together two major trends in outpatient care. The first trend is the delegation of certain clinical tasks and responsibilities to health workers other than physicians, and to patients themselves. The second trend is the movement toward standard-setting, peer review, audit and quality assurance, and cost-effectiveness of medical practices. Most of the studies of the use of protocols have been with nurse practitioners, physician assistants, office nurses, and health workers. These studies indicate that non-physicians using protocols - in comparison with physicians using traditional methods - give care that is equally thorough, and that leads to comparably accurate diagnosis treatment, and appropriate referral to physicians. Additionally, health workers guided by protocols achieve relief of patients; symptoms and patient satisfaction, and provide care that is efficient in terms of practitioner time, medication, and test ordering. Consequently, health workers using protocols can reduce the cost of care. Protocols have been developed for use in out-patient areas in both developed and developing nations. Protocosl can also be easily audited as part of a quality assurance program, effecting even further saving in costly provider time.     

Pneumatosis intestinalis; no disease, but a symptom

In three patients, men aged 77, 83 and 69 years, pneumatosis intestinalis was detected during CT for abdominal pain occurring in the first patient after an aortic stent had been placed, and during laparotomy because of ileus in the latter two patients. The first patient underwent removal of an ischaemic intestinal segment but died later due to infection around the prosthesis. The other two patients recovered after conservative therapy. Pneumatosis intestinalis is defined as the presence of gas in the wall of the gastrointestinal tract. Often it is detected by accident during abdominal radiographic examination or laparotomy. Pneumatosis intestinalis is a symptom and has been found in a wide variety of diseases. The clinical condition of the patient and the underlying disease determine the clinical significance of pneumatosis intestinalis and the therapy. The main issue is whether surgical intervention is necessary because of intestinal ischaemia or perforation.