Collective health: a challenge for nursing

This study takes public health as the point of departure to discuss both the concept of collective health and its object and field of action, emphasizing the concepts of man, collective and individual spheres, and health-disease, through a discussion of the interdisciplinary construction of the collective health field. The authors then place nursing within this field, emphasizing what appears to be the greatest challenge, i.e., to approach nursing as a practice of relationships.     

Reflections about death: a challenge for nursing

This reflection proposes a reinsertion on the death theme, in a more present form, in the daily routine of the nurse and its similar, starting with a historic on death, focusing on the transfer of it, that occurred in the bedroom of the moribund, to the hospital bedroom. Soon after, some considerations about the reason to fear death and the need of discussing it, as well as a reflexion on the planning of actions looking as much as to care as to confort the dying patient. With that, it is easy to realize the relevance of the come back of the approach of the subject in the professional daily basis, considering the need to demystify it, to allow that nurses and its similars plan actions of confort to the dying patient.     

Educating nurses for the SUS: a challenge for nursing schools

The stuty shows the selection of some strategy to be used for the graduation courses in Nursing to arouse in the students more interest in the collective healthy area. The study is about a case study, that took place in a private graduation course in the Southern of Brazil, which was noticed the systematised option form the students to the hospital area when the choice of trainee fields to the development from the Essay when they accomplish the graduation course. It was used a method from Situation Strategic Planning (PES) like a tool to enlarge the analysis of the problem and reach the aim proposed. As a result, the method showed to be efficient in allowing a revaluation of the Teaching Strategy from the couse to reach the profile expected.     

Curricular change: a challenge for an undergraduate nursing course

This work presents a research that intended to contribute with the evaluation of the Pedagogic Political Project (PPP) of an undergraduate nursing course. The objective is to analyze and to argue the curricular reformularization; contributing to the process of discussion and evaluation. The used methodology was the comparative analysis between the PPP of 1995 and 2003 and the data collected with professors and students concerning the theoretical presuppositions of the course that it was the identified innovative element in the PPP of 2003. The data revealed that the theoretical presuppositions, inyour majority guided the formation process, but there are concepts that still little incorporate like the interdisciplinarity. Another raised data was the non-effective participation of students and professors in the process of implantation and evaluation of the PPP.     

Humanized care in the teaching of nursing

This 'teaching experience' report addresses contents related to the humanized care given to children/adolescents and to their family. It was made in collaboration with students of the Undergraduate Course in Nursing. The Creativity and Awareness workshops proposed by Cabra I (1999) have been used as methodology because they proved adequate to approaching complex themes such as prevention of violence against children/adolescents and assistance to families that experience child sickness. During the workshops, the aim is to create an environment for reflection on humanized care on the basis of students' experiences. We found out that it is important to introduce alternative methodologies into the teaching/learning process of students, seeking the construction of knowledge and giving priority to their experiences.     

Reduction of vertical HIV transmission: a challenge for nursing care

With the crescent rates of HIV infection within female population in reproductive age, we may observe a correspondent increase in congenital infections. Thus, the obstetric nurse must be updated to participate and to develop programs of pre-natal care for HIV pregnant women. The purpose of this study was to review the pre-natal follow-up of this population regarding nursing care. Authors did not intend to approach all aspects of this subject, especially considering that investigations extend the great improvements already achieved since the acknowledge of the disease.     

Change in the collective construction in the nursing undergraduate nursing course: a challenge

This study aims to draw up a proposal of integration for the fourth term of Nursing from NOVAFAPI. The main focus was to describe the subjects' structure chain, the competencies and abilities to be developed, as well as discuss the methodology and the method of assessment specified and draw up a proposal for the fourth term. A qualitative approach was used, based on the action research referential. The subjects were the faculties and students from the term, plus the coordinator of the course. Its results show there is already the understanding that the integrated curriculum will contribute for the education of subjects more capable of transforming social reality.     

人性化护理应树立和谐理念

随着医学科学的发展,本世纪的护理管理将由经验管理、科学管理进一步向文化管理、人性化管理迈进.加强护患之间的和谐关系,是减少医患纠纷,创建安全护理环境的基础.我们只有将“和谐”理念贯穿于人性化护理中,才能广泛最充分地调动护士的积极性,不断提高护理水平.     

Undertreatment of acute pain in the emergency department: a challenge.

OBJECTIVE: Evaluation and improvement of pain management in our emergency department (ED). DESIGN: This was a "before-after" study. For each subject, the nurse, the physician, and the patient were asked to rate the initial intensity of the pain on a Visual Analogue Score (VAS). The timing and the type of analgesics administered were then recorded and follow-up VAS was performed. SETTING: A teaching, community-based, 400-bed hospital. STUDY PARTICIPANTS: 140 patients admitted for acute pain related to orthopedic injuries. MAIN OUTCOME MEASURES: The gap between the VAS expressed by the patient and estimated by the staff, the proportion of patients receiving analgesics, and the length of time delays between admission and analgesic administration. INTERVENTION: The intervention included education of medical and nursing staffs, insertion of a VAS template in the patient's chart, initiation of routine VAS assessment and re-assessment, and implementation of a protocol for pain management with standing orders for nurses. RESULTS: The VAS gap between the patient and the nurse decreased significantly from 1.91 2.04 to 1.03 1.97 after the intervention (P = 0.01). The percentage of patients receiving analgesics rose from 70 to 82% following the intervention. Time from admission to analgesia decreased from 80 +/- 68 min (mean +/- SD) before the intervention, to 58 +/- 37 min after the intervention (P = 0.05). CONCLUSION: Inadequate pain management in the ED appears related to poor staff assessment of pain and may be improved by routine VAS recording and by a nurse-based pain protocol.     

Remote support for emergency medicine using a remote-control laser pointer

We have developed a laser pointing system, the GestureLaser, which allows a remote operator to control a videocamera and a laser beam via a networked personal computer. The laser spot can be moved by the mouse cursor controlled by the remote instructor. The system was tested by giving remote instruction in thoracentesis to inexperienced operators using a training mannekin. Seven medical students received instructions using the laser pointer and another seven received instruction without the laser pointer. All operators completed the task correctly. The laser pointer group correctly identified the centesis space and performed the task on the first trial. When the laser pointer was not used, four operators (57%) made a mistake in selecting the centesis space at the first trial. The mean times for both stage 1--verbal versus GestureLaser 59 s (SD 13) versus 44 s (SD 5), p = 0.015 - and stage 2--verbal versus GestureLaser 98 s (SD 20) versus 64 s (SD 7), P = 0.002 - were significantly shorter when the GestureLaser was used. The study shows that the laser pointing system can be used to remotely instruct a novice operator in performing thoracentesis. It could improve collaboration between geographically separated sites.     

Physician migration: a challenge for America, a challenge for the world

For five decades, medical education policy in the United States has been built around the expectation that, if too few physicians were produced, additional physicians would be available from other countries. That policy is examined in the context of the desire for an ever-increasing number of physicians who will provide an ever-expanding array of services in the future. This reality is juxtaposed against the realities that the medical education infrastructure in the United States has yet to respond to the projected needs of the future. Also, other countries have growing needs for English-speaking physicians, particularly the developing countries from which most such physicians migrate. I explore the history of physician migration to the United States, catalogue the countries of origin, examine the attitudes of current students and physicians about migration, and consider the consequences that are likely for donor countries if even higher levels of migration are stimulated. I conclude that the deepening shortages of physicians now being experienced in this country cannot be rectified without substantial increases in the flow of physicians from developing to developed countries. The challenges that this will create call for mutual understanding and a high degree of discipline and creativity among all countries if global health care needs are to be respected.