Advanced practice nursing: opportunities and challenges

Planning for the future may not be easy but it is always worthwhile. Resources that can help in making choices include professional organizations such as the Kentucky Coalition of Nurse Practitioners and Nurse Midwives, KNA, American Academy of Nurse Practitioners, American College of Nurse Practitioners, the Internet, and the college and university Schools of Nursing. Taking control of one's destiny is the best gift that can be given to one's self. Increasing options for career development is just one of the benefits of pursuing educational goals. The first step is commitment to goal. Selecting the right specialty, planning how financial obligations will be met and choosing the program that best meets identified needs are steps that will follow. Health care changes are occurring at such a rapid pace the individual nurse may feel caught in a whirlwind without control. Making the choice to seek change will present its own challenges but without change, growth is impossible. For those considering an Advanced Practice role, making the commitment, outlining a plan with each step clearly identified, reliance on a strong support system, and maintaining a vision of the completed goal will lead to success.     

Living with diabetes: issues for nursing practice

Discussion in this paper is based on findings drawn from research undertaken within a qualitative framework of analysis, and with the purpose of exploring people's perceptions of living with diabetes, including the nursing care they receive A major theoretical concern is to demonstrate the importance of placing patients’and clients’experiences at the centre of nursing interest and practice It is argued that understanding a disease process should of necessity include an understanding of the concerns of those who live with it Findings related to the following research questions are discussed first, what are the challenges of living with diabetes? and second, what are people's perceptions of the nursing care they receive?     

21st century nursing practice in Ghana: challenges and opportunities

DONKOR N.T. & ANDREWS L.D. (2011) 21st century nursing practice in Ghana: challenges and opportunities. International Nursing Review 58 , 218–224 Aim: This article is intended to stimulate critical thinking and generate fruitful discussion on nursing practice in Ghana as experienced by the authors. Its rationale is to promote exchange of ideas and creative partnerships to ensure that right decisions are made in preparing competent, adaptable and resourceful nurses who can contribute to health for all in the 21st century. The problem: The challenges of nursing education, practice and migration in Ghana seem grim. There is inadequate capacity of training institutions, low staff morale, poor distribution and serious workforce shortages. Methods: Government reports and policy documents on nursing were sourced from official websites and reviewed and discussed in the context of the international scholarly published literature. Opportunities: The authors note that despite the severe crises, a number of opportunities such as improved home‐based training, international nursing education partnerships and welfare and human resource development could foster effective nurse retention and managed migration. Conclusions: To address the issues with nursing health service delivery and nursing shortages in Ghana requires all stakeholders to move beyond the traditional stereotypes and be flexible and forward‐looking. Needed policy options include expansion of local nursing education and training capacity, collaborative training opportunities, improving the welfare and retention rates of current staff and international exchange of nurse resources that is mutually beneficial to both source and sink countries.     

Assisted living issues for nursing practice

Assisted living has become a popular setting for older people and their families. Although health care services in these settings are limited, many residents require some level of medication management. In some states, unlicensed assistive personnel can perform medication management, suggesting delegation of nursing activities. However, confusion may arise between the licensing requirement for settings and the nurse practice act on this issue. This report discusses assisted living, nurse delegation with regard to medication management, and recommendations for nursing practice for both delegator and delegate.     

Perioperative nursing: moral and ethical issues in high--technology practice

The caring component of perioperative nursing practice entails responsibility and accountability for nurses to identify and address the moral/ethical issues inherent in the practice. Ethical/moral issues in perioperative nursing are becoming more complex as technology becomes more sophisticated, financial resources become more restricted, and choices regarding care occur in an ambiguous environment. The practice environment must provide processes by which nurses can examine the ethical/moral choices made or to be made both to support the nurse and to increase the body of knowledge of perioperative nursing practice.     

Global issues in mental health across the life span: challenges and nursing opportunities

This article describes what is known about mental health in children, adolescents, adults, and the elderly globally in high-, middle- and low-income countries. The social determinants of health are described as well as the paradigm shift from focusing on psychopathology to looking at ways in which individuals and communities can embrace mental health promotion to decrease stigma and provide care for all individuals in resource-rich and resource-poor environments. The need to expand the content in nursing curricula to include mental health concepts at all levels of training, foster mental health research, and promote international collaboration around best practices is also discussed.     

Unemployment and health: issues in a primary care nursing practice

A group of clinical nurse specialists in primary care examined unemployment through the frameworks of stress/coping and relative deprivation theories. The moderating effect of social support was also considered. The impact of unemployment on health was elicited from unemployed clients and records kept by the nurses providing care. Nursing diagnoses were found to fall into three major categories: subsistence problems, increased psychosocial stress, and lack of necessary health care. Nursing interventions included exploration and constructive mobilization of emotional responses and assistance with problem solving, including support of existing strengths and identification of alternative behaviors and resources. The need for advocacy on behalf of clients emerged as a continuing concern.