What's your specialty, Doc? Perioperative nursing

Perioperative nurses who are contemplating the pursuit of a doctoral degree in nursing need information about the current status and characteristics of doctoral education to make informed decisions. This article addresses questions both philosophic and pragmatic that should be addressed by prospective students. Information sources are identified for assistance with making the selection from the 75 plus programs that offer a nursing doctorate nationwide. Suggested sources include professional organizations as well as current students, faculty, and alumni. Determinations should be based on academic information, such as similarities and differences in degrees awarded; the program of studies leading to the degree; admission and progression standards; research interest of the student relative to identified focus and expertise of program faculty, dissertation process, and university and nursing education resources and services, including financial and technological support. Attainment of the doctorate is presented as an enriching experience that prepares nurses for leadership in both education and health care as clinicians, educators, and administrators. Particular attention should be paid to selecting programs that compare favorably with the published American Association of Colleges of Nursing quality indicators for doctoral programs. There must be strong support in the program from both faculty mentors and peer colleagues, reflective of a community of scholars, pursuing not only individual but also collective wisdom, whereas engaging an individual's mind and soul in the pursuit of new knowledge and skills in an atmosphere of mutual trust and respect.     

Health disparities: what can nursing do?

Health disparities result from lack of caring within the society. Central to nursing, caring makes the profession best suited for leadership in reducing disparities. Nursing is losing its capacity for caring. Nursing's progress in gaining status has alienated it from the needs of other oppressed groups. It has also been seduced by the scientific model and does not always use its best judgment of truths about human suffering. Research has identified unequal treatment, discrimination, workplace and social status, income inequality, and policy decisions to deplete resources as social and economic determinants of health. All involve relationships. Nursing is the profession for which relationships are primary. Nursing can rebuild the capacity for caring and social and relational practice through transforming nursing education on the principle of mutuality. Nursing can also promote nurse-managed primary care and focus on changing local, state, and national policies to increase access, equity, and health protection.     

The status of HIV/AIDS nursing in Australia: a specialty in decline?

Since the introduction of highly active antiretroviral therapy (HAART), occasions of service for patients with HIV/AIDS have altered drastically. HIV/AIDS nurses perceived that this change in activity had caused an exodus from the specialty by experienced nurses, and those that remained were rapidly deskilling. A survey of nurses working in HIV/AIDS in Australia and New Zealand was conducted to assess the impact of HAART on nursing skills and retention. More than 72% of respondents reported that they had lost some or many clinical HIV/AIDS nursing skills. About 37% of nurses reported that they were losing confidence in their knowledge of the management of opportunistic infections and cancers. About 27% reported larger numbers of nurses leaving their specialty area than in previous years. To enable nurses to respond rapidly to a potential decline in the effectiveness of HAART, this loss in skills and knowledge must be addressed.     

Health Service Ombudsman report: decline in quality of nursing care?

A number of cases of failures in nursing care have been revealed in the recent Health Service Ombudsman (HSO) Annual Report for England 2000-01. This article highlights some cases from the report as well as recent HSO investigations carried out over the past 4 months.     

Community/public health nursing: Is there a future for the specialty?

Graduate nursing education in the United States has undergone significant changes over the last decade with institution of the doctorate in nursing practice (2006) and the revised Essentials of Master's Education in Nursing (2011). An overview of the status of community/public health nursing (C/PHN) education and practice during the past 100 years provides a historic context for understanding the current situation of the specialty. An analysis of U.S. graduate nursing programs in C/PHN is used to foreground a discussion of the factors that may significantly affect community/public health nurses' interest in graduate education and the ability to sustain a master's-prepared C/PHN workforce. Questions are raised about how the potential loss of this particular specialty may influence the practice of C/PHN and the role of nursing in general in ensuring the public's health. Recommendations are offered for strengthening the specialty long-term, with a particular focus on C/PHN education and practice.     

Health care transition for adolescents with special healthcare needs: Where is nursing?

The population of adolescents with special healthcare needs (ASHCN) surviving into adulthood has increased dramatically over the past two decades. Approximately, nine of every 10 children diagnosed with a chronic condition are expected to reach adulthood. Experts estimate nearly 750,000 ASHCN enter into adulthood each year. Advances in medical treatments, new technologies and scientific discoveries have all contributed to the increases in ASHCN life expectancies. As a result, new demands for services have emerged to address their clear needs for long-term services and supports. Foremost among the ASHCN service needs are healthcare transition services. Healthcare transition is recognized as a needed area of practice to facilitate ASHCN transfer of care from pediatric to adult healthcare and to support the acquisition of the developmental competencies needed to successfully transition to adulthood. Yet, few evidence-based and exemplary models of care exist. Healthcare transition research is in the early stages of development. The medical community has provided the leadership with the development of healthcare transition policy, practice, and research. As a result, policymaking, practice issues, and research have a prominent medically related focus. In contrast, the influence of nursing as it pertains to these areas of professional practice is limited. Opportunities exist for pediatric and child health nursing leaders to provide direction for greater involvement in this emerging and growing field of specialty practice.