The lived experiences of adolescent girls' relationship with tobacco

PURPOSE: Despite increased efforts to educate youth about the dangers of cigarette smoking, the percentage of teenagers who smoke continues to rise. This study was designed to explore the lived experiences of 14 adolescent girls who enrolled in a tobacco cessation program. DESIGN: Phenomenology. METHODS: The experiences of fourteen adolescent girls were studied over a 10-week period while they were enrolled in a school-based tobacco cessation program. A combination of interviews, group discussions, and journaling were used to describe the experiences of these girls with tobacco use. Three common themes and two subthemes emerged that were supported by data. RESULTS: Tobacco use in the lives of these girls changed over time. The importance of listening to their stories and giving meaning to the behavior is clear. Nurses must continue to explore these methods as they support clients in tobacco cessation programs. While none of the girls in this study quit smoking, the need for nursing interventions to support tobacco users by understanding their physical and emotional relationship with tobacco is important for future success.     

Critical care clinical experience for novice students: reinforcing basic nursing skills

To better match students' learning priorities with their practicum experiences and to facilitate skills learning, undergraduate faculty devised the innovative strategy of incorporating a critical care rotation into the first semester of students' clinical experience. The authors describe the basics of this previously untested critical care clinical experience and the essential planning steps prior to implementation, including faculty approval, hospital administrative and nurse manager approval, preceptor identification and education, means of evaluating and grading the students, and evaluation of the overall experience.     

Writing Across the Curriculum: using Healthy People 2010 and the DHHS Secretary's Award for Innovations in Health Promotion and Disease Prevention

The authors detail a Writing Across the Curriculum (WAC) exercise that combines the Department of Health and Human Services' Secretary's Award for Innovations in Health Promotion and Disease Prevention (Secretary's Award) and the DHHS document Healthy People 2010.The authors discuss the writing competition as a way to encourage innovative problem solving and provide curricular instructions for using Healthy People 2010 and the Secretary's Award as a WAC exercise.     

Unicompartmental knee arthroplasty (alias uni-knee). An overview with nursing implications

During the past 30 years, the unicompartmental knee arthroplasty has undergone growing pains with various implant designs, refining indications, and improving surgical techniques and instrumentation. Today, studies show survivorship results comparable to the tricompartmental total knee arthroplasty and a renewed interest has emerged. Even though the unicompartmental knee arthroplasty is recommended for only a select 10-15% who have osteoarthritis of the knee, it has many advantages over the total knee arthroplasty. Although the nursing care and rehabilitation are similar to the total knee arthroplasty, including wound care, prophylactic antibiotics, and venous thromboembolism prophylaxis, the patient frequently has less pain, increased range of motion, shorter hospitalization, and fewer complications, resulting in a quicker rehabilitation.     

Homophobia and heterosexism in cancer care: the experiences of lesbians.

This participatory, qualitative study examines "what is lesbian" about lesbians' experiences of cancer and cancer care. Twenty-six lesbians were interviewed about their experiences of cancer diagnosis, treatment, and support, and their feelings and perceptions about shifts in identity, body, sexuality, and relationships. This paper highlights how homophobia and heterosexism, in contemporary nursing practice and as historical features of the health-care system, shape the experiences of lesbians with cancer. A minority of participants were targeted, denied standard care, or had aspects of their identity and social context relevant to cancer care dismissed. The majority commented on the lack of attention to lesbian realities in psychosocial support. A legacy of heterosexism appears to prompt strategic efforts to avoid homophobia and also appears to foster gratitude for equitable care. Nurse educators, practitioners, and policy-makers have critical roles to play in the accessibility of cancer care.     

Prevalence and detection of urinary incontinence among older Medicaid recipients

Low-income older adults have higher rates of many medical disorders than those with higher income, but rates of urinary incontinence have not been examined in this population. A random sample of older Medicaid recipients was interviewed (n=910) and medical records examined for the subset with urinary incontinence (n=236). Nursing home residents were randomly selected from Medicaid enrollment files (n=480). Forty-two percent of community residents reported urinary incontinence, with higher rates among women, older respondents, and whites. The medical records for only 22% of community-dwellers contained a diagnosis of urinary incontinence, compared with 77% for nursing home residents. Type of urinary incontinence was specified for 65% of diagnosed community dwellers and 7% of diagnosed nursing home residents. Urinary incontinence rates are high among Medicaid recipients compared with estimates from general population studies, but detection rates are lower for community-dwellers. Physicians may need to do more among low-income older adults in order to detect urinary incontinence.