Community Hospital-Based Obstetrical Primary Nursing

A 200-bed community hospital in Seattle, Washington, delivering approximately 2.000 infants per year, was the site of a pilot project in expanded nursing care for childbearing families. Obstetrical primary nursing provides a one-to-one nurse-patient relationship beginning in early pregnancy and continuing as long postpartum as a need exists. Project development, implementation, and results are discussed.     

Pelvic Exenteration: A Nursing Challenge

Pelvic exenteration, a radical surgical procedure usually performed for recurrent cancer of the cervix, results in changes in body function and appearance requiring extraordinary physical, emotional, and sexual adjustments by the patient and deeply affecting her immediate family. Her health care needs are best met when a primary care nurse is available to provide continuity from the initial contact with the gynecologic oncologist through convalescence at home. It is necessary that the nurse understand some of the problems in surgical management, pre- and postoperative physical care, and healing in order to deal with certain aspects of care. During convalescence, emphasis should be placed on the use of support and education to assist the patient in coping with tremendous body changes.     

The Clinical Specialist—Link Between Theory and Practice

The Clinical Specialist is often asked what she does and how her activities differ from those of the staff nurse or supervisor. In addition to a practitioner and role model, she is a teacher, researcher, counselor, and change agent. The differences in how or why she does things arise from her education and experience.     

Skeletons in the closet: exploring personal family background as a prerequisite for family nursing

A nurse's family background, values and experiences will either positively or negatively affect the kind of care he or she gives. This depends on whether the nurse either has explored his/her background and uses it as a valuable resource or fails to see that it may affect care or even be a restriction to quality care. An individual can take specific steps to use family background as a potent and valuable resource. This paper describes a collection of self-directed and group exercises developed at the University of British Columbia School of Nursing that can be used to explore family background and hence use it more positively.     

Wrist injuries in children and adolescent athletes: macrotrauma and overuse

Young children and adolescents are becoming increasingly involved in recreational and professional sports. This inevitably leads to an increase in the number of sports-related injuries involving the hand and the wrist. Hence, physicians should have a good insight into macro- and microtraumas affecting the hand and the wrist. Prevention of injuries, correction of muscle-tendon imbalances, and maintenance of strength and flexibility are important issues for the prevention of disabilities in this age group.     

Campath-1H in B-chronic lymphocytic leukemia: report on a patient treated thrice in a 3 year period

Monoclonal antibody (mAb) therapy is a novel alternative treatment for lymphoid malignancies. In this report we present a 55-year-old patient with B-chronic lymphocytic leukemia, who was initially treated with chlorambucil p.o. and subsequently with cyclophosphamide iv with poor response. Then Campath-1H mAb was administered. He received three cycles of Campath-1H, over a 3 yr period, lasting 12 weeks each, at a final dose of 30 mg weekly, on an outpatient basis. After each cycle of Campath-1H administration there was a significant decrease of the size of the palpable lymph nodes, spleen and liver. Restoration of the blood lymphocyte count to normal and a significant decrease of the bone marrow lymphocytic infiltration was observed at the end of each cycle. Therefore, a major clinical response was obtained after all cycles. Campath-1H administration was well tolerated without causing any serious toxicity.     

Cervical Dysplasia and Condylomata Acuminata in Young Women

A retrospective investigation compared the medical records of 56 young women with abnormal Pap smears with the medical records of 60 women who comprised the control group to determine if there is a relationship between cervical dysplasia in young women and a history of condylomata acuminata. A statistically significant link between condylomata acuminata and cervical dysplasia was shown. Implications for nurses are discussed.