Coaching: An essential leadership skill for the advanced practice nurse

Leadership in the 21st century requires that individuals lead in creative ways that enhance and support their employees' growth, development, and performance. Employees have reported that they need to feel respected and valued. As a member of the nursing leadership team, the advanced practice nurse (APN) is on the front line, involved with staff on a daily basis, and able to coach staff in a variety of different situations. Using coaching as a leadership skill assists the APN in making a significant contribution to the health care field and to employee growth and development. Copyright © 2001 by W.B. Saunders Company     

Neonatal Nurse Practitioners Who Are They?

A neonatal nurse practitioner (NNP) serves as the primary-care provider for in-hospital neonates. These practitioners receive different education and formal training than other nurse practitioners. The NNP's responsibilities may include managing patient care in an intensive-care unit, conducting normal newborn assessments and physical examinations, and providing high-risk follow-up visits. Career stressors, job satisfaction, and salaries vary among NNPs. The authors describe the variation in education and roles in this expanded nursing practice.     

A Randomized Trial of Heparin and Saline for Maintaining Intravenous Locks in Neonates

purpose . To determine, the effects of saline, heparin 2 units (U) per ml saline, and heparin 10 U/ml saline flush solutions on the duration of intravenous (IV) locks and the incidence of IV infiltration in neonates.

design.

design. Randomized double-blind experiment.

setting.

setting. Tertiary-care nursery.

participants.

participants. Neonates (N = 90) hospitalized at birth in the intensive, intermediate care, or newborn units.

main outcome measures.

main outcome measures. Total hours from the time the IV was inserted to the time the IV was removed; hours from the time the IV was first flushed to the time the IV was removed; number of IVs removed because of infiltration.

results.

results. No statistical or clinical differences between the three groups for duration of IV nor for incidence of complications.

conclusions.

conclusions. The use of heparin in IV lock flush solution did not affect the duration of IV locks nor the incidence of infiltration in neonates.     

Patent ductus arteriosus

Patency of the ductus arteriosus (DA) is a problem for the preterm and occasionally for the term newborn. In neonates born with certain congenital heart defects, the patency of the DA is critical for their survival. This article provides an overview of the anatomy, physiology, and pathophysiology of the DA and a patent ductus arteriosus. Clinical manifestations of the preterm and term infants are presented. The various management options of pharmacological therapy with indomethacin, medical strategies such as fluid restriction, and surgical treatments are also discussed. It is important for nurses who provide care for infants of all ages to have a thorough understanding of the DA in the healthy newborn to provide better care to infants with ductal pathophysiology.     

Life inside the womb: implications for newborn and infant nurses

The education of nurses working with newborns and infants does not typically include a lengthy discussion on the fetal environment, yet existence in the womb has a significant impact on the long-term outcome. This article is a review of the specific aspects of the fetal environment, including the cervix, uterus, placenta, chorion, amnion, amniotic fluid, and maternal aspects, and the potential meaning of these facets to the newborn and infant.