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The purpose of this case study is to examine the role of the nurse practitioner in the management and treatment of a 35-year-old female patient diagnosed with several conditions, including fibromyalgia posttraumatic stress disorder, anxiety, and depression. Fibromyalgia is a chronic, nonprogressive rheumatic condition with cardinal symptoms of widespread pain and fatigue; it affects more than 5 million people in the United States. This case study examines the nurse practitioner's role in managing fibromyalgia. Benzodiazepines and opioids may be prescribed for treatment of symptoms but prove ineffective, thus contributing to dependency issues. Controversy exists over classification of fibromyalgia as a rheumatologic condition versus a mental health disorder. Fibromyalgia frequently is accompanied by anxiety and depression, making this illness difficult to diagnose and treat.

Background: According to the Baby Friendly Hospital Initiative, when supplementary feeding occurs, mothers should be counseled on the use and risks of feeding bottles and teats. To help support this initiative it is important to understand the supplementation practices of Internationally Board Certified Lactation Consultants (IBCLC)®. Research aims: To determine (1) if the location of an IBCLC’s practice has any impact on supplemental feeding methods; (2) the preferred methods of and the main reasons for supplementation; (3) the level of an IBCLC’s confidence with supplemental feeding methods; (4) who is making supplemental feeding decisions; and (5) if there are geographical differences among supplementation choices and reasons for supplementation. Methods: An exploratory, descriptive, cross sectional survey of IBCLCs was conducted to generate data about their use of supplemental feeding methods. The survey was sent via email invitation through the International Board of Lactation Consultant’s Board of Examiners, with a response rate of 11.5% (N = 2,308). Results: There was no standard method of supplementation among participants. Participants indicated that they were confident advising mothers on alternative feeding methods. Only 17.6% (n = 406) of participants reported that the IBCLC was the caregiver who recommended the method of supplementation used. The majority of participants believed the Supplemental Feeding Tube Device SFTD) best preserves the breastfeeding relationship, and this was their preferred method of supplementation. However, the bottle was ranked as the number one method used in the United States, Australia, and Canada. The use of alternative feeding methods may be overwhelming to the mother. Conclusion: Supplementation by alternative feeding methods might help preserve the breastfeeding relationship and help reach the World Health Organization’s goal of increasing exclusive breastfeeding rates. © The Author(s) 2019.

Aim A benchmark of 4 has been determined for the reduction of self-reported stress by nursing students’ status post 5 weeks of holistic educational activities and interventions provided by a nurse educator. Design Provision 5 in the American Nurses Association Code of Ethics for Nurses with Interpretive Statements emphasizes the duty of the nurse to not only promote the health and safety of others, but to self as well (ANA, 2015, Code of ethics with interpretive statements, Nursebooks.org). A self-care for nurses’ pilot project was trialled with 25 accelerated nursing students over the course of 5 weeks. Holistic education programmes were facilitated by a nurse educator uninvolved in providing clinical or classroom education to the students. Methods The Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines are used in this pilot project as a framework to explore standardization of education of nursing students about self-care in nursing programmes and to promote positive health behaviours and student nurses’ insight into how nurses’ self-care can have an impact on patient outcomes. The self-care pilot project introduced the importance of self-care for the pre-licensure nursing student by teaching healthy eating, physical exercise, the value of sleep, use of positive affirmations and aromatherapy to a cohort of accelerated nursing students over the course of 5 weeks. The Star Model of Knowledge Transformation was the theoretical framework for the pilot study. Two questionnaires were used by the principal investigator to obtain participant data, the Project Participant Questionnaire and the Final-Year Group Questionnaire. Results On completion of the self-care for nurses’ pilot, the nursing students reported a reduction in stress and an increased ability to cope with stress after exposure to different holistic stress reduction strategies. An average benchmark of 4.36 was achieved indicating that the nursing students’ self-care had improved status post the interactive teaching intervention. Self-care taught to pre-licensure nursing students by nurse educators can enhance their self-awareness of the importance of stress reduction and care of themselves while enduring the academic rigour and simultaneous clinical practicum experiences in nursing programmes. Applying self-care behaviours to reduction of stress for nursing students may be of benefit to of students as they transition from the pre-licensure to graduate nurse roles. Hence, teaching health behaviours that are self-protective and contribute to maintaining safe clinical environments for nurses and the patients in their care.

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This article presents select findings from an interpretive phenomenological study which aimed to describe the lived experience of parental bereavement. Six parents, each of whom experienced the death of a child due to cancer at least one year prior, participated in conversational interviews to share what it has been like for them since their child's death. Heideggerian (1962) phenomenology provided the philosophical underpinnings of the study, while van Manen's (1997) phenomenological method guided data collection and analysis. From this methodological approach, a structure of the meaning of parental bereavement experience was revealed. Profound suffering emerged as one essential theme. Pertinent findings related to this theme are discussed. Parents share ways others might minimize their suffering and provide support in their lifelong journey towards healing. Findings will enhance nurses' practice of providing bereavement care, which is an expectation of quality palliative care. Copyright © 2019 Elsevier Inc. All rights reserved.

Aim: The aim of the study was to examine the orientation learning needs of adjunct clinical faculty as they transition from expert clinicians to novice educators. Background: Schools of nursing are increasingly using adjunct clinical faculty because of the nurse faculty shortage. Retention is a concern. Method: This descriptive quantitative study used the Needs Assessment Survey for Topic Inclusion in a Guide to Orientation. Adjunct clinical faculty rated the level of importance of orientation topics and if they received needed information. Results: The majority of topics were found to be rated very important or important. Several items deemed very important or important were either not discussed or not sufficiently discussed in orientation. Conclusion: The information obtained demonstrates the vast amount of information that adjunct clinical faculty want and need in an orientation. © 2019 Lippincott Williams & Wilkins.

Though various authors have refined and described the concept of compassion fatigue (CF), the overarching features, predisposing factors, and potential consequences remain relatively consistent. Available literature demonstrates that caregivers caring for patients who are chronically ill and/or traumatized are at highest risk for developing CF. Potential consequences for unmitigated CF include physical, emotional, and work-related consequences, all of which can have negative effects on the quality and safety of care and degree of engagement with one’s employer. CF is further exacerbated by exposure to cumulative, unresolved stress and neglect of one’s own emotional needs over time. Caregivers must be knowledgeable on CF’s risk factors, symptoms, and management strategies to decrease its incidence and negative impacts. This article details the creation, execution, and evaluation of an evidence-based practice change project implemented with the goal of increasing knowledge needed to prevent, identify, and alleviate CF in high-risk nurses. The project involved a series of educational workshops containing information on CF’s risk factors, symptoms, and consequences, with a strong emphasis on self-awareness, self-care, and stress management. Pre- and postknowledge tests showed a significant increase in knowledge was achieved via the workshops, and qualitative surveys indicated a high level of participant satisfaction with the program contents, format, and impact.

My story began when I was 49 years young and told I had Stage IV colorectal cancer. That was almost 12 years ago, and today I am one of the fortunate ones—not only has it been almost 12 more years of living, but my oncologist has used the word “cured”. Like most cancer patients and …

Background The benefits of human milk for the preterm infant are well established. Preterm infants have lower breastfeeding rates and often face breastfeeding challenges. It is important that feeding practices for preterm infants optimize their chances of breastfeeding. Objective The purpose of this integrated review is to synthesize and critically analyze research related to the safety and efficacy of cup feeding as an alternative, supplemental feeding method for breastfed infants. Data Sources The electronic data bases of PubMed, CINAHL and were used to identify studies published in English from 1998- 2017. Design Using inclusion and exclusion criteria, 27 articles were initially assessed. After further screening 19 articles were included in the full review and of these 5 more were excluded. Lastly, an in-depth review of these 14 studies resulted in 2 more exclusions, for a total of 12 studies that met full inclusion and exclusion criteria. Review Methods Studies were examined for information on safety and efficacy of cup feeding as an alternative, supplemental feeding method for preterm breastfed infants. Studies were grouped into categories of outcomes that included (a) safety and physiologic properties; (b) breastfeeding outcomes. Results Use of cup feeding resulted in more stable heart rate and oxygen saturation than bottle feeding with similar weight gain. Additionally, breastfeeding rates were higher at discharge with continued higher rates at 3 and 6 months post-discharge for cup fed infants. Conclusions Premature infants face more breastfeeding obstacles than term infants. The potential for cup feeding as an alternative to bottle-feeding for breast fed preterm infants is positively supported by these results It is fundamentally important for NICU professionals to establish a protocol, education and training for the potential use of this feeding method for this vulnerable population.

Traditionally, nursing is acknowledged as a caring profession and is associated with advocating for others. However, incivility is increasingly occurring amongst nurses, both in the clinical and academic environments, and is causing affected nurses both psychological and physical harm. Incivility Among Nursing Professionals in Clinical and Academic Environments: Emerging Research and Opportunities provides emerging views and consequences surrounding workplace bullying in the healthcare profession including recognizing the signs and symptoms of incivility in the workplace, identifying ways in which affected nurses can seek help, and examining healthy methods of coping with the incivility. Featuring coverage on a broad range of topics such as human resources, therapy, and clinical nursing, this book is ideally designed for nurses, managers, healthcare workers and consumers, hospital and clinical staff, researchers, students, and policymakers.

Exclusionary behaviors can be detrimental to the health and well-being of faculty in the workplace. When colleagues are judged by their peers because of the color of their skin, the language they speak, their gender, or who they choose to love (lesbian, gay, bisexual, transgender, asexual, or questioning), affected faculty are left emotionally and physically vulnerable. Institutions of higher learning must set standards of zero tolerance for faculty-to-faculty incivility. With standards taken from each faculty discipline, codes of conduct can be implemented not only at a departmental level, but also throughout the educational system.

Prayer is viewed in modern medicine as a complimentary alternative treatment. However, to many patients, it is a source of hope and comfort. Patients, when facing illness, advanced disease, disability or death, can benefit from prayer. For healthcare providers, comfort with praying with patients can be deemed as unprofessional conduct or blurred therapeutic boundaries, particularly, when prayer is offered to patients' unsolicited by the patient or their family member(s). Therefore, it is imperative that healthcare providers await the request of prayer by the patient before prayer is initiated.

In Modern health care, the creation of cultures of safety for patients is of the upmost importance. Impacting the institutional stabilization of health care facilities safety initiatives, is the preparation of pre-licensure nursing students to safely administer medications to patients. Therefore, preparation of the pre-licensure nursing student must be evidence-based practice focused and incorporate innovative ways to reduce the potential for medication errors. Copyright © 2018. Published by Elsevier Ltd.

Ongoing education of experienced psychiatric nurses is imperative given the historically complex health presentations of psychiatric patients. Psychiatric patients tend to have medical co-morbidities and often do not have the financial resources for preventative health care. The hospitalization for acute psychiatric stabilization, is an opportunity for psychiatric nurses to teach and advocate for patients' physiological and psychological health. Documentation of patients' changes in condition and overall clinical presentation, is necessary to ensure patients' health care needs are met. Copyright © 2018 Elsevier Inc. All rights reserved.

Workplace incivility remains a problem within the nursing profession. As nurse leaders, we must recognize and not ignore the complexity of cultures that have adapted incivility into the work environment. Nursing education is a discipline that requires collaborative team work, independent drive, and commitment. New nursing faculty experiencing incivility can use mindfulness-based meditation approaches to cope with uncivil behaviors experienced within the workplace. Nurse educators applying the concepts of mindfulness can learn how to provide themselves self-care by reducing stress, as enhanced daily awareness of peace and calm are incorporated into their lifestyle. Mindfulness provides a realization that control can only be given to other persons when an individual allows or accepts another's negative behaviors. Awareness of the value and importance of oneself can assist the nurse educator experiencing incivility to maintain his or her emotional, physical, and spiritual health despite the volatility of the work environment.

Background: According to the Healthy People 2020 goals, the sustainability of breastfeeding duration rates within the United States has not been achieved. To increase these rates, it is important that women with breastfeeding difficulties receive the support needed to continue breastfeeding. When supplementation occurs, it is essential that the breastfeeding relationship be preserved. Various methods of supplementation are often recommended including use of the supplemental feeding tube device (SFTD). Purpose: The question guiding this brief is “What evidence exists to support the use of an SFTD as a method of supplementation for breastfed infants?” Search Strategy: The PubMed and CINAHL databases were queried for original research published in English from 1990 through July 2016. Search terms included “supplemental feeding tube,” “breastfeeding,” “term infants,” “premature infants,” “Supplemental Nursing System,” “Lact-aid,” and “supply line.” Findings: Very limited research exists on the use of SFTDs as a method of supplementation for breastfed infants; however, existing research suggests that an SFTD may be useful as a supplementation method for breastfed infants. High-quality research is needed to evaluate the efficacy of using an SFTD for supporting exclusive and all breastfeeding rates. Implications for Practice: Nurses and providers need to be educated and trained in the use of SFTDs as well as all supplemental feeding methods. Information on efficacy and SFTD use should also be included in policies related to breastfeeding and human milk use. Implications for Research: Further research should determine best methods of supplementation for breastfed infants and should examine differences in breastfeeding rates when using the SFTD for supplementation.

The complexity of the human body is such that any disturbances to its homeostatic state, unreversed, can lead to the development of illness or disease. When one considers the terminology of incivility as a concept, one does not automatically equate this concept with disease or illness. However, incivility left to persist in work environments can prove mentally and physically damaging to the victim. Mindfulness can be used as a means to help nurses experiencing workplace incivility, to begin the process of emotional and physical healing.