Fidelindo Lim

A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs

AIM This article assesses the knowledge of faculty in baccalaureate nursing programs and their readiness to teach about lesbian, gay, bisexual, and transgender (LGBT) health. BACKGROUND Although health disparities affecting the LGBT population are increasingly acknowledged in the literature, a dearth of information exists on how LGBT health is integrated in nursing programs. METHOD A survey was sent to a nonprobability purposive sample of nursing school administrative leaders (N = 739); they were asked to share the link with their faculty. More than 1,000 faculty completed the survey. RESULTS The knowledge, experience, and readiness for teaching LGBT health among baccalaureate faculty are limited. LGBT faculty reported greater awareness, knowledge, and readiness compared with heterosexual faculty. The estimated median time devoted to teaching LGBT health was 2.12 hours. CONCLUSION Findings will help inform the design of faculty development programs and guide in aligning the curricula with current LGBT health priorities.

Promoting awareness of LGBT issues in aging in a baccalaureate nursing program.

&NA; It is estimated that up to 10 percent of the American population is lesbian, gay, bisexual, or transgender (LGBT) and that up to 7 million members of this population are elderly. Both the Institute of Medicine and Healthy People 2020 have addressed the health disparities that affect elderly members of the LGBT community. Nurses are well positioned to bridge health disparities and provide culturally sensitive care across the lifespan, but compared with that of other disciplines, the nursing literature is lacking in content addressing LGBT health. Eliminating health disparities in the care of LGBT elders should be a priority in nursing education. The authors review the issues LGBT elders face and recommend how content related to LGBT aging can be integrated into nursing curricula.

Nursing Students' Attitudes toward Lesbian, Gay, Bisexual, and Transgender Persons: An Integrative Review

AIMThe aim of this study was to critically appraise and synthesize findings from studies on the attitudes of nursing students toward lesbian, gay, bisexual, and transgender (LGBT) persons. BACKGROUNDThere is paucity of research to assess the attitudes of nursing students toward LGBT persons. METHODAn electronic search was conducted using PubMed, Medline, Web of Science, EbscoHost, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature using medical subject headings terminologies. Search terms used included gay, lesbian, transgender, bisexual, LGBT, nursing students, baccalaureate nursing, undergraduate nursing, homophobia, homosexuality, sexual minority, attitudes, discrimination, and prejudice RESULTSLess than 50 percent of the studies (5 out of 12) suggested positively leaning attitudes of nursing students toward LGBT persons; six studies reported negative attitudes, and one study reported neutral attitudes. CONCLUSIONThere are some indications that student attitudes may be moving toward positively leaning. Studies published before 2000 reported a preponderance of negative attitudes.

Lesbian, gay, bisexual, and transgender health: disparities we can change.

Epidemics have an uncanny way of highlighting health disparities. Nurses, by virtue of our scope of practice, are the witnesses and recorders of every health disparity known to people. As a staff nurse at the peak of the AIDS epidemic, I witnessed the lesbian, gay, bisexual, and transgender (LGBT) community suffering the brunt of the AIDS crises. Enduring themes related to health inequities linger to this day: bias, moral distress, and increased demand for dwindling resources. Only recently have disparities among the LGBT population become a health priority, not only by interest groups but also by federal health care agencies. Commenting on the lack of research in LGBT health, the Institute of Medicine’s consensus report emphasized the lack of science-based knowledge on the health of LGBT persons. Healthy People 2020 and the US Department of Health and Human Services (HHS) further underscored the health disparities and the lack of compassionate services that these populations deserve. Because health issues are closely linked with policies, the political arena is also a platform for discussion. At the direction of President Obama, HHS took action to ensure that LGBT persons have equal visitation rights to their partners in hospitals or nursing homes. In December 2011, US Secretary of State Hilary Rodham-Clinton addressed the United Nations, during the anniversary of the Declaration of Human Rights, to remind world leaders that LGBT rights are human rights. Clinton admonishedpolicymakers, health advocates, researchers, practitioners, and patients to engage in a more proactive role in bridging health disparity among the ‘‘invisible minority. Healthy People 2020 identified significant health disparities and sought much needed collaboration from healthcare professionals and policy makers to address them. Among its findings are the following:

Honors Programs: Current Perspectives for Implementation.

The changing demographics of the nursing workforce, including large numbers of impending retirements, highlight the need for innovative programs to attract the next generation of nursing leaders, educators, and researchers. Nursing honors programs provide an enhanced educational experience for high-achieving and highly motivated students, developing them as future nursing leaders. This review describes the current perspectives, characteristics, and values of nursing honors programs, opportunities for implementation, and recommendations for integration within nursing education.

Factors Influencing Weaning Older Adults From Mechanical Ventilation: An Integrative Review.

This study aim was to describe the influences that affect weaning from mechanical ventilation among older adults in the intensive care unit (ICU). Adults older than 65 years comprised only 14.5% of the US population in 2014; however, they accounted up to 45% of all ICU admissions. As this population grows, the number of ICU admissions is expected to increase. One of the most common procedures for hospitalized adults 75 years and older is mechanical ventilation. An integrative review methodology was applied to analyze and synthesize primary research reports. A search for the articles was performed using the PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases; using the keywords and Boolean operators “older adults,” “weaning,” “mechanical ventilation,” and intensive care unit. Although physiologic changes that occur with aging place older adults at higher risk for respiratory complications and mortality, there are many factors, other than chronological age, that can determine a patients ability to be successfully weaned from mechanical ventilation. Of the 6 studies reviewed, all identified various predictors of weaning outcome, which included maximal inspiratory pressure, rapid shallow breathing index, fluid balance, comorbidity burden, severity of illness, emphysematous changes, and low serum albumin. Age, in and of itself, is not a predictor of weaning from mechanical ventilation. More studies are needed to describe the influences affecting weaning older adults from mechanical ventilation.

Stuck inside a cloud: Optimizing sedation to reduce ICU-associated delirium in geriatric patients

Elderly population account for more than 50% of all intensive care admissions, and during their stay, up to 87% of them suffer from delirium. There is a large body of evidence demonstrating increased mortality and worse cognitive function for elderly patients who become delirious during their intensive care unit stay. Although the cause of delirium is multifactorial, inappropriate and outdated sedation methods are preventable causes. We review the current best evidences and provide what we believe are the best sedation strategies that are in line with the Society of Critical Care Medicines Pain, Agitation and Delirium best practice guideline to reduce the incidence of intensive care unit-associated delirium.

Beliefs and perceptions of mentorship among nursing faculty and traditional and accelerated undergraduate nursing students

BACKGROUND In order to meet the demands of a dynamic and complex health care landscape, nursing education must develop and implement programming to produce a highly educated nursing workforce. Interprofessional honors education in nursing with targeted mentorship is one such model. PURPOSE To describe undergraduate nursing student and faculty perceptions and beliefs of mentorship in the context of interprofessional honors education, and compare and contrast the perceptions and beliefs about mentorship in interprofessional honors education between undergraduate nursing students and faculty. METHODS The study used a cross-sectional, descriptive design. Data were collected at an urban university in the northeast US, using a researcher-developed electronic survey. The sample included 24 full-time nursing faculty, and 142 undergraduate nursing students. RESULTS Perceptions and beliefs regarding mentorship in the context of interprofessional honors education were similar for faculty and students, with both ranking mentorship among the most important components of a successful honors program. CONCLUSIONS Honors education with a dedicated mentorship component may be implemented to improve the undergraduate education experience, facilitate advanced degree attainment, and develop future nursing leaders.

Faculty and Student Perspectives on Mentorship in a Nursing Honors Program

Abstract Honors programs in nursing can facilitate the professional development of high-achieving students, supporting their lifelong engagement in nursing practice, education, research, and health care policy issues. Strong mentoring relationships are commonly identified as essential to the success of nursing honors programs, but literature on mentoring relationships in an honors context is limited. The purpose of this study was to gain insight into faculty and student expectations for mentorship. Faculty and students shared similar expectations for both the mentor and mentee, highlighting key themes of engagement, facilitation, accountability, and collaboration as necessary for the success of an undergraduate nursing honors program.

Managing hypocalcemia in massive blood transfusion

MR. P, 56, had a history of cirrhosis, pancreatitis, and peptic ulcer disease. He was admitted to the ED with hematemesis (estimated at about 1 L). On presentation, he was responsive to painful stimuli only. He was immediately placed on a cardiac monitor. His initial vital signs were: BP 70/40, hear