Lynn C. Parsons

Thoughtful Nursing Practice: Reflections on Nurse Delegation Decision - Making

This article discusses delegation challenges and legal and regulatory oversight associated with delegation in the clinical practice setting. The authors address moral and legal attributes of the roles and responsibilities of health care providers regarding delegating health care interventions. The article also explores guiding principles and rules of delegation within professional standards, national practice guidelines, and state nurse practice acts. Nurse experts provide thoughtful reflection on nursing models and the role of delegation, emphasizing the critical role of delegation in extending the role of the health care professional in patient care services.

Allergy Skin Testing: What Nurses Need to Know

Skin testing is a common procedure in any clinical setting. Critical care nurses will encounter skin testing in the inpatient and outpatient settings primarily to test for patient allergies to environmental factors, or allergies to certain medications. As there is a great deal of controversy about standard practices surrounding the different tests, information about various allergy tests and testing protocols is vital. Quality assurance standards should be met to ensure adequacy of the skin testing technique. Persons performing skin tests should undergo evaluation of their technique. To improve the predictive values of skin testing, and to ameliorate the incidence or severity of adverse affects, it is important for the critical care nurse to understand the dynamics of the test and the possible risks, along with variables that can confound the results. By doing this, nurses will improve not only patient outcomes related to the testing itself but also the value and reliability of the most effective diagnostic tool available for allergic disease.

Orthopedic trauma. Managing secondary medical problems.

Caring for the multiply injured orthopedic trauma patient is a challenge. Managing secondary medical problems associated with injury is enhanced when rehabilitation clinical nurse specialists, orthopedic advanced practice nurses, and the interdisciplinary team are consulted immediately following trauma. Educating the public on actions and behaviors that reduce the likelihood of accidents is an important role of the RN. Nurses play a key role in restoring the patient to the preinjury level of functioning or assisting the patient in adapting to temporary/permanent disability. Early intervention may result in shortened length of hospital stay, earlier return to work, restoration of family role function, and healthier psychologic and physical recovery. All RNs must be actively involved in educating the public on injury prevention, which includes teaching responsible behavior and the adverse effects of alcohol use.

Avian Influenza: Are We Ready?

The threat of an H5N1 influenza virus (avian flu) pandemic is substantial, and an effective response is contingent upon effective coordination among state and local public health authorities and individual health care providers. It is imperative that critical care nurses take an active role in the plans to meet the demands that will be placed on the health care system. This can be accomplished by developing an understanding of the etiology and manifestations of the virus, and becoming familiar with recent advances in research that address the demands of a pandemic. Equally important are the ethical considerations our state of preparedness will pose on the health care system, the community, and health care workers, both professionally and personally.

Living the Healthy Heart Path: Rehabilitation After a Cardiac Event

Although cardiac rehabilitation has traditionally been linked to specific programs in which patients participate after having a cardiac event, the concept of cardiac rehabilitation has expanded to many domains of nursing. Not only are critical care nurses the initiators of cardiac rehabilitation through thorough and accurate teaching of the cardiac event but all nurses should be attuned to the modifiable risk factors to direct patients at high risk for possible prevention of a cardiac event. It is a critical care nurse who is knowledgeable about the focus and goals of cardiac rehabilitation, who incorporates the patients family in the early rehabilitation stages, and who considers cultural variations who can provide optimal care to the patient, helping him or her lead a healthy and productive life.

Book reviewWhat is Addiction?, A Bradford Book, D. Ross, H. Kincaid, D. Spurrett, P. Collins (Eds.), The MIT Press, Cambridge, MA (2010), 448 pp

This book, edited by Ross, Kincaid, Spurrett, and Collins, includes the writings of several scholarly authors in the fields of research, prevention, and treatment of addiction that examine various ...

Angiography: From a Patient's Perspective

In critical care, nurses are expected to react quickly to urgent and emergent situations. It is imperative that nurses have the ability to recognize signs and symptoms in patients that require diagnostic intervention. This article begins with a brief description of angiography and its role in the critical care environment. This is followed by a description and comparison of several modalities used to evaluate the cerebral and carotid vessels. A related case study, from a patients perspective, provides the context for this discussion.

As Time Goes by: Boomerang Marriages, Serial Spouses, Throwback Couples, and Other Romantic Adventures in an Age of Longevity, by Abigail Trafford: New York, NY: Basic Books, 2009, 275 pages, hardcover,

Abigail Trafford, a Washington Post columnist, examines in her book As Time Goes By: Boomerang Marriages, Serial Spouses, Throwback Couples, and Other Romantic Adventures in an Age of Longevity the trends in generational changes in marriage. Coupled with increased longevity, these changes result in a greater variety of relationship and family structures among older adults than we have previously known. As Time Goes By gently, with stories of couples, studies the changing nature of romantic relationships between older adults age 50–85 in current time. The author relies primarily on a narrative style, making generous use of interviews and story lines, allowing an easy but informative reading. This timely book is comprised of 12 chapters in 4 sections. Part I, “Turmoil,” explores the discontinuities and transitions associated with aging through retirement, illness, and differences in aging rates. One central theme of this section is the challenge posed when couples go through these transitions at different times. Each partner is living in a different mode. Transitions are different today compared to a century ago because of increased longevity. Family unit bonds are different across the lifespan. Part II of the book is titled “Surprise.” This section focuses on the inaccurate stereotype of stability in relationships among older couples. Role changes, breaking up, and falling in love are among the phenomena that are not traditionally associated with this age group. The ebb and flow of relationships during critical life events are explored. Today we are seeing these transitions as the norm. Part III, “Truth and Reconciliation,” is concerned with the positive, stable aspects of relationships among older couples. Long-term couples probably have been through the crucible of hard times at some point, and tend to be the stronger for it. Stable marriages endure many challenges in life and the triumphs of survival endure forever. Other relationship types are also explored. For example, “boomerang” couples, who have previously divorced and remarried each other, are becoming more common.