Vicki L. Zeigler

Almost Normal: Experiences of Adolescents With Implantable Cardioverter Defibrillators

PURPOSEnThe purpose of this study was to describe the experiences of adolescents with implantable cardioverter defibrillators (ICDs).nnnDESIGN AND METHODSnThis qualitative study explored the lived experiences of 14 adolescents with ICDs using face-to-face, semistructured interviews.nnnRESULTSnSix themes were identified: life interrupted; still the same, except; sometimes its tough; it cuts both ways; unique joule; and living life regular.nnnPRACTICE IMPLICATIONSnThese findings suggest that nurses could make a significant impact on the lives of adolescents with ICDs by focusing their efforts away from viewing the adolescent through an illness lens and more toward a normalization lens.

Factors that influence pediatric intensive care unit nurses to leave their jobs.

The purpose of this qualitative study was to discover why 10 nurses voluntarily left the pediatric intensive care unit (PICU) at 1 large pediatric hospital in the southwest. Critical theory provided the philosophical framework, whereas action research and Heideggerian hermeneutic phenomenology provided the methodological framework. Data analysis was conducted using the circular hermeneutic process described by Heidegger and explicated by Diekelmann. From the findings of this study, it was concluded that there is an inescapable and inevitable tension between the human factors and the PICU work environment. Nurses identified the constitutive pattern of unrelieved job stress as the major reason they left the PICU. The multidimensional and interactive environmental characteristics of nature of the job, insufficient resources, and negative perceptions of managers/team leaders contributed to the development of job stress. The results of this study revealed the evidence needed to begin to focus on interventions in the areas of nursing practice, education, and research required, reducing the likelihood of losing more PICU nurses.

Acute Cardiac Arrhythmias Following Surgery for Congenital Heart Disease: Mechanisms, Diagnostic Tools, and Management

This article focuses on the management of those cardiac arrhythmias most commonly seen in the immediate postoperative period. They include ventricular tachycardia, ventricular fibrillation, atrial flutter, junctional ectopic tachycardia, bradycardia, and atrioventricular block. The mechanisms of cardiac arrhythmias are reviewed followed by a brief overview of the predominant acute arrhythmias, tools used for the diagnostic evaluation of these arrhythmias, management strategies, and, finally, nursing considerations.

A Study to Develop a Disclosure to Children Intervention for HIV-Infected Women

&NA; One of the most difficult issues for an HIV‐infected woman is the task of telling her children that she has HIV. Interventions are needed to support women in the distressing task of disclosing the diagnosis to their children and to give them directions based on the experiences of others. The purpose of this study was to develop an intervention to help and support women in disclosing a diagnosis of HIV to their children. Information was gathered from four sources: (a) women with HIV, some of whom had disclosed to their children and others who had not; (b) nurses, case managers, and counselors in HIV care; (c) the body of literature on knowledge and best practices related to disclosure of sensitive information to others, especially children; and (d) an expert in the psychology of mothering. The outcome of the project was an intervention, part of which was a printed brochure, to help HIV‐infected women in the disclosure process.

Congenital Heart Disease and Genetics

Improvements in the diagnosis and treatment of congenital heart disease have drastically reduced the morbidity and mortality associated with such defects. Knowledge regarding the genetic contributions to congenital heart disease is considered to be in its infancy; however, the field of cardiovascular genetics in humans is moving at a rapid pace. This article discusses what is currently known about the genetic contribution to congenital heart disease, including structural defects and congenital cardiac arrhythmias. Genetic and chromosomal syndromes that involve the heart are reviewed along with genetic testing.

Conscious sedation in the pediatric population. Special considerations.

The child requiring sedation has unique needs. The nurse caring for pediatric patients must have adequate knowledge to incorporate the physical, emotional, and psychological differences between children and adults into the childs overall plan of care. Because of these differences, sedation of the child presents a challenge. The nurse must continue to assess his or her knowledge of all facets of sedative agents and monitoring principles in the pediatric population to provide safe, effective quality care to children and their families.

Gerontology Found Me: Gaining Understanding of Advanced Practice Nurses in Geriatrics

Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants’ personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs’ personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.

Ethical Considerations in Pediatric Critical Care Research

Pediatric critical care nurses are exposed to research in the critical care environment on a routine basis and should be knowledgeable about the ethical considerations inherent in this process. The following discussion includes information that centers on the ethical issues of conducting research with children. First, children as a vulnerable population is explored, followed by selected ethical principles that pertain to research, the role of the technological imperative in research, the process of informed consent, and finally, nursing considerations.