Caring for organ donors: The intensive care unit nurses' view

The nursing care for patients who are pronounced brain-dead but kept alive to serve as organ donors demands technical-scientific skills and the ability to handle situations that are often in conflict with the traditional concepts of nursing care. Based on the phenomenological approach in this article, essential themes of the lived experience of caring for these patients, including the technical and specific nursing care, the relationship with organ donors and their families, and the nurses' perception of themselves in this professional situation are described. The results point to the contradictions and ambiguities of this type of nursing, especially in regards to the affective and philosophical aspects.

Caring for heart transplant recipients: The lived experience of primary caregivers

Objective: To understand the experience of primary caregivers of heart transplant recipients. Methods: A phenomenological approach was used to understand the caregivers' experience of caring for a heart transplant patient. In-depth interviews were conducted with 11 caregivers, in a Brazilian hospital, from December 2008 to March 2009. Results: Following the transplant, caregivers' lives change drastically; their priority becomes providing care for their relative. Despite successful transplant results, the uncertainty about future remains, generating permanent distress. Anxiety is exacerbated by familial or economic problems and, consequently, many participants turn to their local communities for support. Some caregivers learn from the experience and plan return to regular activities. Others feel helpless, unable to overcome personal losses and difficulties. Conclusions: Nurses are ideally placed to lead the way by providing family-centered support and education for caregivers of heart recipients. Listening to the concerns of family caregivers seems to be an essential aspect of effective interventions. © 2013 Elsevier Inc.

The Caring Teacher: A Multiple Case Study That Looks at What Teachers Do and Believe about Their Work With At-Risk Students

Caring teachers have been identified as a critical component of successful interventions with at-risk students, however just what constitutes a caring teacher is less well understood. Specifically, what are the behaviors, characteristics, and beliefs of caring teachers, and how are they impacted by the contexts within which they work? The purpose of this multiple case study was to understand more about caring teachers who work with at-risk students in secondary schools located in a Midwestern city and thereby to add complexity to the literature. Two middle school teachers and two high school teachers were recruited to participate. They were observed on multiple occasions and interviewed twice. The data from these observations and interviews were initially analyzed case by case; the cross case analysis based on the results from the individual case resulted in 6 themes that were present across the four cases. The following themes were identified: the role of relationships, perspective on at-risk students, providing opportunities for students to develop a positive sense of themselves, the value of a positive classroom experience for both students and teacher, negotiating power, and flexibility. Implications of this research for psychologists, educators, and policy makers, as well as future research are also discussed.

CARING FOR TUBERCULOSIS PATIENTS IN THE FAMILY HEALTH STRATEGY: THE NURSES' PERCEPTIONS

The objective of this study was to analyze the nurses' perceptions regarding tuberculosis control, according to the theoretical axis of comprehensive healthcare and the concepts of attachment and teamwork. This qualitative study involved 13 nurses from the Family Health Strategy of a priority city in the metropolitan region of Joao Pessoa, Paraiba, Brazil. Data were collected in focal groups and subjected to thematic content analysis. Factors that strengthen tuberculosis control were: supervised treatment, free medication and the provision of supplies. Weakening factors were: worker's turnover, the lack of encouragement for patients and incipient educational actions. The factors that, according to the nurses, weaken tuberculosis patient care should be reviewed by administrators, workers, users and educators with a view to redefining healthcare activities that strengthen attachment, comprehensive healthcare and teamwork.

Paternal Care Decreases Foraging Activity and Body Condition, but Does Not Impose Survival Costs to Caring Males in a Neotropical Arachnid

Exclusive paternal care is the rarest form of parental investment in nature and theory predicts that the maintenance of this behavior depends on the balance between costs and benefits to males. Our goal was to assess costs of paternal care in the harvestman Iporangaia pustulosa, for which the benefits of this behavior in terms of egg survival have already been demonstrated. We evaluated energetic costs and mortality risks associated to paternal egg-guarding in the field. We quantified foraging activity of males and estimated how their body condition is influenced by the duration of the caring period. Additionally, we conducted a one-year capture-mark-recapture study and estimated apparent survival probabilities of caring and non-caring males to assess potential survival costs of paternal care. Our results indicate that caring males forage less frequently than non-caring individuals (males and females) and that their body condition deteriorates over the course of the caring period. Thus, males willing to guard eggs may provide to females a fitness-enhancing gift of cost-free care of their offspring. Caring males, however, did not show lower survival probabilities when compared to both non-caring males and females. Reduction in mortality risks as a result of remaining stationary, combined with the benefits of improving egg survival, may have played an important and previously unsuspected role favoring the evolution of paternal care. Moreover, males exhibiting paternal care could also provide an honest signal of their quality as offspring defenders, and thus female preference for caring males could be responsible for maintaining the trait.

Sharing vs. caring--the relative impact of sharing decisions versus managing emotions on patient outcomes

To assess the relative impact of cognitive and emotional aspects of shared decision making (SDM) on patient outcomes.

Changing Europe and The Relevance of Care and The Caring Professions

The aim of the paper is to introduce the challenges of the international care debate of the last ten years in order to grasp basic social needs, to analyse their treatment in the public and private sphere and to look at the orientation of professional answers by the care-professions. The concept of care enhances the societal dealing with - or ignoring of - different forms of dependency on informal and formal personal and social services throughout the life-cycle (child-care, nursing sick or handicapped persons, supporting the elderly) and in special life situations (from help to lone mothers and their children, via help to drug-addicts to help for homeless people). All societies have different approaches to deal with these life-situations, they do so by employ-ing various mixtures of: familial support, mostly provided by women, social politics, organized by the state, public and/or private social services. This welfare-mix shows different combinations of private and public obligations, paid and und unpaid work, professional and laymen's tasks based on a specific understanding of mo-rality and justice embedded in the gender structure and intergenerational relationships. The importance of social work as a profession in this context differs according to the historical developments and cultural traditions. Characteristic for the profile of social work is the rele-vance of a care ethics and the existence of social rights, the tension of mothering and profes-sional methods, the relationship between help, denial and punishment and the ways of institu-tionalisation. The actuality of this debate is closely intertwined with the restructuring of societal bonds in the face of globalisation, the political reorganisation of states, the changes in the living to-gether of different generations and both sexes and the consequences for the organisation and contents of welfare. Looking at Germany and Eastern Europe two new phenomena of social relevance for the dis-cussion of care work and care needs can be taken as an example: the extent of cheap illegal women laborers travelling between east and west, especially Polish women working intermit-tendly in private care for old people and the highly organized traffiking of women from Russia to Germany to work in the sex business. The care debate entails a reframing of welfare issues in the light of social justice between classes, ethnicities and gender groups.

Caring Minds

Honoring a Leader 25th Anniversary Symposium Four Investments in Innovation --Accelerated Ph.D. Campaign --House Bill 4471 Aids Nursing --“Pacesetter” Model --John S. Dunn Research Foundation Gift Fabulous from the Start PARTNERS Luncheon Robert Wood Johnson Foundation Executive Nurse Fellow Alumni News Faculty Scholarship

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DEAN’S MESSAGE CELEBRATING 35 YEARS AKERS SCHOLARSHIP ENDOWMENT NANCY B. WILLERSON ENDOWED PROFESSORSHIP PARTNERS LUNCHEON UT PARTNERS WITH ALDINE ISD THE FUTURE IS HERE RETIRED PHYSICIANS SHARE YEARS OF KNOWLEDGE CARING FOR BABIES RESEARCH STARS CENTER ON AGING VIDEOS/ALUMNI NEWS FACULTY SCHOLARSHIP

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Greetings from Dean Patricia Starck New DNP program explores new frontiers of nursing Profile Joanne V. Hickey, PhD, APRN, BC, ACNP, FAAN, FCCM With assistance from PARTNERS scholarship, Family Practice Nurse pursues her dream through new DNP program School of Nursing offers training in geriatrics for nurses PARTNERS organization endows first professorship University of Texas Health Services planning to expand number of clinics Caring Leaders The Engine of Innovation: School of Nursing researchers part of $36 million NIH grant to spur innovation Johnson and Johnson gala spotlights nurses Chad and Heath LePray UT School of Nursing and Memorial Hermann Hospital create partnership with Chief of Advanced Practice position A Tribute to Frank Cole Faculty Scholarship Endowed Faculty Positions

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Welcome from Dean Patricia Starck The Face of Health Care Leading Technology School of Nursing Collaborates to Initiate Texas Medical Center’s First Digital Repository Nursing Research, A Growing Field Nursing in the Wake of the Storm Profile: Huaping Liu, RN, PhD, Dean and Associate Professor, School of Nursing at Peking Union Medical College Newsbrief: Planning for the Future with a New Doctor of Nursing Practice Program in Fall 2006 Newsbrief: Fast Track Nursing Program Gives Students a Speedy Start Profile: Susan Bankston, RN, BSN, Psychiatric Nursing, Currently enrolled in the MSN to DSN track Newsbrief: University of Texas Health Services Reports Outstanding Achievements in FY’05 Student Grants Newsbrief: New Degree Program Develops Leadership and Business Skills for Today’s Nurses Profile: Pamela Klauer Triolo, PhD, RN, FAAN Clinical Professor of Nursing Director, Nursing Leadership and Administration in Health Systems Newsbrief: Successful Luncheon Completes $1 Million Endowment UT School of Nursing Building Recognized as Blending Form and Function Faculty Scholarship Endowed Faculty Positions

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Greetings Biobank and Centers model collaboration – Enable work of young researchers AccPhD Scholars Find First Year Exciting, Challenging Event Salutes AccPhD Donors Fay named to UT System’s Academy of Health Science Education PARTNERS Luncheon – Opera star hails nurses as “Beautiful Angels” at 2011 PARTNERS Spring Luncheon Hodges Voted School’s 2011 McGovern Outstanding Teacher Graduates soar– Steady growth and success of DNP program follows being first in Texas Reception honors Freds “Best Graduate Schools” – Guide ranks UTHealth tops in Texas/Newsbriefs Faculty Publications Faculty Research Endowed Faculty Positions

Caring Minds

Greeting Consortium on Aging Biobank at School of Nursing PARTNERS Luncheon/ "Ralph Thomas knows the value of investing in the future..." UTHealth, HCC Partnering for more Bachelor's Degree Nurses in Texas/ New Pacesetters Program Fast-Track PhD Program/ AccPhD scholars took many routes to same commitment Profiles and Newsbriefs McCombs School's MBA Program/ Keeping in Touch with Alumni Faculty Publications Faculty Research Endowed Faculty Positions

Caring for ageing migrants in nursing homes: 'doing diversity' while 'doing death'

The proposed paper will present first results of a research project investigating how nursing homes in Switzerland deal with migrant elders who are in intensive need of care. Focusing on the end-of-life in institutional care settings, the intention is to explore the dimensions of ‘doing death’ in Swiss nursing homes when the elderly involved are of migrant background. The focus is laid on the co-construction of end of life in interactions between residents of migrant background and professional carers involved (often of migrant background themselves), and will thereby focus on processes of ‘doing diversity’ while ‘doing death’. To do so, we chose an ethnographic approach focusing on the participant observation of everyday practices of ‘doing death’ and ‘death work’ and on interviewing staff, residents and their relatives. Caring for ageing migrants at the end of their lives is studied in different types of assisted living at the end of life: The field of research was entered by studying a group specific department for residents of so-called ‘Mediterranean’ background. It was contrasted by a department stressing the individuality of each resident but including a considerable number of residents with migrant background. We are interested in how (and if at all) specific forms of ‘doing community’ within different types of departments may also lead to specific ways of ‘doing death’, which aim at a stronger embeddedness of dying trajectories in social relations of reciprocity and exchange. Furthermore, migrant ‘doing death’ is expected to be particularly negotiable since the potential diversities of symbolic reference systems and daily practices are widened. If the respective resident is limited in his/her capacities to play an active part in negotiating about ‘good care’ and ‘good dying’ – either due to language competences, which would be migrant specific, or due to degenerative diseases, which is not migrant specific – the field of negotiations will be left up to the professionals within the organization (and to the relatives, which are, however, not constantly present). Strategies of stereotyping the ‘other’ as well as driving nurses, caring aides and other professionals of migrant background into roles of ‘cultural experts’ or ‘transcultural translators’ are expected to be common in such situations. However, the task of negotiating what would be a ‘good dying’ and what measures are appropriate is always at stake in contemporary heterogeneous societies. Therefore we would argue that studying dying processes involving migrant residents is looking at paradigmatic manifestations of doing death in recent contexts of reflexive modernity.

In the aftermath of medical error : Caring for patients, family, and the healthcare workers involved

Medical errors, in particular those resulting in harm, pose a serious situation for patients ("first victims") and the healthcare workers involved ("second victims") and can have long-lasting and distressing consequences. To prevent a second traumatization, appropriate and empathic interaction with all persons involved is essential besides error analysis. Patients share a nearly universal, broad preference for a complete disclosure of incidents, regardless of age, gender, or education. This includes the personal, timely and unambiguous disclosure of the adverse event, information relating to the event, its causes and consequences, and an apology and sincere expression of regret. While the majority of healthcare professionals generally support and honest and open disclosure of adverse events, they also face various barriers which impede the disclosure (e.g., fear of legal consequences). Despite its essential importance, disclosure of adverse events in practice occurs in ways that are rarely acceptable to patients and their families. The staff involved often experiences acute distress and an intense emotional response to the event, which may become chronic and increase the risk of depression, burnout and post-traumatic stress disorders. Communication with peers is vital for people to be able to cope constructively and protectively with harmful errors. Survey studies among healthcare workers show, however, that they often do not receive sufficient individual and institutional support. Healthcare organizations should prepare for medical errors and harmful events and implement a communication plan and a support system that covers the requirements and different needs of patients and the staff involved.