People who are diagnosed with a substance use disorder can experience stigmatizing interactions with health and social service providers, which may decrease both quality and continuity of care. For women with a substance-exposed pregnancy (SEP), this stigma can increase exponentially. Stigmatizing interactions can be difficult to identify due to social sanctions against expressing stigmatizing attitudes, beliefs, and behaviors and because stigma often resides in accepted cultural norms. Examining discourses around care provision can serve to identify instances of social stigma as well as illuminate the cultural norms in which they are embedded. Using data from a seven-year grounded theory study on perinatal substance use service provision, this paper reports on the perceptions and experiences of service providers working with mothers who have an SEP and illustrates complexities behind stigmatizing patient-provider interactions. Data collected included observations at meetings, workshops, and conferences addressing best practices across the continuum of care for perinatal substance use as well as interviews and focus groups with providers. The construct of “good mothering,” or hegemonic motherhood, was identified as an important cultural norm that supported social stigma and was embedded in providers’ interactions with mothers with an SEP. Discursive elements found in providers’ descriptions of perinatal substance use service work are presented and highlight the role of hegemonic motherhood as a stigmatizing agent.

Topic Neonatal nurses who care for infants with symptoms of neonatal abstinence syndrome (NAS) may experience moral distress through conflicting professional ethics. The nurse may find it difficult to simultaneously exemplify beneficence and nonmaleficence. Objective The purpose of this paper is to explore the moral distress of nurses in the context of infants experiencing symptoms of NAS and apply a new conceptual model to this phenomenon. Understanding how nurses navigate moral dilemmas may provide insight into strategies to better support them to address moral conflict. Methods Moral distress was explored in the context of nurses who care for infants with symptoms of NAS. A literature review was completed, followed by the application of the model onto the derived themes. Results The theoretical application resulted in a framework that exemplifies the experience of caring for infants with symptoms of NAS and their families described by many nurses within the literature. If moral distress is not resolved, negative outcomes may be experienced by the nurse, with additional negative outcomes experienced by the family. Conclusion This theoretical model provided insight into the experience of moral distress surrounding nursing care for infants with symptoms of NAS. Additional research is needed to investigate moral residue and moral resilience in this particular caregiving dynamic.

➢ Gustilo-Anderson type-III open fractures remain a considerable cause of morbidity and amputation.➢ Systemic antibiotic prophylaxis with cephalosporins was introduced in the 1970s and substantially reduced the prevalence of infectious complications following injury.➢ The use of antibiotics with an extended gram-negative (EGN) spectrum, such as aminoglycosides, is controversial; however, they are commonly used in type-III open fractures.➢ Emerging literature has suggested that EGN antibiotic prophylaxis for type-III open fractures may not reduce infectious complication rates.➢ Reducing the routine use of EGN antibiotics may be an important component of antimicrobial stewardship in orthopaedic trauma to reduce bacterial resistance and thus more complicated infections.

PurposeTo explore the caregiving dynamic between NICU nurses and mothers with a substance-exposed pregnancy (SEP) by examining how nurses view these mothers compared to mothers without an SEP.DesignA qualitative design using interviews with NICU nurses who care for infants and families with an SEP.SampleThe sample (n = 9) was all female, with an average of approximately 10 years of nursing experience in the NICU, with two-thirds having achieved a Bachelor of Science in Nursing (BSN) or higher.Main outcome variablePerceptions of nurses working with families affected by an SEP.ResultsStigmatized views and trust issues shaped nurses' views of mothers with an SEP as different from other mothers. Empathy levels toward mothers differed related to nurses' views of substance use as either a moral decision or chronic disease. These viewpoints shaped the nurse's judgment of the mother's potential to provide a safe environment and independently care for the infant at home. Nurses described personal distress when caring for these families.

Women in the United States are retiring at an unprecedented rate, with many retirements driven by recent economic downturns and social expectations, such as caregiving. Successful retirement transition is a key component of happiness during older adulthood, but many factors suggest that forced retirement may have a negative impact on health. The purpose of the current research study was to explore the lived experiences of women who were forced to retire. The current study population comprised 10 women, age ≥55, recruited from community settings to participate in individual semi-structured interviews. Participants shared common experiences, despite having different reasons for retiring. The overarching theme of Now What? Denied the Opportunity to Mentally Prepare was identified. Findings suggest opportunities for nurses to assess women for mental and physical health indicators and assist them as they transition into retirement, particularly if the retirement was unplanned. [ Journal of Psychosocial Nursing and Mental Health Services, 57 (10), 12–16.]

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Background: Retention of online nursing students in graduate education is essential as the need for nurses exceeds the current supply. Method: The factors contributing to student attrition are reviewed, and a real-world case exemplar is presented to demonstrate the theoretical design and implementation of an orientation to support retention. Results: Knowles' theory of adult learning and Cooper's PECS (purpose, expectations, connections, and support) model for an evidence-based orientation framework guided the design of the orientation. Knowles' theory was aligned with the PECS model to further describe how student and environmental factors can be addressed in an orientation framework and provide strategies for implementation. Additionally, these PECS definitions were applied to specific activities within a conceptual, theoretical, and empirical framework for development of orientations. Conclusion: This case exemplar demonstrated an orientation framework for a feasible application of theory and evidence-based strategies for graduate online nursing programs. [ J Nurs Educ . 2022;61(6):314–321.]