Such findings are important as they provide information for student nurses, preceptors and educators in guiding clinical placement experiences that are able to facilitate the development of the nursing identity.
Conclusion. Patients on ECMO support had low rates of palliative care utilization despite long hospitalizations and aggressive interventions. Withdrawal from life sustaining therapies was very common in this population. Implications for Research, Policy or Practice. Patients receiving ECMO support could benefit from palliative care consultation given high rates of aggressive interventions and frequent withdrawal of life sustaining therapy at the end of life. Further research regarding timing and focus of palliative care intervention might benefit symptom burden and quality of life in this patient population.
status (married vs. single; aOR¼1.92 (1.01, 3.66)), number of family members involved in decisions (2+ vs. 1; aOR¼1.84 (1.05, 3.21)), and religious affiliation (none vs. any religion) (aOR¼4.87; (1.12, 21.09)) were associated with discordance. Surrogate-rated quality of communication (Family Inpatient Communication Survey; aOR¼0.98 (0.96, 0.99)) was also associated with discordance. Conclusion(s) and Impact. Nearly half of patients received at least one discordant medical treatment or order, including CPR inconsistent with treatment goals. Patients with low surrogate contact and poor communication with clinicians may be at higher risk for discordant care. Quality of communication may be one modifiable factor that could reduce discordance and reduce the risks of unnecessary and unwanted interventions.
Background: Mature aged nursing students of the 'Baby Boomer' generation are important for health workforce retention and planning because once graduated, they are viewed as being more loyal to the profession and consequently likely to remain in the nursing workforce. A challenge though, related to this group is providing them with a fulfilling and worthwhile work integrated learning experience that enables them to engage with their new profession. Methods: An exploratory study was conducted using an online survey with open-ended questions to explore the supports for and barriers to the learning opportunities of "baby boomer" aged undergraduate-nursing students (n = 35) during their work integrated learning experience. The study sought to understand how these supports and barriers impact on their emergent Registered Nurse (RN) self-concept. Results: Four key themes emerged to explain the supports for and barriers to the development of the RN self-concept. These are: quality communication, feeling connected, role clarity, and feedback. Each theme was informed by several sub-themes that identified supports for and barriers to the development of the nurse self-concept in baby boomer undergraduate nursing students. The time era in which nursing students grow up has a significant impact on the way they learn as well as the way they expect to be taught. Understanding the fundamental differences between learners will help meet their needs more effectively. Attitudes deemed as supportive by 'baby boomer' students in this study are belongingness, supportiveness and appreciation of their role. 'Baby boomer' students indicated that it is important their facilitator or preceptor as well as ward staff demonstrate high levels of these attitudes. Many mature aged students may already have previous nursing experience (70% in this study). As such, it is imperative to take time to inquire about past experiences which contribute to learning new skills so as to ensure their past experience is not devalued. Besides the valuing of past experiences, 'baby boomers' appreciate immediate quality feedback and encouragement.
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