Aim To identify strategies that older adults use to adapt to live in long‐term care. Background The use of long‐term care services has risen and this trend is expected to continue as the population reaches old age. Moving into a long‐term care setting has been documented internationally as an overwhelming life change for many older adults. It has been observed that residents adjust differently over time, but the basis for these differences needs further exploration. Design A qualitative design using grounded theory method was employed. Methods A total of in‐depth interviews were conducted in October 2008–February 2009 with a sample of 21 participants. Participants ranged in age from 65–93 years, 81% women and 19% men; mainly Caucasian with one African American and one Hispanic. Length of stay ranged from 3 days to over 9 years living in long‐term care so that all stages of adjustment were included in the study. Ground theory method was used to analyse the data. Findings The results of this study yielded 21 facilitative strategies. The core category identified was personal resiliency, which served as the underpinning for the strategies used by the participants. Strategies were identified in making the decision to move into long‐term care and in day‐to‐day living. Conclusion Understanding the strategies that facilitate residents to make a successful transition to long‐term care life will assist nurses to intervene in ways that are supportive. The strategies identified in this study may be used to develop interventions for residents that are having difficulty living in long‐term care. Further exploration of how resiliency has an impact on strategies used by residents is clinically relevant, but further research is needed.

At least 1 in 5 Americans die while using intensive care service-a number that is expected to increase as society ages. Many of these deaths involve withholding or withdrawing life-sustaining therapies. In these situations, the role of intensive care nurses shifts from providing aggressive care to end-of-life care. While hospice and palliative care nurses typically receive specialized support to cope with death and dying, intensive care nurses usually do not receive this support. Understanding the experiences of intensive care nurses in providing care at the end of life is an important first step to improving terminal care in the intensive care unit (ICU). This phenomenological research study explores the experiences of intensive care nurses who provide terminal care in the ICU. The sample consisted of 18 registered nurses delivering terminal care in an ICU that participated in individual interviews and focus groups. Colaizzi's steps for data analysis were used to identify themes within the context of nursing. Three major themes consisted of (1) barriers to optimal care, (2) internal conflict, and (3) coping. Providing terminal care creates significant personal and professional struggles among ICU nurses.

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The findings provide an understanding of expert nursing practice that can serve as a foundation for efforts to transfer knowledge from expert nurses to less expert nurses in all practice settings to reduce the expertise gap that is now widening.

Violence against women is a global epidemic with potential consequences of injury, illness, and death. Children exposed to the violence may also be impacted with functional impairments. Little is known of the inter-generational impact of violence experienced by the mother from an intimate partner on functioning of her children. No dyad analysis was found in the literature. To examine the inter-generational impact of violence against women on the behavioral functioning of children, 300 mothers reporting intimate partner abuse and one randomly chosen child, age 18 months to 16 years of age; were evaluated for borderline and clinical diagnostic levels of problem behaviors. Linear, Logistic, and Ordinal regression models were applied. Mothers' problem behavior scores were significantly related to children's problem behavior scores (internalizing r = 0.611, externalizing r = 0.494, total problems r = 0.662, all ps < 0.001). Mothers who reported clinical and borderline clinical internalized problems (i.e., depression, anxiety) were 7 times more likely to have children with the same problems and mothers with borderline clinical and clinical external problems (i.e., aggression, hostility) were 4.5 times more likely to have children with the same external problems. These dyadic analyses provide evidence of a direct relationship of maternal functioning on child behavioral functioning. Intervention strategies to decrease internalizing maternal behavioral problems, such as depression, anxiety, and post traumatic stress disorder, and/or externalizing problems, such as hostility and aggression, can be expected to have a pass through, secondary impact on the behavioral functioning of children. Awareness of the relationship between intimate partner violence against mothers and child behavioral function can support interventions that decrease the distress experienced by mothers and their children, interrupt intergenerational transmission of abusive behaviors, and promote better maternal child functioning.

Nursing students from disadvantaged backgrounds must overcome many barriers in order to succeed. This article will focus on how a multidisciplinary team helped 76 percent of these high-risk students persist in their nursing programs by addressing some of these barriers. Three baccalaureate nursing schools in the Texas Medical Center embarked on a three-year retention program designed to enhance the success of students identified by federal criteria as being at risk. Multidisciplinary teams led various activities, including a study skills component, which included preparing for lectures, taking notes, critical thinking, and test-taking strategies. Also addressed were written and oral communication skills, medical terminology, critical thinking, career coaching, and socialization activities. Collaboration among faculty and students at the three schools was key to the success of the program.

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The women in this study reported ACE scores consistently higher than national rates. Our data highlight the added benefit of using ACE criteria as a global prevention strategy to identify those most at risk for delayed mental and behavioral health issues and to intervene with supportive strategies and guided referrals as indicated.