The findings from the present study supported an existing model of moral injury, while extending it in several important ways. Preliminary clinical recommendations and directions for future research are discussed based on the study findings. These include directly exploring the context surrounding the morally injurious event, examining the veterans' moral appraisals, and helping them assume appropriate responsibility for their actions to reduce excessive self-blame. (PsycINFO Database Record
One of the goals of nursing education is to develop caring and responsible nurses with clinical reasoning skills who are capable of improving outcomes in complex healthcare systems. Using the Model of Situated Learning in Nursing Leadership, generalist entry graduate nursing students at Rush University in Chicago, part of a large academic medical centre with Magnet recognition for excellence in nursing practice, are educated using a curriculum based on the clinical nurse leader (CNL) competencies. This article presents a case study that demonstrates how the model is used to provide experiences for learning the CNL role. The students learn leadership in practice through their involvement in ongoing efforts at the medical centre to improve the care of patients with intellectual and developmental disabilities. The case study provides lessons in teaching CNL leadership competencies through efforts to improve the quality of care for an at-risk group of patients.
Individuals with intellectual and developmental disabilities (ID) represent a small but important group of patients who have high levels of hospitalisation, and who are likelier to have more complications and spend more days in intensive care than those without ID admitted to hospital for similar problems. However, nursing and medical staff lack training in the care of people with ID. To address the needs of this patient group, an academic medical centre in the mid-western United States has developed specific standards of nursing care. This article describes the standards, which cover nursing interventions to enhance communication, the provision of safe and accessible environments, and collaboration with and support for caregivers; it also outlines the online educational programme that was developed for nurses to support their implementation and use of the standards.
The COVID‐19 pandemic has highlighted the need for public health nursing as an integral part of a strong public health workforce. However, it has also created challenges in preparing future nurses as much of nursing instruction, including clinical experiences, needed to urgently transition learning to a virtual environment. This paper describes the process faculty experienced during spring 2020 to quickly transition public health nursing clinicals from in‐person to virtual learning in response to COVID‐19. Further, faculty lessons learned are shared and include the importance of creating a supportive team dynamic, embracing innovation, continuing to engage with community partners, and adapting to meet emerging student needs during the evolving pandemic. The process and lessons learned may act as a guide for other nursing programs as we continue to navigate nursing education during this and future pandemics.
Individuals with intellectual disability (ID) represent a small but important group of hospitalized patients who often have complex health care needs. Individuals with ID experience high rates of hospitalization for ambulatory-sensitive conditions and high rates of hospitalizations in general, even when in formal community care systems; however, no research was found on the common reasons for which this population is hospitalized. Academic medical centers often treat the most complex patients, and data from these centers can provide insight into the needs of patient populations with complex needs. The purpose of this study was to analyze descriptive data from the UHC (formerly known as the University Healthsystem Consortium; an alliance of 115 U.S. academic medical centers and 300 of their affiliated hospitals) regarding common reasons for hospitalization, need for intensive care, and common hospitalization outcome measures of length of stay and complications for adult (age ≥ 18) patients with ID. Findings indicate the need for specific attention to the needs of hospitalized patients with ID.
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