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Treating against a stated refusal: The ethics of substitute decision-making when a patient cannot capably refuse. 反对明确拒绝的治疗：当病人无法拒绝时替代决策的伦理。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000387
Jennifer A Gibson, Tyler Paetkau
{"title":"Treating against a stated refusal: The ethics of substitute decision-making when a patient cannot capably refuse.","authors":"Jennifer A Gibson, Tyler Paetkau","doi":"10.1097/NSG.0000000000000387","DOIUrl":"10.1097/NSG.0000000000000387","url":null,"abstract":"<p><strong>Abstract: </strong>Decision-making capacity in health care refers to a person's ability to understand information relevant to a decision, appreciate how the decision affects them, make a choice, and communicate that choice. Capacity is essential in ethics and professional nursing practice because it forms the basis of informed consent. Nurses encounter various medical conditions, such as dementia, that can contribute to changes in cognitive abilities and result in diminished capacity. However, having a cognitive condition such as dementia does not necessarily mean a person lacks the capacity to make a specific decision or provide informed consent. This article examines a surgical clinical case involving a patient with diminished decision-making capacity related to dementia and probable delirium who needed a surgical intervention. Using this case study, the authors explore the ethics of substitute decision-making, the best interests standard, and a principled approach to supporting a patient who is incapable of refusing a recommended invasive treatment.</p>","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Peter Principle and Nursing. 彼得原理与护理。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000400
Lynda A Stear
{"title":"The Peter Principle and Nursing.","authors":"Lynda A Stear","doi":"10.1097/NSG.0000000000000400","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000400","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The new grad dilemma: Ready to serve, waiting for a chance. 新的毕业生困境：准备好服务，等待机会。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000397
Jessica Servoss
{"title":"The new grad dilemma: Ready to serve, waiting for a chance.","authors":"Jessica Servoss","doi":"10.1097/NSG.0000000000000397","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000397","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"37-38"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addressing human trafficking in health care settings: Simulation and interprofessional education strategies. 解决卫生保健环境中的人口贩运问题：模拟和跨专业教育战略。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000421
{"title":"Addressing human trafficking in health care settings: Simulation and interprofessional education strategies.","authors":"","doi":"10.1097/NSG.0000000000000421","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000421","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"23-24"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dual nursing roles for regulatory compliance and retention. 双重护理角色的法规遵从和保留。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000386
Shawnna Cunning
{"title":"Dual nursing roles for regulatory compliance and retention.","authors":"Shawnna Cunning","doi":"10.1097/NSG.0000000000000386","DOIUrl":"10.1097/NSG.0000000000000386","url":null,"abstract":"<p><strong>Abstract: </strong>The nursing profession faces significant challenges, including high turnover rates, burnout, and job dissatisfaction, with over one-quarter of registered nurses planning to leave the profession within 5 years. Simultaneously, health care organizations spend $38.6 billion annually on regulatory compliance, creating substantial administrative and financial burdens. A dual-role nursing model that combines traditional bedside care responsibilities with regulatory compliance and quality improvement activities can be used as a strategic solution to address both nursing retention challenges and organizational regulatory costs. The proposed model utilizes existing bedside nurses in expanded roles that split time between direct patient care and regulatory activities. Implementation involves comprehensive training on Medicare Conditions of Participation, participation in regulatory councils and committees, and application of Rogers' Diffusion of Innovation theory to promote compliance adoption among peers. The dual role model addresses multiple organizational challenges simultaneously by: reducing regulatory compliance costs through utilization of existing staff rather than contracted services or dedicated positions; enhancing nurse job satisfaction, autonomy, and professional development opportunities; improving regulatory readiness through clinicians who understand frontline care delivery; and supporting the American Nurses Association's Nursing Human Capital Value Model by positioning nurses as capital investments rather than operational expenses.</p>","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"44-48"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementing an admission-discharge nurse program to improve patient and nurse outcomes: A quasi-experimental study. 实施入院-出院护士计划以改善患者和护士的预后：一项准实验研究。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000401
Brandie Bailey, Brooke Garrity, Brandon Jones, Kimberly Ferren Carter
{"title":"Implementing an admission-discharge nurse program to improve patient and nurse outcomes: A quasi-experimental study.","authors":"Brandie Bailey, Brooke Garrity, Brandon Jones, Kimberly Ferren Carter","doi":"10.1097/NSG.0000000000000401","DOIUrl":"10.1097/NSG.0000000000000401","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the impact of implementing an admission discharge registered nurse (RN-AD) on five inpatient units at an acute care, 718-bed Magnet®-designated, academic, and Level I trauma center on throughput pressures, nurse staffing ratios, and increased workload.</p><p><strong>Method: </strong>To assess the impact of implementing RN-ADs, the authors conducted a nonequivalent pre/post quasi-experimental study utilizing electronic health record data (discharge time, admission date, discharge date) and standardized patient experience survey scores. Predata were collected from August 2016 to July 2017, and postdata were collected from August 2017 to July 2018.</p><p><strong>Results: </strong>Of the 19 114 patient encounters examined, length of stay decreased, discharge before noon increased, and patient experience scores increased; nurses also noted a positive impact on patient discharge.</p><p><strong>Conclusion: </strong>Implementation of an RN-AD role was associated with improvements in length of stay, earlier discharge timing, patient experience, and nurse satisfaction. These findings suggest that dedicated admission and discharge nurse support may be an effective workforce strategy to improve patient flow while reducing the operational burden on bedside nurses.</p>","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Finding joy and fulfillment in nursing. 在护理中找到快乐和成就感。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000422
Linda Laskowski-Jones
{"title":"Finding joy and fulfillment in nursing.","authors":"Linda Laskowski-Jones","doi":"10.1097/NSG.0000000000000422","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000422","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do not cut scopolamine or cloNIDine patches for partial medication doses. 对于部分用药剂量，不要切开东莨菪碱或可乐定贴片。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000402
Ann Shastay, Shannon Bertagnoli
{"title":"Do not cut scopolamine or cloNIDine patches for partial medication doses.","authors":"Ann Shastay, Shannon Bertagnoli","doi":"10.1097/NSG.0000000000000402","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000402","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"53"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Steatotic liver disease and cardiovascular-kidney-metabolic syndrome: A case study. 脂肪变性肝病和心血管-肾-代谢综合征：一个案例研究。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000420
{"title":"Steatotic liver disease and cardiovascular-kidney-metabolic syndrome: A case study.","authors":"","doi":"10.1097/NSG.0000000000000420","DOIUrl":"https://doi.org/10.1097/NSG.0000000000000420","url":null,"abstract":"","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"35-36"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Steatotic liver disease and cardiovascular-kidney-metabolic syndrome: A case study. 脂肪变性肝病和心血管-肾-代谢综合征：一个案例研究。
Nursing Pub Date : 2026-06-01 Epub Date: 2026-05-18 DOI: 10.1097/NSG.0000000000000389
Heidi Kolodziejczyk, Elena Ignatiev
{"title":"Steatotic liver disease and cardiovascular-kidney-metabolic syndrome: A case study.","authors":"Heidi Kolodziejczyk, Elena Ignatiev","doi":"10.1097/NSG.0000000000000389","DOIUrl":"10.1097/NSG.0000000000000389","url":null,"abstract":"<p><strong>Abstract: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease, is the leading cause of chronic liver disease in the world, and is closely linked to metabolic syndrome, and cardiovascular-kidney-metabolic (CKM) syndrome. This article discusses key considerations in diagnosis and management of MASLD, its relevance to CKM syndrome, and associated nursing implications through use of a case example. The article reviews the epidemiology and risk factors of MASLD, summarizes noninvasive diagnostic tools, and discusses lifestyle and pharmacologic treatment options. Incretin therapies, such as glucagon-like peptide-1 (GLP-1) receptor agonists and gastric inhibitory polypeptide/GLP-1 receptor agonists are emphasized, due to their systemic benefits. A simplified screening algorithm using Fibrosis-4 Index and staging criteria for liver fibrosis and CKM syndrome are also provided. Nursing considerations include weight bias awareness, patient-centered communication, interdisciplinary coordination, and the realities of insurance obstacles. Future directions call for system-level efforts to improve equitable access, integrate guideline-based practice, and improve early identification and intervention.</p>","PeriodicalId":35641,"journal":{"name":"Nursing","volume":"56 6","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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