True collaboration between clinical nurses and physicians in acute care settings can be difficult to achieve. The author describes a patient care unit dedicated to the study and development of such collaborative relationships. She reports an unexpected favorable outcome of such collaboration: the decline in incidents of moral outrage among nurses faced with moral dilemmas. This decline is attributed to such factors as mutual trust and respect between nurses and physicians, an appreciation that the two practice areas are interdependent, and the development of a synergistic alliance between the two that enhances patient care.

Aged↗

PubMedDate not supplied

On the nature and place of empathy in clinical nursing practice.

Empathy has long been thought of as a fundamental component of nurse-patient interactions. Despite the central role empathy has been accorded, understanding how the concept is operationalized in practice is difficult. A review of nursing literature on empathy is presented to help clarify the concept, and an analysis is given concerning the relationship of empathy to recent findings on expert caring in nursing. Vignettes are presented as illustrations of the concepts discussed.

Clinical Competence↗

PubMedDate not supplied

A multiple infusion start time (MIST) protocol for stable isotope studies of fetal blood.

A new approach utilizing multiple infusion start times for two stable isotopes of leucine was applied to seven pregnancies in order to assess equilibration times for isotopic studies when a single fetal blood sample is available. Two infusates, one containing l -[1-(13)C]-leucine and the other l -[5,5,5-D3]-leucine, were given as a primed constant infusion in the maternal circulation at fetal blood sampling (FBS). In five patients l -[1-(13)C]-leucine infusion was started at time zero (T(0)) whereas l -[5,5,5-D3]-leucine infusion began 30 min later, and both were continued until the umbilical sample was obtained at 149.7+/-8.8 min. In order to assure non-steady state conditions, in two patients the first infusion started at T(0)and the second 17 and 6 min before FBS was performed at 115 and 154 min, respectively. The fetal/maternal ratio for l -[5,5,5-D3]-leucine over the fetal/maternal ratio for l -[1-(13)C]-leucine was 0.98+/-0.03, indicating steady state conditions for both infusions for the first six patients. In the last patient the ratio was 0.51, indicative of non-steady state conditions for the shortest infusion time. Our results show that a single fetal sample can provide data for fetal amino acid enrichments reflecting multiple time points. Leucine steady state is achieved 20 min after a primed continuous infusion both in the maternal and fetal circulations.

Blood Glucose↗

PubMedDate not supplied

Antiseptic use in wound management.

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Administration, Topical↗