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Biomedical subjects

Elizabeth A Steinmiller

Publications and source records attributed to Elizabeth A Steinmiller.

3 recordsLinked to original sources

Working with complex care patients.

The following article provides the authors' definition of complex care patients. It is based on what they have learned about these special patients from the literature and from their personal clinical experiences. When I received this article for review, I decided to do a literature search on the term complex care patient and had a difficult time finding relevant articles. I asked a wonderful librarian from the Boston Children's Hospital, Alison Clapp, to help me with the search, and she had to maneuver through a maze of clinical subheadings. She described the search as "a difficult one." It is ironic that the search for information pertaining to these patients mirrors the complexity of care that they require from us. Are complex care patients the same as complex patients? The insertion of the word care may make a difference: You decide. There are complex patients who challenge us technically and intellectually, and then there are those who require even more from us--they challenge us technically, intellectually, physically, emotionally, and spiritually. The term complex care patient encompasses all these care dimensions. I think it is an excellent choice of words to make us consider what we are increasingly expected to do--and how we cannot do it alone.--Maura MacPhee, RN, PhD, Clinical Practice Column Editor.

Adolescent↗

Nursing interventions for a chronically ill, nonadherent teenager with a psychiatric diagnosis.

ISSUES AND PURPOSE: To describe the complex care of an adolescent with chronic psychiatric and medical problems. CONCLUSIONS: The nonadherent, self-abusing, adolescent was empowered to progress developmentally, as well as medically. PRACTICE IMPLICATIONS: A planned team approach helped the adolescent become more developmentally appropriate and independent in self-care. The care plan designed by nursing staff included a change in nursing focus, creative problem solving, team nursing, and utilization of multidisciplinary resources.

Adolescent↗

Waiting together: translating the principles of therapeutic relationships one step further.

ISSUES AND PURPOSE: Inconsistent nursing practices created nurse-patient boundary issues on a cardiac step-down unit related to confidentiality, limit setting, and professionalism with patients and families awaiting organ transplantation. CONCLUSIONS: A staff work group designed and implemented a plan to translate the principles of therapeutic relationships into daily practice. PRACTICE IMPLICATIONS: A work plan developed for nursing staff outlined concrete solutions and resources available within the hospital. This framework can be used to empower staff in the ongoing effort to manage relationships with chronically ill patients and their families.

Adolescent↗