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Biomedical subjects

M Gilliland

Publications and source records attributed to M Gilliland.

9 recordsLinked to original sources
PubMed1995

Caring for the nurse self: verbal abuse as a case in point.

An assumption that undergirds quality improvement activities is that a practitioner cares for himself or herself. The article describes six caring attributes. The discussion focuses on care of the nurse self with verbal abuse as a case in point. Nurses average five to six incidents of verbal abuse every month. Understanding oneself and implementing certain techniques can help one overcome feelings of powerlessness, incompetence, and decreased self-worth. Self-knowledge and self-change are important aspects of the nurse caring for himself or herself. Quality nursing practice is a positive outcome.

Humans↗
PubMed1991

The use of a decision analysis model in multidisciplinary decision making.

This paper describes a conceptual decision analysis model for use in multidisciplinary decision making. Decision analysis was used to structure a decision process that ensured the best choice through consensus building among hospital decision makers. The four basic steps of the decision analysis model included: (1) identifying and establishing boundaries of the decision problem; (2) structuring the decision problem; (3) characterizing information needed to fill in the structure; and (4) choosing a preferred course of action. The selection of the best intermittent intravenous drug delivery system for Presbyterian Hospital illustrates the application of the conceptual model. This type of decision analysis model becomes a useful consensus building and communication device for the administrative pharmacist who is involved in multidisciplinary decision-making processes.

Decision Making, Organizational↗
PubMed1991

Communications at the pharmacy-nursing interface.

The next evolutionary step at the pharmacy-nursing interface is the implementation of a new patient care delivery model to enhance quality and contain costs. In addition, increasingly sophisticated biotechnology drugs and drug delivery systems will require close communication and collaborative practice between pharmacy and nursing. The effective communication interface already established will form the foundation for an even closer relationship and for working together effectively and efficiently in the constantly evolving health care environment. Indeed, regardless of what the future may hold, effective communications and resultant teamwork will continue to strengthen the achievement of patient care goals and ensure a bright future for both departments.

Communication↗
PubMed1987

Preliminary report: natriuretic effect of calcium supplementation in hypertensive women over forty.

Twenty-four hypertensive women over 40 years of age were given calcium carbonate 1 g/d for 12 weeks after a 4-week period of observation. Blood pressures were measured every 2 weeks. Plasma ionized calcium (Ca++), sodium (Na), and potassium (K) were measured twice in the control period and twice in the Ca-supplementation period. Urine measurements included Ca, Magnesium (Mg), Na, K, prostaglandin E2, and osmolality. Blood pressures were averaged to get group means, and these were compared using the paired t-test. For the group, seated systolic blood pressure fell from 141.5 +/- 13.2 to 136.3 +/- 11.4 mm Hg (p less than 0.025) at the end of 12 weeks of supplementation, and diastolic blood pressure fell from 84.5 +/- 7.5 to 81.1 +/- 7.1 mm Hg (p less than 0.025). There was no correlation between serum Ca++ and blood pressure. The urinary Na excretion was markedly elevated during the Ca supplementation period: 25.8 +/- 14.2 vs. 18.4 +/- 7.9 mmol/4 hr (p less than 0.005). These results suggest an indirect (natriuretic) effect as the means by which Ca supplementation lowers blood pressure.

Blood Pressure↗
PubMed1983

Hypotension-induced post-traumatic necrosis of the right colon.

Necrosis of the right colon developed after hemorrhagic shock in six young traumatized patients who did not have colon injury. The mean duration of hypotension was 112 minutes, and the mean resuscitation fluid volume required was 22 liters. Signs of right colon necrosis appeared 2 to 7 days after injury (median 2 days). All patients survived right colectomy and ileocolostomy or ileostomy and mucous fistula. The cause of necrosis of the right colon after hemorrhagic shock from major trauma is not clear. Anatomic abnormalities in blood supply to the right colon or a derangement in the physiologic processes of the microcirculation of the right colon must be considered.

Adult↗
PubMedDate not supplied

Workforce reductions: low morale, reduced quality care.

As the number of positions decreases, the workload becomes more stressful for nurses left to pick up the slack. Mistakes are made, patient complaints increase as tensions rise, and the quality of nursing care decreases. The use of contingency staffing and overtime may increase as the workforce is reduced. Lack of job security forces acceptance of overtime, leaving less time for family life which may lead to resentment. The success of an organization is linked to employees' willingness to perform and use their skills. With deteriorating attitudes, employees will not perform at maximum effectiveness. Services do not meet established standards or customer expectations and are reflected in negative customer feedback and decreasing revenues. "There are no quick fixes. Tossing out last month's 'cure' to usher in this month's idea is a big waste of time" (Austin, 1994, p. 19). The impact from layoffs has long-lasting effects on employees, their families, and the community. Support for those displaced, and for those retained, provides a release for pent-up emotions and allows employees to get on with the work at hand. Workforce reductions will continue with the decrease in funding and the decline in patient census, but it is imperative that the quality of care be maintained. Registered nurses cannot be replaced at the bedside by UAP who do not have the specialized knowledge and skills required to provide safe and effective care (Thomas, 1995). Efforts to cut costs should be directed toward decreasing waste and eliminating redundant work, not at decreasing the number of RNs. The RN must remain the primary caregiver at the bedside to maintain quality care. Changes that remove the RN from the bedside will influence the quality of care that patients receive in the future. Increased demands and fewer, less-experienced staff result in less time for patient care. One negative patient outcome can be much more costly, directly and indirectly, than the salaries of several staff nurses.

Health Care Reform↗