Chronic Sorrow in Stage 4 Cancer: A Spiritual Challenge.

Living with Stage 4 cancer impacts how individuals conceptualize themselves and how they conduct their everyday lives. Within this synopsis, I describe my experiences living with progressing Stage 4 breast cancer. The construct of chronic sorrow is applied to my experiences. I suggest that grief and chronic sorrow are largely spiritual issues and give examples of my spiritual practices. Finally, recommendations are offered for healthcare professionals.

When Breast Cancer Survivorship Discourse Doesn't Work: Reflections From a Patient.

Within this narrative, I document my experiences with breast cancer. On 2 separate occasions, diagnoses did not qualify me for survivor identity within the current interpretation of breast cancer survivorship discourse. Yet each time, I underwent treatments that were necessary, but physically and emotionally difficult. I briefly discuss how breast cancer survivorship discourse is interpreted, including how this discourse has benefitted women, but also, the challenges in survivorship discourse adoption (including how the current survivorship definition differs). I then discuss my struggles in feeling like I could not assume breast cancer survivorship discourse, including the confusion and despair, as well as feeling ineligible for support groups. Briefly, one suggestion for change is made.

Aging Individuals With Down Syndrome and Dementia as Teachers: Learnings from Staffin a Developmental Disability Program in Long-Term Care.

Older adults with Down syndrome (DS) and dementia are an emerging sub-population. With much longer life spans than decades ago, issues have arisen as to where these aging adults will live and how nurses and other staff in facilities can provide effective care to these individuals. The current article presents a research study that examined the learnings of nurses and staff members working within a western Canadian program for older adults with DS and dementia. These learnings include: the importance of learning from each other; importance of collaboration; how individuals with developmental disabilities communicate; older adults with DS and dementia differ from older adults with dementia; and residents' impact on staff. [Journal of Gerontological Nursing, 45(5), 17-22.].

PTSD Symptoms, Vicarious Traumatization, and Burnout in Front Line Workers in the Homeless Sector.

Work with clients who have trauma-related problems is reported to lead to a constellation of reactions including vicarious traumatization, compassion fatigue, and burnout. Traumatic experiences are ubiquitous in the lives of homeless people, stemming from multiple life events prior to, and as a result of, experiencing homelessness. While most studies examine either burnout and vicarious traumatization or potential PTSD in people who work with those who are traumatized, they generally do not look at the possible co-existence of all three factors. They also do not explore if these factors indicate the extent to which burnout or vicarious traumatization may lead to PTSD symptoms or that the existence of PTSD symptoms may precipitate greater rates of burnout. In addition, there are no existing studies that provide a quantitative view of the characteristics of frontline workers in homeless services. In this study, we surveyed 472 individuals who work in frontline positions in homeless shelters in 23 different organizations. We found rates of burnout, vicarious traumatization and compassion satisfaction, comparable to workers in other social services organizations but found rates of PTSD symptoms to be at 33% of the total population. This higher incidence of PTSD symptoms suggests that workers under-report traumatic stress when it is described as vicarious traumatization, that they specifically attribute this to client contact, and that vicarious traumatization is traumatic stress specifically attributed to job-related events.

What Do Family Members Really Want When Older Adults Transition to a Nursing Home?

The purpose of the current study was to explore family members' perceptions of supports received during the transition experience of their older adult family member into a nursing home. In this exploratory, descriptive, qualitative study, interviews were conducted with six family members during the initial 6-month period following admission of the older adult family members. One overarching theme was found: importance of recognizing and supporting the personhood of older adult family members. Implications for how older adults' personhood can be supported are described. [Journal of Gerontological Nursing, 43(11), 9-14.].

Educator or Counselor? Navigating Uncertain Boundaries in the Clinical Environment.

BACKGROUND: Nurse educators in the clinical environment experience great rewards and challenges in their work with undergraduate students. However, closely working with students can lead to the challenge of intervening with those who are emotionally distressed. How do nurse educators navigate the precarious and subtle territory between educating and counseling? METHOD: This article briefly reviews how boundaries are explored in nursing. Two case studies are presented to demonstrate how nurse educators can determine when their support and education begins to move into the counseling role. Finally, future directions for nurse educators are suggested. RESULTS: Little research exists that examines how nurse educators navigate the boundaries between educator and counselor roles with students in clinical settings. CONCLUSION: Navigating between the educator and counselor roles with students experiencing emotional distress in clinical settings can be challenging for nurse educators.

Gerontological content in canadian nursing and social work programs.

METHOD: A survey of gerontological content in nursing and social work programs across Canada (English speaking) was conducted. The survey tool was the competencies list developed for interprofessional gerontological education by the National Initiative for the Care of the Elderly (NICE). Deans or designates of English-speaking nursing and social work programs across Canada were contacted by e-mail. Data was collected by Zoomerang.com. RESULTS: Findings indicate that clear progress is being made in ensuring that students have the knowledge and skills needed to provide the care required by older adults in a variety of settings.

Placement of undergraduate students in nursing homes: careful consideration versus convenience.

Several decades ago, concerns were raised about using nursing homes as clinical placement sites for undergraduate nursing students. As a result, some nursing programs moved away from using these clinical sites. However, within the past 15 years, a shift back toward reconsidering nursing homes as viable placement options has begun. What has brought about this shift, and what must happen to ensure that nursing homes provide positive learning experiences for students? This article reviews the literature on placing students in nursing home environments and presents a model that is designed to enhance gerontological competence in undergraduate nursing students, as well as to enhance students' learning in nursing home placements. If programs use nursing homes for student placements, a carefully constructed plan that encompasses gerontological education throughout the nursing degree program is recommended.

Are gerontological nurses apathetic about apathy in older adults.

Despite its serious health consequences, apathy in older adults is often underrecognized by gerontological nurses and other health care professionals. Within this article, we discuss what apathy is and present a review of the literature and research. Two frameworks emerging from the literature search-one regarding rehabilitation and the other illness-are introduced as ways in which apathy may be conceptualized and addressed. Using these frameworks, implications for gerontological nurses are outlined.

Placement of older adults from hospital mental health units into nursing homes: exploration of the process, system issues, and implications.

Decision making about placing older adults with mental illness and the process of placement from mental health units into nursing homes is challenging for older adults, family members, and health care professionals. In this article, I present an individual example drawn from an institutional ethnography examining the process of placement from mental health units into nursing homes in western Canada. I offer an analysis of the institutional processes and system issues that factor into the difficulties of placing this older adult with mental illness and suggest implications for nurses.