Mastering Your Distinctive Strengths as an Introverted Nurse Leader.

This article contrasts the nursing leadership styles of introverts and extraverts and examines what each brings to the nurse leader role. While introverts and extraverts bring unique strengths, it may appear to introverts that extraverts garner the preponderance of attention in meetings and committee work. Strategies for the self-identified introvert nurse leader to successfully lead in an extraversion-centric workplace are described. The article ends with the personal journey of 2 nurse leaders who embraced their introversion traits and learned ways to flourish in health care and academic settings.

Brief review: chemotherapy-induced painful peripheral neuropathy (CIPPN): current status and future directions.

PURPOSE: Chemotherapy-induced painful peripheral neuropathy (CIPPN) affects up to 90% of cancer patients treated with chemotherapy agents. Despite the fact that it is relatively common, the underlying pathophysiology is still unclear and its treatment remains generic. Mechanisms of CIPPN are multifactorial, dependent on the specific chemotherapeutic agent used, and include multiple patient-related factors, including genetic factors that may predispose patients to either develop or not develop CIPPN. The purpose of this article is to review mechanisms, clinical signs and symptoms, diagnosis, treatment options, and prognosis for patients who develop CIPPN. We also offer research considerations for this complex and unpredictable phenomenon. PRINCIPAL FINDINGS: Chemotherapeutic agents can damage the peripheral nervous system, including the nerve terminals, axons, cell body, and myelin sheath of sensory nerves. Herein, we describe some of the anatomical and functional changes that are thought to take place at various levels of the nervous system. On a clinical level, patients with CIPPN report multiple symptoms. It is essential to obtain an accurate history from the patient and to perform a thorough physical examination in order to obtain the patient's subjective perspective. Additionally, objective measurements may be needed in order to articulate clearly the effects of this complex syndrome and to ensure an accurate diagnosis, treatment, and prognosis. CONCLUSIONS: The management of CIPPN remains a clinical challenge for pain practitioners. As more research is being carried out to elucidate its pathophysiology and therapy, the innovative use of several non-traditional categories of drugs seems promising in the management of this complex phenomenon. Studies addressing predictability and possible genetic predisposition are necessary not only for preventive measures but also for targeted treatments.

Return of bowel sounds indicating an end of postoperative ileus: is it time to cease this long-standing nursing tradition?

UNLABELLED: Evidence and rationale supporting return of bowel sounds as an unreliable indicator of the end of postoperative ileus after abdominal surgery are provided. INTRODUCTION: A loss of gastrointestinal motility, commonly known as postoperative ileus (POI), occurs after abdominal surgery. Since the 1900s, nurses and other clinicians have been taught to listen for return of bowel sounds to indicate the end of POI. Evidence-based nursing literature has challenged this long-standing traditional nursing practice. PURPOSE: The purpose of this study was to provide evidence from a randomized clinical trial and rationale supporting evidence-based inquiry concerning return of bowel sounds as an unreliable indicator of the end of POI after abdominal surgery. METHOD: Time (days) of return of bowel sounds after abdominal surgery was compared to the time (days) of first postoperative flatus, an indicator of the end of POI, in 66 patients recovering from abdominal surgery randomized to receive standard care compared to those who received standard care plus a rocking chair intervention. FINDINGS: Pearson's correlation between time to first flatus and return of bowel sounds for combined groups was not significant (r = 0.231, p = 0.062, p < 0.05) indicating that time to return of bowel sounds and time to first flatus were not associated. CONCLUSIONS: The results of this study provide support to evidence-based inquiry that questions the relevance of traditional nursing practice activities such as listening to bowel sounds as an indicator of the end of POI.

A randomized trial of rocking-chair motion on the effect of postoperative ileus duration in patients with cancer recovering from abdominal surgery.

Patients who undergo abdominal surgery experience a phenomenon commonly called postoperative ileus (POI). Standard of care requires patients to get out of bed, sit in a chair, and begin ambulating the first postoperative day. No evidence supports standard care activities reduce POI duration. Rocking-chair motion has shown promise in reducing POI duration. Sixty-six participants were randomized into 2 groups. The experimental group (n = 34) received standard care plus the rocking-chair intervention; the control group (n = 32) received standard care. Participants in the experimental group had shorter duration of POI, no effect on medication use, and time to discharge.

Accelerated enhanced Recovery following Minimally Invasive colorectal cancer surgery (RecoverMI): a study protocol for a novel randomised controlled trial.

INTRODUCTION: Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments. While a few studies have shown that discharge within the first 24 hours after minimally invasive colectomy is possible, the safety, feasibility and patient acceptability of a protocol for short-stay colectomy for colorectal cancer have not previously been evaluated in a prospective randomised study. Moreover, given the potential for some patients to experience a delay in recovery of bowel function after colectomy, close outpatient monitoring may be necessary to ensure safe implementation. METHODS AND ANALYSIS: In order to address this gap, we propose a prospective randomised trial of accelerated enhanced Recovery following Minimally Invasive colorectal cancer surgery (RecoverMI) that leverages the combination of minimally invasive surgery with enhanced recovery protocols and early coordinated outpatient remote televideo conferencing technology (TeleRecovery) to improve postoperative patien-provider communication, enhance postoperative treatment navigation and optimise postdischarge care. We hypothesise that RecoverMI can be safely incorporated into multidisciplinary practice to improve patient outcomes and reduce the overall 30-day duration of hospitalisation while preserving the quality of the patient experience. ETHICS AND DISSEMINATION: RecoverMI has received institutional review board approval and funding from the American Society of Colorectal Surgeons (ASCRS; LPG103). Results from RecoverMI will be published in a peer-reviewed publication and be used to inform a multisite trial. TRIAL REGISTRATION NUMBER: NCT02613728; Pre-results.

Human scrotal myiasis: botfly infestation.

Cutaneous infestation of the scrotum with botfly larva from the order Dioptera, family Cuterebridae, species Dermatobia hominis is extremely rare. The first reported case of scrotal myiasis in the United States of America is described here. There is increased potential for human infestation with botfly larva (Dermatobia hominis), due to a more affluent and mobile population traveling to tropical areas for exotic vacations where the botfly is endemic. Urology nurses in a clinical setting should be aware of patients with unusual clinical presentations involving the genitourinary system.

The good catch pilot program: increasing potential error reporting.

With only 175 reports submitted into an available close call reporting system during 2.5 years, the Good Catch Program was implemented to promote 3 strategies: (1) changing terminology from "close call" to "good catch," (2) implementing an "end-of-shift safety report," and (3) executive leadership sponsored incentives. The authors discuss the program and its positive outcomes in increasing potential error reporting.