Recognizing the Role of the Adult-Gerontology NP.

Whether certified in acute or primary care, AGNPs are prepared for many practice settings.

Integrating Behavioral Health into Primary Care: The Role of Psychiatric Nursing in the Development of the Interprofessional Team.

BACKGROUND: Integrated behavioral health in a primary care setting is a paradigm shift that requires academic reconfiguration on how health care professionals are educated and trained in the clinical arena. METHOD: An academic university was able to create interprofessional didactic and clinical learning experiences for students within the Schools of Nursing, Social Work, Health Professions-Rehabilitation Counseling Department and Pharmacy resulting in improved models for patient care delivery. RESULTS: Interdisciplinary faculty developed the didactic, clinical and evaluative areas based on the HRSA grant work plan. Deliverables included 18 modules, case studies focused on population health, and team-focused standardized patient experiences to test their behavioral health and psychiatric skills in a primary care setting. CONCLUSIONS: Faculty from the different disciplines were able to collaborate on the deliverables, take the opportunities to engage students and collaborate on scholarly presentations at a national, state and local professional organizations. Academic course for interprofessional practice has been developed and implemented as an outcome of this grant.

Bisphosphonate drug holidays: One size does not fit all.

Bisphosphonates have been safely used to treat osteoporosis, effectively reducing fracture risk after 3 to 5 years of treatment. Recent concerns about long-term safety coupled with posttreatment fracture risk reduction have increased support for drug holidays. The decision to start low-risk patients on drug holidays must be based on current fracture risk assessment.

Understanding hydatidiform mole.

Hydatidiform mole (often referred to as molar pregnancy) is the most common disorder in a category of pathologies known as Gestational Trophoblastic Diseases that are associated with abnormal fertilization in pregnancy. Current practices in screening and monitoring during early pregnancy allow for better identification of hydatidiform mole, sometimes prior to the onset of significant symptoms.Once a diagnosis is established, a thorough physical examination and laboratory testing are necessary. Initial treatment includes uterine evacuation. Serial monitoring of serum human chorionic gonadotropin levels is warranted until levels become nondetectable and continues for another 6 months. Reliable contraception is necessary until it has been determined that no trophoblastic tissue persists.Pregnancy is usually a joyful time, with maternal attachment to the developing fetus beginning early in the pregnancy. The woman who experiences hydatiform mole, however, must face the inability to maintain this pregnancy, the possible health consequences of the mole, and then be allowed the time to grieve. Nurses can be the first-line in providing compassionate, empathetic care for women in these circumstances.

Nurse case managers' perceptions of advocacy: a phenomenological inquiry.

Case managers are at the forefront of managed care as they seek creative ways to advocate for the best interests of patients, while adhering to the increasingly stringent utilization guidelines and cost constraints of managed care. Nurse care managers are in the ideal position to act as effective advocates because they have the skills needed to "work the system" both within and outside the hospital to ensure that the patient's needs are met.