A review and application of suicide prevention programs in high school settings.

Teen suicide is a terrible tragedy and is the third leading cause of death among high school children aged 14 to 19. School based intervention programs have been regarded as an effective and essential means of addressing this problem. A comprehensive review of the extant literature provides examination of the risk and protective factors of suicide in this age group, the development of these programs, the current state of the science and recommendations for enhanced assessment and intervention.

Patterns of knowing: proposing a theory for nursing leadership.

In a time of chaotic and unpredictable health care, it is vital for nursing to employ a nursing leadership theory that is specifically applicable to nurses and will holistically, and comprehensively address and support both the science and art of this honored profession. The authors propose that Nursing Leadership Knowing can address and impact the myriad issues confronting managers and administrators within the turbulent health care industry, with the ultimate goals of quality comprehensive patient care and improved employee satisfaction. They believe that Nursing Leadership Knowing, grounded in the realties of nursing experience, is a logical theoretical extension that can be translated into nursing leadership practice particular and specific focus on empirics and evidence-based practice will not attend to the robust and multidimensional underpinnings of the lived experience that is so vital to nursing as a caring profession. The ideal of nursing leadership theory is not a single-focused shadow of its history, but a rich, inclusive, multi-faceted network of knowing. As such, Nursing Leadership Knowing provides a forum for leaders to enhance their practice, as well as their relationship with their employees, which ultimately translates into optimal care for the patients we serve.

Integrating intimate partner violence content across curricula: Developing a new generation of nurse educators.

Abuse between intimate partners can take many forms. Prevalence data analyses confirm that intimate partner violence (IPV) is a widespread problem. Meeting the objectives of World Health Organization's "Global Campaign on Violence Prevention" will involve many organizations and institutions within and beyond the health care community. Educating prospective Nurse Educators about IPV does, however, present challenges, as most nurses lack awareness of IPV as a public health problem, have limited knowledge and erroneous beliefs about IPV, and are inexperienced in caring for survivors of IPV. Thus providing formal education and training in a supportive environment will enhance Nurse Educators' knowledge and skills about IPV while helping them to examine the benefits and limitations of various pedagogical approaches for teaching this critical content to students. Hence targeting educational efforts at nurses who are pursuing the academic role is an important first step toward raising the collective consciousness of nurses to the point that IPV education becomes an integral component of the nursing curriculum, and competence in caring for IPV survivors becomes the standard rather than the exception.

Persons with developmental disability exposed to interpersonal violence and crime: approaches for intervention.

PURPOSE: Psychoeducational and psychotherapeutic interventions, by psychiatric advanced practice registered nurses and caregivers working with people with developmental disabilities exposed to interpersonal violence and crime, are recommended to help the individual resolve the intrapsychic trauma. CONCLUSIONS: Persons with developmental disabilities experience the full affective range of the effects of trauma and may benefit from a variety of interventions. What may be different in comparison to other survivors are the ways psychotherapeutic and psychoeducational interventions are adapted so that emotions, resultant actions, and ongoing concerns can be effectively expressed and addressed. PRACTICE IMPLICATIONS: Advanced practice registered nurses have an important role in addressing the sequelae of trauma by employing flexible, creative, and direct therapy with individuals. Additionally significant is provision of educational and supportive measures for the caregivers, who have the potential to generate an ongoing socially therapeutic environment.

Persons with developmental disabilities exposed to interpersonal violence and crime: strategies and guidance for assessment.

PURPOSE: Persons with developmental disabilities are frequently exposed to interpersonal violence and crime, directed at themselves and others, and are in need of specific interventions tailored to their unique needs. CONCLUSIONS: What may be different in comparison to other survivors are the:ways therapeutic interventions are adapted so that fears and ongoing concerns can be effectively expressed and addressed. PRACTICE IMPLICATIONS: Persons with developmental disabilities may benefit from a variety of interventions in the treatment of intrapsychic trauma after exposure to interpersonal violence and crime.

Changing the lens for youth 'gone wild': the call for primary prevention research by forensic nurses.

Young people today are bombarded with information suggesting consequences do not apply to them. Increasing alarm over the exposure to violence of America's youth has sparked intensified examination of the need for targeted and enhanced primary prevention efforts.

The impact of stress management on nurse productivity and retention.

Throughout the history of nursing there is a seeming legacy of personnel shortage, lack of funds, and, based on the nature of the role and related services, heightened levels of stress involved in patient care. The future of the profession, and more imminently, patient care and the health of nurses, may be significantly impacted by repeated challenges where current levels of stress and burnout are contributing to organizational problems, burnout, and attrition. Employee stress and burnout commonly lead to myriad health-related problems that result in significant organizational consequences. There are many methods of stress management, and sometimes the best and most effective begin with simple recognition, validation, and visible and committed efforts by the nurse executive. Regardless of the technique or approach, what is clear is that there is a need for nurse executives to include the development and enhancement of comprehensive stress-management programming for employees as a priority item to avoid burnout and attrition.

Intrapsychic dynamics, behavioral manifestations, and related interventions with youthful fire setters.

Fire setting in youth has often been overlooked and misunderstood as a coping skill for expressing rage. The act of deliberate fire setting, if uninterrupted, may continue throughout an individual's lifetime. Forensic examiners, mental health care providers, and criminal justice professionals can help guide referral and treatment through better understanding of behaviors and intrapsychic dynamics.

Why SANEs matter: models of care for sexual violence victims in the emergency department.

This study examines models of SANE service in the ED and quality of care. Nurse managers of all 82 EDs in Virginia were surveyed (RR 76%). Five models emerged: 1) No SANE services (27.4%); 2) Victims transferred off-site for services (14.5%); 3) Partial coverage of services by ED SANEs (16.1%); 4) SANEs called in from off-site (6.5%); and 5) Full-coverage of services by ED SANEs (35.5%). Models 4 and 5 consistently provided a higher quality of care.

Frightened in isolation: unique considerations for research of sexual assault and interpersonal violence in rural areas.

One of the least understood topics in forensic science is the unique nature of sexual assault and interpersonal violence in rural settings. There is a need to identify and clarify intervention strategies at all levels of prevention in geographically isolated communities.

Caring for the future: strategies for promoting violence prevention in pediatric primary care.

PURPOSE: To identify strategies that will assist nurse practitioners (NPs) to incorporate universal youth violence screening and prevention strategies into their practices. DATA SOURCES: Extensive reviews of the extant literature, clinical and anecdotal information, and professional experiences and encounters were utilized to explore and identify current practice recommendations related to youth violence prevention. CONCLUSIONS: NPs' expertise in health promotion makes them an important member of interdisciplinary team efforts to prevent youth violence. Knowledge of risk factors, appropriately focused assessment, and relevant intervention strategies can assist NPs to fulfill a valuable role in this critical endeavor. IMPLICATIONS FOR PRACTICE: Recently, there has been an increased recognition of the role that healthcare providers at all levels can play in decreasing youth violence. A greater emphasis on strategies already employed by NPs to promote the development of healthy families can contribute greatly to reducing the problem of youth violence. Universal screening for warning signs and level of violence risk in youth, as well as utilizing appropriate interventions and referrals will provide NPs with the opportunity to contribute to this important goal.

Patterns of knowing as a foundation for action-sensitive pedagogy.

Graduate students in the health sciences often juggle full-time careers, demanding programs of study, and family responsibilities. Frustration, a perception of limited caring on the part of role models, and a sense of disengagement, or even despair, are common features of postbaccalaureate study for many of them. Nursing has long recognized the value of multiple perspectives in knowledge development. Previous work involving patterns of knowing not only has advanced the disciplinary knowledge base but has also encouraged innovative applications of the patterns to philosophy, evidence-based practice, and research aimed at reducing health disparities. In an effort to both extend the dialogue about ways of knowing and humanize the experience of graduate education for nursing students, the authors propose six patterns of knowing as a foundation for effective, action-sensitive pedagogy.

Information processing of sexual abuse in elders.

Sexual abuse is considered to be a pandemic contemporary public health issue, with significant physical and psychosocial consequences for its victims. However, the incidence of elder sexual assault is difficult to estimate with any degree of confidence. A convenience sample of 284 case records were reviewed for Post-Traumatic Stress Disorder (PTSD) symptoms. The purpose of this paper is to present the limited data noted on record review on four PTSD symptoms of startle, physiological upset, anger, and numbness. A treatment model for information processing of intrapsychic trauma is presented to describe domain disruption within a nursing diagnosis of rape trauma syndrome and provide guidance for sensitive assessment and intervention.

Survivors' guilt following sudden traumatic loss: promoting early intervention in the critical care setting.

Survivors' guilt is a pervasive mental health issue that is often initially manifested by family members in the critical care unit. With increased awareness and enhanced targeted assessment, critical care nurses are in a unique position to begin the initial processes of adaptive coping and functional grief and bereavement in surviving family members. Because the trajectory of grief and bereavement are often complex and long term, the additional complication of survivors' guilt can lead to many psychosocial and physical manifestations and sequelae. However, with early identification and intervention relative to the underlying factors of survivors' guilt, including appropriate referral and psychoeducational intervention and resources, critical care nurses can enhance and extend their care to families in the throes of significant and sudden loss and intrapsychic trauma.

Gay-male couples who adopt: challenging historical and contemporary social trends toward becoming a family.

TOPIC: Gay-male couples who adopt children face ongoing challenges that stem from both historical and contemporary social issues. PURPOSE: To examine and identify key points and guidance for advanced practice psychiatric mental health nurses regarding multicultural awareness involved in counseling gay-male couples who explore or exercise their right to adopt and raise children. SOURCES: A comprehensive review of the extant scientific literature and public media, clinical anecdotes, therapeutic experiences, and an examination of Healthy People 2010 as it relates to how community health is profoundly affected by the collective beliefs, attitudes, and behaviors of everyone who lives in the community. CONCLUSIONS: Heterosexism, homophobic fears, oppression, and the general stigma that surround gay-male couples who choose to adopt children are a few of the relevant contemporary issues and community beliefs for which advanced practice psychiatric mental health nurses need to assess, explore, and intervene.