Intergenerational views of hardiness in critical care nurses.

As all nurses are aware, healthcare is experiencing a time of great change. This change can lead to stress, nurse vacancy rates, and burnout. However, the effects of stress can be mitigated by personal hardiness. This article presents an overview of hardiness, as well as the results of a qualitative study to describe hardiness in the workplace.

Medical futility: a paradigm as old as Hippocrates.

Medical futility is a concept commonly used to describe medical therapy that has no known or anticipated immediate or long-term benefit for a patient. The concept of futility has existed since the time of Hippocrates and has become the predominant dilemma for many end-of-life situations. Today, clinicians grapple with ethical conflicts and concepts in their daily practice. Many healthcare providers use the concept of medical futility when they are talking with patients and families who are in a quandary about their loved one's care. This article provides an overview of medical futility.

Innovative solutions: a plurality of vision--integrating the chaplain into the critical care unit.

Banner Good Samaritan Medical Center is a 650-bed quarternary care facility located in the Southwestern United States. It contains 12 intensive care units (ICUs) and experience a high patient acuity as a result of being a referral center for Arizona. The palliative care nurse practitioner and ICU clinical nurse specialist collaborated with the chaplain to entrance his visibility in the ICUs and to incorporate the philosophy of spiritual care assessments in the ICU.

Innovative solutions: family conference progress note.

The grief and anxiety of complex medical illness, with a high likelihood of death, strains communication between medical staff and patients' families in the intensive care unit (ICU). For decades, the emphasis has been on curative intent and a paternalistic approach to decision making, which has been fostered by physicians, when patients are unable to communicate for themselves. However, the past 15 to 25 years have seen a paradigm shift in both what families expect from physicians and what physicians see as the goal of medical (especially ICU) care with respect to the patient and family wishes. This article will address this topic.

Palliative care services.

This article presents a program developed at one facility to help provide palliative care services to patients in the intensive care units.