Nurses' stories from Beirut: The 2020 explosive disaster on top of a pandemic and economic crises.

The World Health Organization designated last year as the International Year of the Nurse and the Midwife. And as we know worldwide, 2020 became an unforgettable year as nurses and midwives everywhere confronted the COVID-19 pandemic. To be a nurse in 2020 was challenging and heroic, but being a nurse in 2020 in Beirut, Lebanon was so extraordinarily charged with adversity. The country witnessed in a one-year series of tragedies of epic dimensions - laying a heavy toll on front-line nurses. We present our stories as eight Lebanese nurses, giving voice to our incredible experiences and our ongoing resilience in the face of these adversities. We served in the emergency department of a Beirut city hospital after a catastrophic explosion occurred in the capital on the 4th of August 2020. We reported for duty during a disaster of immense magnitude and are now coping with the aftermath of trauma. As nurses, we have faced many traumas in our country that has experienced through war and terrorism for decades. Arising from this disaster and challenges of the pandemic, we give policy recommendations that deserve urgent attention in Lebanon and underscore the need for disaster preparation, funding, education and importantly mental health care for nurses and other health professionals with help and support of the international community.

Comparing nurses' perceptions of governance related to hospitals' journeys to excellence status the Middle East.

The interest in the Magnet Journey extends to the Middle East. The results of this study revealed nurses in hospitals that are on the Journey to Magnet perceive that decision making is shared between nursing management/administration and staff nurses. Nurses in these hospitals positively attribute their involvement and engagement in every aspect of the nursing profession. This scheme of shared governance promotes professional accountability and enhances individual autonomy, authority, and control. The growth of health care in the Middle East region with rising expectations for patient care outcomes will challenge the nursing profession in the future. Shared governance will certainly help nurses take ownership in making decisions for patient care and as a result achieve better patient outcomes.

On the scene: American University of Beirut Medical Center, Beirut, Lebanon.

American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.

End-of-life practices at a Lebanese hospital: courage or knowledge?

End-of-life care requires knowledgeable and culturally sensitive clinicians to assist patients and families dealing with the difficult journey of death. The authors present important end-of-life considerations for health care providers dealing with culturally diversified patients. A case study approach is used illustrating two case vignettes derived from the practice of an intensive care setting of a tertiary teaching facility in a large urban area in Lebanon. In a multidisciplinary fashion, practices of end of life were explored and a protocol developed to guide health care providers. Special cultural values were identified such as importance of family involvement and religious beliefs. Implications for practice are described.