Online Journal of Issues in Nursing

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Cornerstone, or guiding documents, for nursing and healthcare support the profession of nursing throughout the world. This article describes the impact of the civil war and instability in Cambodia that led to poverty and destruction of the healthcare system and provides a brief overview of nursing in Cambodia today. Since the 1990s, the Cambodian healthcare system has been recovering from war. Nurses have been transitioning from task oriented roles to more sophisticated roles that incorporate the nursing process...

To practice competently and with integrity, today's nurses must have in place several key elements that guide the profession, such as an accreditation process for education, a rigorous system for licensure and certification, and a relevant code of ethics. The American Nurses Association has guided and supported nursing practice through creation and implementation of a nationally accepted Code of Ethics for Nurses with Interpretive Statements. This article will discuss ethics in society, professions, and nursing and illustrate how a professional code of ethics can guide nursing practice in a variety of settings...

The interplay of policy, milestone events, and cornerstone documents was critical in the evolution of the specialty of public health nursing (PHN) from 1890-1950. Using our contemporary lens, this article examines PHN development from an historical perspective, including events and milestones driving growth in the early 20th century. Some of the challenges faced by our founding public health nursing leadership are not unlike challenges we face today. In 1950, Ruth Hubbard, a former leader in the National Organization of Public Health Nurses and Director of the Visiting Nurse Society of Philadelphia, spoke of the value of examining the past to forge a new future...

The 2010 Institute of Medicine report, the Future of Nursing, recommended that nurses work to the "full extent of their training" to address the primary healthcare needs of United States citizens. This article identifies and describes historical antecedents, cornerstone documents, and legislative acts that served to set the stage for today, laying the groundwork for an expanded role for advanced practice nurses in the 21st century. Beginning with Lillian Wald's work in Henry Street Settlement in 1893, through Mary Breckenridge's founding of the Frontier Nursing Service in 1925, the discussion describes how nurses provided access to care for thousands of urban and rural citizens throughout the United States in the past...

Nursing specialization involves focusing on nursing practice in an identified specific area within the entire field of professional nursing. A defined specialty scope of practice statement and standards of professional practice, with accompanying competencies, are unique to each nursing specialty. These documents help assure continued understanding and recognition of nursing's diverse professional contributions. The purpose of this article is to demystify the process for specialty nurses who are creating or revising their specialty nursing scope and standards of practice...

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The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made...

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The purpose of this article is to describe how heterosexism impedes the provision of culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) residents in long-term care (LTC) facilities. LTC facilities continue to employ staff members who lack an understanding of sexuality and sexual diversity in the elderly. In this article, we identify the heterosexual assumption, namely heterosexism, as the primary issue surrounding the holistic care of the LGBTQ elder in LTC. We first review the literature related to LGBTQ elders in LTC facilities, identifying the themes that emerged from the review, specifically the definitions of homophobia and heterosexism; perceptions of LGBTQ elders as they consider placement in LTC facilities; and staff knowledge of and biases toward sexuality and sexual diversity in LTC settings...

The term buy-in can be found in almost any article considering individuals' participation in an initiative. At the time of this writing, a Google search of buy-in resulted in 10.5 billion hits. The term buy-in seems intuitive, yet many healthcare organizations struggle to implement and sustain initiatives that depend on nursing buy-in and involvement. The purpose of this article is to identify prerequisites to buy-in and factors that facilitate buy-in which, when cultivated, may positively influence nurse engagement...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Moral distress among practicing nurses is frequently discussed in the nursing literature, along with well-developed recommendations for increasing moral courage in practicing nurses. Implementing these recommendations depends on nurse leaders being morally fit to lead and to create an environment in which moral courage actions can emerge. The literature is lacking pertaining to nurse leaders' preparation to lead in a morally courageous and transformational manner in our current corporate environments and hierarchies of healthcare...

Over five million people in the United States are diagnosed with some form of dementia, and many more with cognitive impairment remain undiagnosed. In addition, most individuals with dementia experience one or more neuropsychiatric symptoms such as depression, anxiety, irritability, agitation, hallucinations, or delusions at some point during disease progression. The vast majority of individuals with dementia, including those with symptoms of serious mental illness, are cared for in home and community based settings by unpaid caregivers, often family members, who struggle with the daily challenges of providing care and services to someone with dementia...

With over 13 years of war and military combat operations, the number of veterans, military families, and service members with mental health needs continues to increase across civilian and federal healthcare services. Knowledge about severe battle wounds, traumatic brain injury, and traumatic stress has influenced the delivery of healthcare. The invisible wounds of war associated with brain injury and traumatic stress will increase clinical care challenges into the foreseeable future. The purpose of this article is to describe two interrelated concepts, military cultural competence and stress injuries...

The United States prison system is the largest in the world. Mental illness is disproportionately represented within this system where half of all incarcerated individuals have a mental illness, compared to 11% of the population. Four of 10 inmates released from prison recidivate and are re-incarcerated within three years. A social hypothesis suggests recidivism is the result of compounding social factors. Mentally ill individuals often find themselves in less than ideal circumstances of compounding social factors such as illicit substances and unemployment...

Suicide is at epidemic proportions both in the United States and across the globe. Yet, it is a preventable public health problem. Nurses practice on the front-lines and have the greatest number of opportunities to identify and intervene with suicidal patients. Most registered nurses (RNs) have little or no training in how to assess, evaluate, treat, or refer a suicidal patient. Because of this lack of training, RNs feel ill-prepared and afraid to talk to patients about suicide. The purpose of this article is to review the state of the science of suicide assessment training for nurses...

The 2014 Psychiatric-Mental Health Nursing: Scope and Standards of Practice is the specialty's description of competent nursing practice. The scope portion of this document identifies the focus of the specialty by defining nursing practice extents and limits. Standards are statements that identify the duties and obligations for which specialty nurses are held accountable, including general registered nurses and advanced practice nurses. This article begins with a brief overview of the revision process. The author describes key factors that influenced the revision, such as external documents and current priorities in healthcare, and synthesizes significant changes to the document, including commentary and comparisons to the generalist Scope and Standards of Practice...