I found the article "Easing the Burden on Family Caregivers" (August, 2013)* very informative. In practice, nurses often encounter family caregivers under considerable strain, but I don't think this issue is always handled appropriately. Nurses can be very busy and may not have the time to support and educate caregivers.
My primary nursing experience has been in a busy ED, so I know it can be challenging to find time to spend with families. I suggest that ED nurse directors consider implementing a process where a nurse, who could be a member or coordinator of the stroke team, meets with an identified caregiver from ED admission to discharge or transfer to a long-term-care facility. This designated person can keep family members informed about what to expect during the hospital stay, during rehabilitation, and at home after the patient is discharged. Guidance starting at the time of the initial visit is beneficial for everyone.
Stroke and many other debilitating events are very common and will only increase as our population ages. As front-line nurses, we should have the tools available to us to help support and educate our patients and their families.
Understanding pain
As a former nurse educator with both chronic and acute pain from arthritis and multiple sclerosis, I highly appreciated the article, "Making an Ethical Plan for Treating Patients in Pain" (Controlling Pain, October, 2013).* I hope this article will be read by many nurses and used in nursing education programs. I've found obtaining adequate pain control a challenge and have been frustrated with some nurses' preconceived ideas regarding how someone with pain should behave. Thank you for a comprehensive article that presents the many aspects of pain assessment and pain control for individual patients.
Evidence of empowerment
I'd like to comment on Daniel Linnen's fine article "Making a Case for Nurse Empowerment" (November, 2013).* In years past, when I spoke to nurses about evidence-based shared governance, there was no evidence connecting shared governance to anything. Now that's changed. Investigators are documenting its link to positive clinical, organizational, and professional outcomes with new research every few months. One of those outcomes is empowerment. The evidence can be found on the Forum for Shared Governance's website, http://www.sharedgovernance.org under the tabs for SG articles and SG measurement (IPNG articles). We've finally made a quantifiable justification for shared governance.
-CASEY LEMONS, BSN, RN
College Station, Tex.
-MARY E. HOLM REPP, MS, BA, RN
-ROBERT HESS, PhD, RN, FAAN
Vorhees, N.J.
* Individual subscribers can access articles free online at http://www.nursing2014.com. [Context Link]