Background Palliative care (PC) services have expanded in Saudi Arabia, yet caregiver misconceptions and limited service visibility may delay referral and create uncertainty about symptom management. Because families play a central role in care navigation and decision-making, caregiver's understanding influences when PC is considered. Addressing misconceptions is essential to improving care quality. Methods A structured narrative review guided by the Scale for the Assessment of Narrative Review Articles involved a search of MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar for literature published from January 1, 2000, to January 16, 2026, with targeted citation and gray literature updates through 2026. Search terms included “PC,” “end-of-life care,” “caregivers/families,” “awareness,” “opioids,” “communication,” “religion,” “Saudi Arabia,” and the “Gulf Cooperation Council.” Of 925 unique records screened, 279 underwent full-text assessment, and 63 met eligibility. The review synthesized 42 eligible evidence and implementation sources, with methodology and clinical tools supported by primary sources. Results Six themes were identified: (1) Misunderstanding Purpose and Scope; (2) Fear of Opioids; (3) Cultural and Religious Dynamics; (4) Noncancer Awareness Gap; (5) System-Level Barriers; and (6) Implementation-Level Gaps. Nursing priorities included repeated caregiver assessment, clear symptom and medication education, teach-back, and coordinated transitions. Conclusion Caregiver misunderstanding remains an important barrier to PC use in Saudi Arabia. Improvement requires nurse-led and interdisciplinary caregiver education, culturally attuned and faith-sensitive communication, earlier PC integration, coordinated transitions, and expanded home- and community-based services.
Aim The purpose of this study was to evaluate the opinions of instructors and clinical nursing staff regarding the effectiveness of an innovative teaching program intended to bridge the gap between theoretical knowledge and practical application in nursing education, and to examine the perceived need among students pursuing this degree to address this discrepancy. Background The nursing profession has struggled with a long-standing divide between theoretical knowledge and practical application. Design Evaluation study of an innovative teaching project. Methods Faculty nurses undertook clinical observerships with practicing nurses in hospital settings. Once the observerships were completed, 10 semi-structured interviews were conducted. Nursing students were also invited to participate by completing an ad hoc questionnaire regarding their perceptions of the project. Results Three themes were identified: (1) The Transformative Potential of Collaborative Practice; (2) Relational Synergies and Institutional Constraints; and (3) The Theory–Practice Gap Re-Examined: Student-Led Pathways for Educational Reform. The student participants assigned the project extremely high ratings for appropriateness and suggested integrating it into other courses. Conclusions This project facilitated collaboration and communication between the clinical and academic settings, enabling teachers to evaluate the practical application of classroom content in real-world clinical settings and adapt their methods and course materials in response to identified needs.
Critical care nurses routinely face complex ethical dilemmas arising from rapid, high-stakes decision making in emergencies. The principle of reconciliation offers a structured framework for navigating these tensions by balancing competing stakeholder perspectives. This article critically examines how reconciliation can be operationalized in critical care nursing and proposes structured strategies for its implementation. Reconciliation involves acknowledging conflicting values and seeking mutually acceptable, ethically defensible solutions through open dialogue and mutual understanding. However, applying reconciliation in critical care is challenging due to limited information, severe time pressures, and the need for rapid decisions. Implementing reconciliation strategies can yield numerous benefits, including improved communication, reduced moral distress, increased patient and family satisfaction, and a culture of collaboration. Challenges to implementing reconciliation include time constraints, power imbalances within interprofessional teams, emotional intensity, cultural and religious differences, and legal and institutional constraints. Addressing these challenges necessitates a multifaceted approach that accounts for team dynamics, emotional demands, and legal and institutional structures.
Background Individuals with disabilities account for at least 15% of the world's population. Students with disabilities are underrepresented in nursing due to systemic barriers, misconceptions about abilities, and rigid technical standards. Purpose This quality improvement project describes strategies of an ongoing initiative to improve accessibility and inclusion by implementing Universal Design for Learning (UDL), interprofessional collaboration, and evidence-based institutional practices. Methods UDL served as the template to improve diversity and adopt inclusive practices in a Nursing Program in the Northeastern region of the United States. These principles facilitate flexible learning and assessment options that promote the development of academic and clinical competence. Strategies were aligned with requirements of the Commission on Collegiate Nursing Education and the American Association of Colleges of Nursing and state that inclusive practice can coexist with rigorous competency expectations. A grant from the Josiah Macy Jr. Foundation supported a partnership between nursing and occupational therapy programs at a mid-sized university to integrate students with disabilities into the nursing curriculum. The project's primary goals included ensuring physical, instructional, and technological accessibility and revising policies that support an inclusive institutional climate.
Background Nurses are widely recognized as patient and family advocates and are among the most trusted professionals globally. Nurses are expected to uphold high ethical standards, including protection of vulnerable populations, through clinical competency and conscious advocacy. Advocacy grows complex when ethical dilemmas arise. Conflicts can occur between expected care, organizational requirements, and/or regulatory directives, and a nurse's own values. Amid social upheaval, political and economic turmoil, and shortages of staff and equipment, nurses in war, disaster, or mass displacement contexts face difficult choices to meet patient needs. Purpose This article explores how nurses respond when confronted with realities potentially harmful to patient rights or welfare, or when asked to deliver care in ways that may compromise outcomes. These crises of conscience arise for many reasons across diverse global contexts. Methods The article reviews vignettes drawn from discussions with nursing colleagues across several countries, highlighting concerns nurses report facing in the current geopolitical climate. Conclusions Findings suggest that these crises of conscience are a common, cross-cultural feature of nursing practice, reflecting shared ethical tensions rather than isolated occurrences. Implications for Practice These vignettes reflect real conditions within global nursing. They resonate across nursing as an international professional entity, highlighting the need for continued attention to ethical challenges nurses face during crises.
