ABSTRACT: Chagas disease (CD), or American trypanosomiasis, is a parasitic infection caused by Trypanosoma cruzi and transmitted primarily by triatomine “kissing bugs.” Once limited to Latin America, CD is now considered endemic in the United States (US), affecting an estimated 280 000 individuals. This article aims to highlight the growing clinical relevance of CD through a case example and review of its epidemiology, clinical features, and management. Globally, 6 to 8 million people are infected, resulting in more than 50 000 deaths annually. Globalization, migration, and climate change have expanded its geographic reach, with increasing detection of infected insect populations in the southern US. CD progresses through acute and chronic phases. The acute phase is often mild or asymptomatic, whereas 30% to 40% of untreated patients progress to chronic disease, most commonly manifesting as cardiomyopathy. Diagnosis is made by serologic or molecular testing, and treatment with benznidazole or nifurtimox is most effective during the early stages of infection. Chronic disease remains incurable, underscoring the importance of early detection and prevention. Containment relies on vector control, screening of blood products and at-risk populations, and prenatal testing. A case of a recently immigrated patient diagnosed at a US urgent care clinic illustrates the need for clinical awareness of this neglected disease. Broader surveillance, education, and integrated public health strategies are essential to reduce CD-related morbidity and mortality.
Abstract: Multidisciplinary care for endometriosis often includes surgical diagnosis and management, and within this context, the registered nurse first assistant (RNFA) plays a critical leadership role across the perioperative continuum. Surgical intervention is critical in endometriosis, particularly for individuals with moderate to severe disease and symptoms unresponsive to medical suppression. As integral members of the surgical team, RNFAs are actively involved in preoperative education, surgical preparation, intraoperative coordination, and postsurgical care. Postoperative responsibilities include pain management, monitoring for complications, wound care, discharge planning, and implementing recovery protocols, while promoting adherence and reinforcing long-term care strategies. Beyond clinical tasks, RNFAs also often advocate for equitable access to skilled surgical care and provide vital support during a frequently physically and emotionally demanding experience for patients. By ensuring continuity and consistency throughout the surgical journey, RNFA contributions and leadership are essential not only to a safe operative experience but also to long-term outcomes, including improved quality of life, symptom management, and functional recovery for individuals undergoing surgery for endometriosis. This article outlines key RNFA responsibilities in endometriosis surgery, aiming to strengthen perioperative coordination, patient support, and outcomes.
Abstract: Human trafficking is a violation of human rights and a global public health crisis with many victims sustaining acute and long-term injuries as well as mental health disorders. Victims face multifaceted barriers to recovery, including restricted health care access, intense fear of retribution, and the profound psychological manipulation exerted by traffickers. However, most victims will seek health care services at some point during their captivity making health care professionals pivotal as “frontline” responders. Despite this critical role, a significant gap exists in professional preparedness. Many health care professionals have not received adequate education or specialized training to detect the indicators or to navigate the complexities of intervention. To bridge this gap, developing robust, evidence-based education programs is essential for all health care professionals. This article explores the necessity of targeted human trafficking training, with a specific focus on simulation-based education. Simulation offers a high-fidelity, low-risk environment where health care professionals can practice clinical identification, communication strategies, and interdisciplinary coordination. By mimicking real-world clinical encounters, simulation-based training empowers professionals to address the vast and complex needs survivors effectively. Also discussed are various simulation-based training programs, highlighting their efficacy in improving clinician confidence and patient outcomes in regards to victims of human trafficking.
Abstract Interprofessional education (IPE) is essential for preparing nursing students to engage in collaborative, team-based care. However, coordinating IPE experiences is challenging for several reasons, including the limited number of health profession programs with summer enrollment. The Accelerated Bachelor of Science in Nursing (ABSN) program at the authors' university operates year-round on a four-semester schedule, making it difficult to ensure consistent IPE opportunities for every cohort, particularly those beginning in summer. To address this gap and advance best practices, the authors present a redesigned virtual simulation structured as an IPE experience that offers meaningful interdisciplinary engagement for summer-entry ABSN students.
Abstract: The American Heart Association (AHA) regularly updates its evidence-based practice recommendations for basic life support, advanced cardiovascular life support, pediatric life support, and neonatal life support. This article reviews the latest AHA guidelines, which were released in October 2025, highlights important changes, and demonstrates how nurses can incorporate these changes into their practice. Examples of new practice recommendations include back blows and abdominal thrusts in the management of severe foreign body obstruction in the conscious adult, use of the two thumbs encircling approach or heel of one hand when providing infant chest compressions, and the administration of an initial 200 Joule synchronized shock in the unstable patient with atrial fibrillation.
Abstract: Holistic nursing emphasizes compassionate, patient-centered care that honors the interconnectedness of mind, body, and spirit. Holistic nurses strive to understand each patient's unique story, values, and emotional needs, moving beyond treating illness or injury alone. This perspective fosters deeper nurse–patient relationships, enhances patient satisfaction, and promotes overall well-being. By integrating empathy, presence, and individualized care, nurses can create meaningful healing environments that support both clinical outcomes and human connection. Drawing on the author's 50 years of nursing experience, this article reflects on how embracing holistic principles benefits patients and enriches nurses' self-care. Key principles and practical strategies are discussed to guide nurses in incorporating holistic care into everyday practice, ultimately transforming the caregiving experience.
Abstract Purpose: This study assessed the impact of implementing an admission discharge registered nurse (RN-AD) on five inpatient units at an acute care, 718-bed Magnet ® -designated, academic, and Level I trauma center on throughput pressures, nurse staffing ratios, and increased workload. Method: To assess the impact of implementing RN-ADs, the authors conducted a nonequivalent pre/post quasi-experimental study utilizing electronic health record data (discharge time, admission date, discharge date) and standardized patient experience survey scores. Predata were collected from August 2016 to July 2017, and postdata were collected from August 2017 to July 2018. Results: Of the 19 114 patient encounters examined, length of stay decreased, discharge before noon increased, and patient experience scores increased; nurses also noted a positive impact on patient discharge. Conclusion: Implementation of an RN-AD role was associated with improvements in length of stay, earlier discharge timing, patient experience, and nurse satisfaction. These findings suggest that dedicated admission and discharge nurse support may be an effective workforce strategy to improve patient flow while reducing the operational burden on bedside nurses.
Abstract: Decision-making capacity in health care refers to a person's ability to understand information relevant to a decision, appreciate how the decision affects them, make a choice, and communicate that choice. Capacity is essential in ethics and professional nursing practice because it forms the basis of informed consent. Nurses encounter various medical conditions, such as dementia, that can contribute to changes in cognitive abilities and result in diminished capacity. However, having a cognitive condition such as dementia does not necessarily mean a person lacks the capacity to make a specific decision or provide informed consent. This article examines a surgical clinical case involving a patient with diminished decision-making capacity related to dementia and probable delirium who needed a surgical intervention. Using this case study, the authors explore the ethics of substitute decision-making, the best interests standard, and a principled approach to supporting a patient who is incapable of refusing a recommended invasive treatment.
Abstract: Annual performance reviews (APRs) are crucial for evaluating, developing, and retaining nursing professionals, especially in high-acuity hospital settings. This article discusses the gaps in current nursing APR systems and presents key elements of an evidence-based framework, which could help transform APRs from routine administrative tasks into powerful tools for professional growth, equity, and improved patient outcomes.
Abstract: My experiences as a student nurse and as a nursing assistant ignited a passion for making a difference, beginning with the moment I witnessed a death. At that moment, I realized the importance of nursing care and my limited ability to influence the health care system. Nurses must amplify their voices to address the systemic challenges in health care delivery. This article describes my internship with the American Association of Colleges of Nursing (AACN) and the phenomena impacting rural health and communities today. Over 100 rural hospitals have closed, thousands of services are being cut, and millions of rural citizens are left stranded without vital health care. During my AACN internship, I learned how federal and state funding and legislation affect health care at every level, and the significance of engagement in policy work. This article serves as a call to action, providing practical resources applicable to all nurses, regardless of their position or level of practice.
Abstract: In June 2025, the International Council of Nurses (ICN) updated its official definitions of “nursing” and “nurse,” which were adopted unanimously at the ICN Congress 2025 held in Helsinki, Finland. Although the updated definitions provide a comprehensive and aspirational global nursing framework that aligns with the broader goals of health equity, leadership, and culturally safe care, a critical analysis of the new definitions shows that global nurse leaders from low- and middle-income countries expressed pragmatic concerns over its implementation. Furthermore, six contemporary nursing elements are underrepresented in the new definitions. This article is a critical analysis of ICN's 2025 redefinition of “nursing” and “nurse,” focusing on local realities and the nursing elements that may have been missed in the redefinition: the centrality of the nurse-patient relationship, well-being as a goal of nursing, legal accountability and professional responsibility, advanced nursing practice, interprofessional collaboration, and technological perspectives and future-proofing of nursing. Including a more complete picture of nursing's multifaceted contributions to health and society is recommended.
Abstract: Vascular access devices (VADs), including both peripheral intravenous (IV) catheters and central VADs, are used across the continuum of health care to administer IV fluids, medications, and diagnostics. Needleless connectors (NCs) are a critical component of the infusion system providing needle-free access to VADs yet many nurses are unaware of their significant impact on VAD-related complications, including infection, thrombotic occlusion, and catheter malfunction. This article provides a review of the critical role of the nurse in identifying risks and applying best practices in NC care, including disinfection, clamping, flushing, and timely replacement. Proper technique and adherence to evidence-informed protocols are vital to maintaining VAD performance and reducing adverse events.
Abstract: This article explores the mutual relationship between emergency nursing and ski patrol, highlighting their complementary roles in providing prehospital and hospital-based trauma and medical care. Ski patrols, acting as a crucial first line of medical response personnel in remote, dynamic, and environmentally challenging alpine settings, stabilize patients and manage extrications under the protocols of the National Ski Patrol's Outdoor Emergency Care program. Emergency nurses, in turn, leverage advanced clinical skills and a broader scope of practice within a controlled hospital environment to continue patient care started in the mountain and austere environments. This partnership and collaboration are essential in rural areas where access to advanced life support may be delayed due to severe weather or difficult terrain, necessitating robust on-mountain care. Acknowledging that many ski patrollers already possess emergency medical services training, the relationship emphasizes collaboration and shared expertise rather than a strict division of labor. The synthesis of these two disciplines creates a more seamless continuum of care, improving patient outcomes from the moment of injury on the mountain to definitive treatment in the emergency department.
ABSTRACT:Cannabis use by nurses puts their professional license at risk, even if cannabis is consumed during off-work hours in US states where cannabis is legal for adult use. As states move out of the cannabis prohibition era and into an era of cannabis regulation, it becomes important to consider the ethical implications of nurses' cannabis use. This article explores the ethical concerns with nurses' use of cannabis during off-work hours and the implications for their licensure. Autonomy, beneficence, and social justice issues are considered. Despite state cannabis laws, nurses must advocate for the protection of their licenses, given that cannabis remains a federally illegal substance.
