Keywords: Chinese herbal medicine; endometriosis; gestrinone; danazolReview question:What is the effectiveness and safety of Chinese herbal medicine (CHM), compared with conventional treatment, on endometriosis-related pain and infertility in women with endometriosis?Nursing Implications:Endometriosis is a disease characterized by the presence of tissue that is morphologically and biologically similar to normal endometrium in locations outside the uterine cavity. Primary symptoms of endometriosis are endometriosis-related pain and infertility. The conventional treatment of endometriosis involves surgery and hormonal drugs, with short term benefits and high rates of rates of symptom recurrence (or return).In China, treatment of endometriosis using CHM is routine. CHM is thought to act via improvement of blood circulation and anti-inflammatory activity. There is considerable anecdotal evidence supporting the use of CHM as a potential treatment for endometriosis. Analyzing the evidence on the effectiveness and safety of CHM in the treatment of endometriosis can promote the development of treatment strategies for endometriosis which may reduce the suffering of patients and improve their quality of life.Study Characteristics:The review included two small, Chinese randomized controlled trials (RCTs), with a total of 158 women aged 23 to 45 years and an average age of 30 years. All participants had a laparoscopically confirmed diagnosis of endometriosis.The two trials, conducted by the same researchers, took place in a hospital outpatient department in China. One trial compared CHM endometriosis pills plus CHM enema (24 participants) and CHM endometriosis pills only (16 participants) with danazol (18 participants), and the other compared CHM endometriosis pills plus a herbal enema (48 participants) with gestrinone (52 participants).Treatment durations were for 3 months. One trial followed up for 1-24 months, while the other one did not follow up. The primary outcome was relief of endometriosis-related pain (both in the long term and short term) while secondary outcomes included improvement in fertility rates (live birth or pregnancy); reduction in the size and extent of endometrial cysts; improvement in quality of life scores; improvement of endometriosis-related symptoms apart from pain (e.g. fatigue); adverse effects resulting from the CHM intervention and rates of reoccurrenceand adverse effects.Both trials described adequate randomization and allocation concealment methods. The trials also reported single blinding for participants, and assessor blinding. Few or no participants were excluded from the analysis. Both studies were evaluated as a moderate risk of bias. …
Citation: Glazer, G., (October 15, 2009), Legislative: Executive Summary of the Report of the Ruckelshaus Center Nurse Staffing Steering Committee (State of Washington) OJIN: The Online Journal of Issues in Nursing. Vol. 15, No. 1. Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Legislative/ReportRuckelshaus-Center-Nurse-Staffing-Steering-Committee-.aspx Pamela H. Mitchell and Jill K. Mount have written a comprehensive, well -referenced summary of current research, policy, and practice regarding nurse and the effects of on patients, nurses, and organizations. This Summary Report was commissioned by the Nurse Staffing Steering Committee of the William D. Ruckelshaus Center. The goal of the W. D. Ruckelshaus Center, a joint effort of the University of Washington and Washington State University, is to enhance the region's capacity for effective policy making and sustainable problem solving. The Executive Summary of the Report follows in this legislative column with a link to the full Report at the Ruckelshaus Center available at http://ruckelshauscenter.wsu.edu. I highly encourage you to read the entire Report because it clearly and succinctly describes what is known and what is not known about nurse staffing, and provides suggestions for future research. While there is research evidence that fewer patients per nurse, or more direct nursing care hours per patient day is associated with fewer adverse outcomes in hospitals, particularly in surgical patients, the mechanisms of causality for this relationship are not established. Moreover, nurse alone is not a reasonable approximation of workload. Rather working conditions and environments must be considered in assessing workload. Future research at single institutions and across institutions, in single states and across the nation, and in single countries and internationally must be prospective. Common definitions of variables and systematic data collection will be essential in establishing these mechanisms of causality. A great strength of this report is that it is based on national and international (Australia, Canada, England, Finland, New Zealand, and Scotland) data. As health reform becomes a reality in the United States (US) this year and beyond, information from this report will be helpful in policy discussions both at the state and national levels. Currently, twenty-two states in the US have either proposed or enacted legislation to regulate nurse by mandating ratios, establishing committees with input from staff nurses, or mandating public posting addressing staffing. We need to assure that any legislation in these states and others is based on fact, and not on emotion or political expethency. Washington... can contribute by serving as an example to other states as it attempts to work from evidence to problem solve and innovate in an area of nurse staffing (Mitchell & Mount, 2009, p. 31). This Summary Report below is your opportunity to learn from the best. Nurse Staffing - A Summary of Current Research, Opinion, and Policy Executive Summary (Mitchell & Mount. 2009). (NOTE: This report is reprinted with permission from the Ruckelshaus Center) This paper was commissioned by the Nurse Staffing Steering Committee of the William D. Ruckelshaus Center, which is comprised of representatives of the Northwest Organization of Nurse Executives; SEIU Healthcare 1199 NW; United Staff Nurses, UFCW 141; the Washington State Hospital Association; and the Washington State Nurses Association. In 2008, these organizations worked collaboratively for the successful passage of the Safe Nurse Staffing Legislation (Substitute House Bill 3123). The new law required each hospital, by September 1, 2008, to establish, where they do not exist, a nurse committee with staff nurses composing at least half of the committee. …
In a healthy work environment (HWE) professionals use skilled communication styles to achieve positive outcomes. In the HWE literature, the major communication emphasis to date has focused on the manager's responsibility to facilitate skilled communication. This article focuses on the individual nurse's responsibility to become a skilled communicator. Parse's Theory of Human Becoming is used to conceptualize a Five-Factor Model for Becoming a Skilled Communicator. These five factors include awareness of self-deception, along with reflection, authenticity, mindfulness, and candor. After reviewing key communication-healthy work environment documents, the article describes five behaviors that help nurses reach their goal of becoming skilled communicators.
An important aspect of the professional nurse role is that of delegating certain activities to others. In 1935 the United States (U.S.) Congress enacted the National Labor Relations Act (NLRA), and the associated National Labor Relations Board (NLRB), to protect the rights of employees and employers and to encourage collective bargaining in industrial settings. In 1947 the Act was amended to exclude supervisors from the definition of “employees” for the purposes of collective bargaining. In 1974 Congress provided for collective bargaining for various professional personnel, including staff nurses in all work settings. Nursing supervisors, because they were supervisors, were excluded from collective bargaining. Over subsequent years the definition of a nursing supervisor has been debated in courts of law. These debates have implications for nurses who practice in agencies that have collective bargaining units. This article considers the NLRA and NLRB activities related to delegation in nursing by reviewing the history of the NLRA and NLRB; defining key terms; presenting the various interpretations, rulings, and decisions of the NLRB; and providing a summary of recent decisions related to workplace supervisory practices. Delegation-related activities of the U.S. Executive Branch and activities of professional nursing organizations are described. Nursing implications of these laws, rulings, and interpretations are addressed.
