Nurses working in the field of obstetrics must have a greater depth and breadth of genetic knowledge over any other subspecialty. In gestation, nurses should include education on the effects of teratogens, prenatal screening options, and prenatal diagnoses. After delivery, early recognition of genetic disorders is important for immediate initiation of potentially life-saving therapies. Preconception education is a critical component of health care for women of reproductive age. The Centers for Disease Control and Prevention (CDC) recommend that all women of childbearing age consume 0.4 mg of folic acid daily to prevent neural tube defects (NTDs). Counseling can still be useful in terms of optimum pregnancy management in a setting best able to cope with any anticipated problems. Complex and multifaceted maternal and fetal factors influence the consequences of drugs, radiation, and chemical and infectious agents to the developing fetus.

This chapter describes the various roles and functions of the treatment program or clinical management staff in the residential facility. It characterizes the roles of support staff and agency personnel. Teachers, physicians, nurses, psychologists, social workers, lawyers, and accountants in the TC ply their professions in the usual way. The relationship between staff and peer roles is rooted in the evolution of the Therapeutic Community (TC). In the TC approach, the role of staff is complex and can be contrasted with that of mental health and human service providers in other settings. An array of staff activities underscores the distinctively humanistic focus of the TC. The chapter describes how primary clinical staff in the treatment program supervise the daily activities of the peer community through their interrelated roles of facilitator, counselor, community manager, and rational authority. Other staff provide educational, vocational, legal, medical, and facility support services.

This chapter examines basic medications that are important for all students to know and reviews medication terminology and accompanying abbreviations. It explains about medication “rights” and dosage calculations, and also offers medication administration guide. Students should be encouraged to learn the characteristics of a variety of medications. The chapter provides medication list that contains the most common drugs used and students must learn their uses, the typical dosage of each, side effects, and so forth. Nurses must possess a wide range of knowledge about the vast number of drugs currently available, including their classification, actions and indications, routes of administration, appropriate dosages, side effects and adverse reactions, and antidotes. Analgesics are drugs used to provide relief from pain. Anticoagulants are drugs that prevent the clotting of blood. Vitamin and mineral supplements are used to treat various conditions caused by nutritional deficiencies.

This chapter examines fundamental skills review and assessment, and also explains how to test the students’ performance of accurate vital signs, hand washing, and taking an oral report on assigned patients per instructor’s observation. It describes benefits to students of shadowing interdisciplinary team members, and providing feedback on the student shadowing experience. The chapter discusses data collection. Information for care plans will be obtained from the physical assessment and data collected from the patient’s chart. Medications should be listed. Learning the correct method of hand washing is a must to prevent the spread of nosocomial pathogens from one patient to another. Obtaining vital signs correctly and appropriately is an important method used to monitor a patient’s health status. Students should learn the appropriate way to assess pulses, respiratory status and rate, temperature, and blood pressure. Bathing the patient allows the nurse to perform an in-depth skin assessment.

Pain remains a common symptom experienced in the palliative care patient population. Despite advances in pain management, patients remain at risk for inadequate relief, especially at end of life (EOL). In order to provide quality pain relief, nurses must possess appropriate knowledge regarding assessment and treatment including pharmacological and nonpharmacological interventions. This chapter provides nurses with a basic overview of the principles of pain assessment and pharmacological management throughout the illness continuum and at EOL. The needs of special populations who have been identified as “at risk” of inadequate pain control are highlighted, including older adults, children, persons with communication impairment, patients with a history of substance abuse, and cancer survivors. These groups represent those in whom pain is often unrecognized, not respected or not believed. Many of the principles of pain assessment and management reviewed can be applied to children.

Aiming for impact means that one not only thinks that one can transform clinical service, but wants to develop and provide patients and their families with the kind of positive moments that are remembered 20 years later. Leadership presupposes aiming for impact; that is, a determination to address the challenges inherent in the current healthcare system. Impact means always giving some thought to how something good can be parlayed into something better. If one is aiming for impact, developmental learning will inevitably move from focusing on mastery of what today is considered to be best practice to imagining and developing a new and improved version of future practice. Nurses have historically been socialized in the direction of convergent thinking, but leadership requires divergent thinking, experiences that promote creativity and innovation.

This chapter showcases the preparation phases necessary to apply for and accept different nursing leadership positions. It explores the components of lifelong learning that are needed to foster new career endeavors. The chapter helps the reader to distinguish between a resume and a curriculum vitae. It provides more in-depth skills to enhance this application process as the nurses continue to move forward in their nursing career. Nurses have so many opportunities within healthcare, but it is up to each individual to best position himself or herself for those opportunities. Nurses who take ownership of their professional development will be able to revaluate their careers at different points to determine where there may be gaps in professional development. Nurses who address an identified gap in their professional development will position themselves in the best possible light for future potential promotional opportunities.

This chapter presents two evidence-based practice (EBP) scenarios that illustrate how implementation of EBP requires an interprofessional collaborative team approach and a well-designed implementation plan. Nurses are at the heart of implementing EBP, and when they do not have team support, collaboration, and a well-thought-out implementation plan, success of an EBP project is unlikely. The chapter provides a review of fundamental concepts and strategies that must be considered with any model when implementing EBP projects. While not detracting from EBP models, the chapter provides suggestions and reminders for selecting key implementation strategies. EBP is becoming the standard for delivery of the best and most up-to-date patient-centered care. Undoubtedly, EBP implementation strategies are becoming a necessary component of the nurse's repertoire for the delivery of optimal care. The chapter outlines useful approaches to EBP implementation spanning from the inception of an EBP idea to the dissemination of the final EBP product.

Loss and suffering are universal experiences that occur across the life span. How one learns to accept, adapt to, and advance through these experiences determines how the individual will move through life itself. Although culture and ethnicity may influence an individual’s views on living with and dying from life-threatening illness, individuals must be recognized as unique and encouraged to grieve as is most appropriate for them. Traditional grieving theories view the process in stages with closure or resolution; more contemporary theories view the process as nonstaged, individual, and ongoing. Terminal illness can occur over an extended period of time or a brief period of time. The nurse functions as both facilitator and participant in this process. The nurse also can add objectivity while the patient and family resolve many feelings, issues, and decisions related to the living–dying experience.