A Case for Leadership Development in Nursing Practice.

The Institute of Medicine (IOM) (2011) report, 'The Future of Nursing: Leading Change, Advancing Health,' was inspired by a vision to strengthen nursing leadership to help transform health care. Paralleling the IOM report, a core belief of the American Nephrology Nurses Association is to provide nurses with leadership opportunities, and encourage nurses to seize opportunities to develop and polish their leadership skills. This article discusses 'The Leadership Challenge' as one model for leadership development that can propel individuals, including nurses, toward exemplary leadership.

Osteoporosis in Patients with CKD: A Diagnostic Dilemma.

Osteoporosis in patients with chronic kidney disease (CKD) is a complex problem, with diagnostic criteria and treatment plans often debated. The debate creates a practice dilemma for clinicians faced with an aging population and an increasing incidence of fragility fractures. This article discusses the dilemma as seen from the perspective of the nephrology clinician on differentiating osteoporosis from other bone mineral disorders in patients with progressive CKD in order to provide the most efficacious and safe care.

An Ethical Approach to Renal Replacement Decisions in the Elderly.

Moral concerns and distress can surround the decision to initiate, withhold, or withdraw renal replacement therapy (RRT) in those ages 65 and older with multiple co-morbidities. The nurse's moral responsibility of caring is often overlooked when healthcare decisions are made regarding RRT. One remedy is shared decision making in which the nurse acts as patient advocate.