Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer.

Background: Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph node dissection (SLND) should be less common, because the surgery is less extensive.

Methods: The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent an ALND for breast cancer.

Creating a collaborative environment to care for complex patients and families.

Today's critical care environment is increasingly complex due to technological advancements, greater intensity of interventions, and a myriad of healthcare providers. Critically ill patients and their families can feel overwhelmed with the stress of the environment in addition to the acute illness. This stress affects the patients' and families' ability to function, cope, and understand complex information.

How healthcare professionals contribute to hope in patients with cancer.

Purpose/objectives: To explore whether healthcare professionals influence the level of hope in patients with cancer and, if so, how they influence their hope.

Design: Descriptive, qualitative design.

Setting: An adult hematology/oncology unit in the upper midwestern United States.

Creative models of spiritual care. As healthcare delivery changes, pastoral care departments must explore alternative staffing approaches.

Recognizing changes are coming to the healthcare delivery system, pastoral care departments are developing a new vision of spiritual care. As they educate and hire staff, many directors are finding that alternative staffing approaches can help them make the transition. Flexible schedules for pastoral care professionals improve the care they deliver and enhance morale.

Responding to DRGs: ethical and mission implications.

Because of diagnosis related groups (DRGs), remaining financially solvent while being true to its mission is a bigger challenge than ever for the Catholic health facility. Tough decisions and judgments must be made, some of them unfamiliar. When does cost cutting compromise adequate care? Will Catholic hospitals be able to care for the "unprofitable" patient? To what extent will the profit motive damage patient trust? What will be the minimum level of care provided for all? Which programs and services can be dropped without sacrificing the Catholic mission? Hospitals should respond to DRGs in a number of ways: 1.