Making decisions about amputation for chronic limb threatening ischaemia.

Introduction: Chronic limb threatening ischaemia causes pain, loss of function and complex wounds, necessitating urgent interventions. While growing options for minimally invasive revascularisation make operating on frail and older persons safer, the challenge is knowing when to stop this option and offer amputation. Decisions about amputation are difficult for the person, or for the family who act as substitute decision-makers.

Chronic limb-threatening ischaemia and confronting amputation: A Heideggerian derived understanding of Being-with and discourse.

Aims And Objectives: To explore the notion of Being-with and authentic discourse for people making decisions about major amputation.

Background: Chronic limb-threatening ischaemia is a devastating disease with a high burden of pain and complex wounds. Patients may deteriorate suddenly after multiple revascularisation procedures and, amputation is offered when further reperfusion is considered futile.

Making things work: Using Bourdieu's theory of practice to uncover an ontology of everyday nursing in practice.

Seeking to answer the question of what it is that nurses do, scholars researching nursing have worked with theoretical approaches ranging from the more abstract to the concrete: from philosophizing the nature of nursing to emphasizing the interpersonal nature of nursing practice to exploring processes of clinical decision-making. In this paper, we engage with Bourdieu's theory of practice as an alternative approach that helps to understand the finer points of nurses' everyday practices of nursing as being grounded in an ontology of practice. We first outline the foundations of Bourdieu's thinking as he established both a relational philosophy of science and an embodied philosophy of action to develop the theory of practice around notions of habitus, capital and field.

Linking hospital and residential aged care: a nurse-led vascular-geriatric model of care.

The interplay of frailty, multimorbidity and polypharmacy in the older person results in complex care needs. Monitoring and proactive management of chronic diseases in this context can be challenging. Early identification of deterioration reduces the risk of hospitalisation in older people, particularly in residential care, where the person can be particularly vulnerable.

Chronic limb-threatening ischaemia and reframing the meaning of 'end'.

Introduction: The possibility of amputation and/or death from chronic limb-threatening ischaemia (CLTI) is real, and deeper understandings of the person and family's capacity and preparedness for limb loss and clinical interventions (active or palliative) are required.

Background: The lead-in period to the surgeon's recommendation for amputation for CLTI may be sudden or protracted; the number/invasiveness of previous revascularisation interventions varies, and limb loss and end-of-life considerations frame the experience.

Method: This prospective, longitudinal, interpretative phenomenological study in three vascular surgical units involved 19 CLTI journeys.

The Frontline Nurse's Experience of Nursing Outlier Patients.

The frontline nurses' experience of nursing with overstretched resources in acute care setting can affect their health and well-being. Little is known about the experience of registered nurses faced with the care of a patient outside their area of expertise. The aim of this paper is to explore the phenomenon of nursing the outlier patient, when patients are nursed in a ward that is not specifically developed to deal with the major clinical diagnosis involved (e.

Descriptive title: The body with chronic limb-threatening ischaemia: A phenomenologically derived understanding.

Aims And Objectives: To explore person and family lifeworld narratives of chronic limb-threatening ischaemia (CLTI) after major amputation has been offered as a treatment option.

Background: Chronic limb-threatening ischaemia manifests as ischaemic pain, ulceration and/or gangrene and is receiving heightened attention due to the increasing health system burden from associated complex wounds and hospitalisations for repeat procedures. The patient and family impact of these manifestations is not well-reported: current studies largely seek to measure treatment outcomes.

Heideggerian hermeneutic phenomenology as method: modelling analysis through a meta-synthesis of articles on Being-towards-death.

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it's clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger's philosophy that there is either an inauthentic positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped.

The chaos of hospitalisation for patients with critical limb ischaemia approaching major amputation.

Aims And Objectives: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI).

Background: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia.

Categorising Patients Mental Illness by Medical Surgical Nurses in the General Hospital Ward: A Focus Group Study.

Aim: To gain insight into medical surgical nurses' process(es) of categorising mental illness in general hospitals.

Background: Categorising patients is a daily social practice that helps medical surgical nurses understand their work and actions. Medical surgical nurses' categorising of mentally ill patients in general hospitals is a means in which they articulate their understanding of mental illness and perform their clinical practice.

Mass casualty education for undergraduate nursing students in Australia.

With the increasing risk of mass casualty incidents from extreme climate events, global terrorism, pandemics and nuclear incidents, it's important to prepare nurses with skills and knowledge necessary to manage such incidents. There are very few documented accounts of the inclusion of mass casualty education within undergraduate nursing programs. This paper is the first to describe undergraduate mass casualty nursing education in Australia.

Patient outcomes following lower leg major amputations for peripheral arterial disease: A series review.

Introduction: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS).

Aim: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease.

An integrative review of health-related quality of life in patients with critical limb ischaemia.

Aims And Objectives: To examine the domains and the domain-specific characteristics within a peripheral arterial disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life.

Background: Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation.

Conceptualizing nurses' night work: an inductive content analysis.

Aim: To develop a conceptual model of nurse-identified effects of night work.

Background: Studies designed to predict shift work tolerance are frequently unsuccessful in incorporating the intersections between physiological, psychological and social issues involved in such work. Where nurses have been the participants of such studies they have rarely been involved in ways that would allow their points of view to be heard directly.

Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model.

Aim: The aim of this study was to evaluate Wenger's Community of Practice as a framework for building research capacity and productivity.

Background: While research productivity is an expected domain in influential models of advanced nursing practice, internationally it remains largely unmet. Establishment of nursing research capacity precedes productivity and consequently, there is a strong imperative to identify successful capacity-building models for nursing-focussed research in busy clinical environments.

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer.

Background: Transarterial chemoembolization (TACE) is an established treatment in managing liver primary neoplasms or liver metastases. Postembolization syndrome (PES) is a common adverse event defined as fever without associated sepsis, pain in the right upper quadrant, and nausea and/or vomiting.

Objective: This integrative review aims to identify effective management strategies for PES or one of its characterizing symptoms (fever, pain, and nausea and/or vomiting).

Night work and the reproductive health of women: an integrated literature review.

Introduction: The aim of this review was to synthesize current evidence on the effects of night work on the major stages of women's reproductive health, specifically the menstrual cycle, fertility, pregnancy, and menopause. Current understanding suggests that night work (work that causes disruption of a worker's circadian [day/night] rhythms) adversely affects workers' health and well-being. A complex relationship exists between circadian rhythms and reproductive hormones, and this may potentially increase the vulnerability of women to the detrimental effect of night work, including during menopause.

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study protocol.

Background And Purpose: Epidemiological studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH.

Methods: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a multi-center, prospective case-control study of ICH.

Clinical credibility and trustworthiness are key characteristics used to identify colleagues from whom to seek information.

Aims And Objectives: To explore the use of information by nurses making decisions in clinically uncertain situations in one aspect of critical care nursing practice (enteral feeding). In this paper, we report the characteristics, which participants identified as important, of the people from whom they sought information for the purpose of making clinical decisions.

Background: Registered nurses have a plethora of information sources available to assist them in making clinical decisions.

Uncovering the common ground in qualitative inquiry: combining quality improvement and phenomenology in clinical nursing research.

Purpose: The purpose of this paper is to describe the use of a common qualitative data set analysed with both a quality improvement tool to facilitate service improvement, and a rigorous research methodology to engage beginning nurse researchers in a mentored project.

Design/methodology/approach: A qualitative cohort study of the experience of hospitalisation across six diagnostic groups interrogated data from 104 patient and carer interviews using the Picker Dimensions of Experience and Heideggerian Phenomenology.

Findings: The paper reveals that well-conducted qualitative interviews can provide common ground for service improvement initiatives and rigorous research analysis.

Rethinking shiftwork: mid-life nurses making it work!

Many current analyses of shiftwork neglect nurses' own voices when describing the dis/advantages of a shiftworking lifestyle. This paper reports the findings of a critical re-analysis of two studies conducted with female mid-life Australian nurses to explore the contention that the 'problem-centred' focus of current shiftwork research does not effectively address the 'real' issue for mid-life nurses, that is, how to develop and maintain shiftwork tolerance. Participants used shiftwork to: (i) manage, navigate and negotiate various aspects of their nursing work and the workplace itself; (ii) facilitate more manageable work/life negotiations; and (iii) self-identify opportunities to engage in their own self-care (body work and mind work).

Black nurse in white space? Rethinking the in/visibility of race within the Australian nursing workplace.

This article presents an analysis of data from a critical qualitative study with 14 skilled black African migrant nurses, which document their experiences of nurse-to-nurse racism and racial prejudice in Australian nursing workplaces. Racism generally and nurse-to-nurse racism specifically, continues to be under-researched in explorations of these workplaces; when racism is researched, the focus is nurse-to-patient racism and racial prejudice. Similarly, research on the experiences of migrant nurses from a variety of ethnicities in Australia has tended to neglect their experiences of the social dynamics of the workplace, thus reinforcing their racialisation.

Preferred information sources for clinical decision making: critical care nurses' perceptions of information accessibility and usefulness.

Background: Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base.

Fitting in: a pervasive new graduate nurse need.

Aim: This qualitative study aims to provide insight into how Australian New Graduate Nurses (NGNs) experienced their transition to acute care nursing practice.

Method: Nine NGNs each participated in three in-depth interviews conducted across their first year of practice. Constant comparative analysis was used to identify the emergent themes.

Concept formation: a supportive process for early career nurses.

Background: Individuals come to understand abstract constructs such as that of the 'expert' through the formation of concepts. Time and repeated opportunity for observation to support the generalisation and abstraction of the developing concept are essential if the concept is to form successfully. Development of an effective concept of the 'expert nurse' is critical for early career nurses who are attempting to integrate theory, values and beliefs as they develop their clinical practice.