BACKGROUND: Survivors of acute respiratory distress syndrome (ARDS) frequently report vivid memories of their hospitalization. These memories can cause intense physical and emotional reactions. The COVID-19 pandemic cont...BACKGROUND: Survivors of acute respiratory distress syndrome (ARDS) frequently report vivid memories of their hospitalization. These memories can cause intense physical and emotional reactions. The COVID-19 pandemic contributed to a dramatic increase in ARDS incidence, but few studies have explored the nature and triggers of memories in postpandemic ARDS survivors. PURPOSE: This qualitative study aimed to analyze the vivid memories and explore the multisensory memory triggers of adult ARDS survivors who received mechanical ventilation in the ICU between 2020 and 2023, during the COVID-19 pandemic. METHODS: An interpretative phenomenological design was used. Semistructured interviews were conducted in person or via videoconference. Participants were asked to describe their most vivid memory from their ICU stay and any visual, auditory, olfactory, and tactile triggers of ICU-related memories. Interview data were analyzed using thematic analysis. RESULTS: A total of 35 ARDS survivors were interviewed. Five major themes and 17 subthemes emerged from the data. Major themes included the following: altered reality "dreams" while under the effects of sedation, recalled experiences of death, loss of control, bedside interactions, and multisensory triggers reminding survivors of real ICU environmental exposures and events. Nearly half the participants (n = 16; 46%) reported dreams as their most vivid memory. The term dreams was used because it was often unclear whether the memories occurred while participants were asleep or in a delirious state. Most participants (n = 31; 89%) reported at least one sensory memory trigger, with visual and auditory triggers the most common. Triggers often prompted the recall of factual ICU-related memories. CONCLUSION: Understanding the content and triggers of memories experienced by ARDS survivors can help guide nursing care across the health care continuum and facilitate interventions geared toward prevention and recovery.
Over the course of a year, 18 nurses from 11 states across the country came together to participate in the Alliance of Nurses for Healthy Environments (ANHE) Fellowship program. The ANHE is a national organization that p...Over the course of a year, 18 nurses from 11 states across the country came together to participate in the Alliance of Nurses for Healthy Environments (ANHE) Fellowship program. The ANHE is a national organization that provides resources and advocacy opportunities to and for nurses. Its vision is a transformational alliance that prepares nurses to ensure the environmental health of all people, overcome environmental health disparities, and heal our communities and the Earth for present and future generations. Nurses are natural leaders in this space, based on their foundational training as holistic carers. Here, the authors share their experiences from the third cohort of the ANHE Fellowship with the aim of inspiring others to embark on, continue, and share their own work in improving environmental health and the health of their communities.
BACKGROUND: Expanding the midwifery workforce is an important strategy for improving perinatal outcomes and addressing the current perinatal workforce shortage. However, the cost of education is a primary barrier to acce...BACKGROUND: Expanding the midwifery workforce is an important strategy for improving perinatal outcomes and addressing the current perinatal workforce shortage. However, the cost of education is a primary barrier to accessing midwifery programs and can affect students' educational experience. State initiatives to fund midwifery education, including through direct scholarships, offer a promising approach to support students and expand the midwifery workforce. PURPOSE: The purpose of this program evaluation was to explore the impact of scholarship funding on students' midwifery educational experiences. METHODS: Data were obtained through the responses to a short survey that was distributed to the 25 students who had received a scholarship for their midwifery education. Quantitative responses were analyzed using frequencies or means, while qualitative responses were coded using the principles of content analysis. RESULTS: Of the 25 eligible participants, 19 completed the survey, yielding a response rate of 76%. The survey responses revealed that cost is a consideration in selecting a midwifery program, although not the principal factor. Scholarship funding contributed to students' academic success, supported their mental health, and alleviated the financial burden of day-to-day expenses. Despite receiving this financial support, most students continued to work during their time in the midwifery program and will still graduate with student debt. CONCLUSION: Scholarships for midwifery students can help to mitigate a primary barrier to accessing education and can support the growth of the midwifery workforce with its associated improved perinatal outcomes. Additionally, targeted state funding can drive workforce diversification, contributing to health equity.
This is the ninth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Practi...This is the ninth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey. To access previous articles in this EBDM series, go to https://links.lww.com/AJN/A256.
Forced displacement has reached unprecedented levels, with over 120 million people uprooted globally and more than 100,000 refugees resettled in the United States in 2024. Refugees arrive with diverse cultural identities...Forced displacement has reached unprecedented levels, with over 120 million people uprooted globally and more than 100,000 refugees resettled in the United States in 2024. Refugees arrive with diverse cultural identities, prior professional roles, and experiences of trauma, yet often face systemic barriers, clinician bias, and unmet health needs. This article offers a practical framework grounded in holistic, person-centered values for delivering palliative nursing care to refugee communities. It outlines the complex resettlement journey and highlights how structural inequities, institutional racism, and communication barriers can undermine trust and care delivery. Cultural humility is defined and proposed as a guiding principle. Through real-world examples, communication strategies, and evidence-based insights, the authors demonstrate how care grounded in this principle can promote dignity, build trust, and improve outcomes. Special attention is given to interpreter use, social integration, and the importance of recognizing both cultural differences and individual strengths. When combined with the interdisciplinary, person-centered principles of palliative care-such as symptom management, effective communication, and cultural and spiritual respect-a strengths-based approach can enhance how care is delivered to displaced populations. By understanding the sociocultural and systemic factors that shape the refugee experience, nurses can better meet the complex needs of these patients and their families.
Ketamine has emerged as a promising intervention for treatment-resistant mental health disorders, such as depression, anxiety, and posttraumatic stress disorder. With rising global mental health burdens and the limitatio...Ketamine has emerged as a promising intervention for treatment-resistant mental health disorders, such as depression, anxiety, and posttraumatic stress disorder. With rising global mental health burdens and the limitations of existing pharmacological treatments, ketamine's novel mechanism of action provides a potential alternative for individuals who have not responded to traditional therapies. Ketamine was initially approved by the U.S. Food and Drug Administration in 1970 for use as an anesthetic, and over the past two decades, has increasingly been investigated and used as an off-label treatment for mental health disorders. Additionally, the S-ketamine enantiomer of ketamine, esketamine (marketed as Spravato), received approval for treatment-resistant depression in 2019. Clinical applications of ketamine in the treatment of mental health disorders include intranasal administration (esketamine), IV infusions, ketamine-assisted psychotherapy, and at-home therapy, with varying levels of oversight. The current ketamine landscape has created a perfect storm in which the regulation of ketamine's use in mental health treatment remains fragmented, the evidence is constantly evolving, and a vulnerable population of individuals who are struggling with treatment-resistant mental health symptoms are desperate for relief. This article addresses these considerations by providing a foundation of clinical information that nurses should understand as they advise patients who are receiving, or curious about ketamine, as well as by discussing the regulatory, ethical, and nursing implications of using ketamine in the treatment of mental health disorders.
BACKGROUND: As a population, college students are known to be at risk for adverse substance use-related events, such as opioid overdose, as they seek relief from academic and social stressors. Sorority affiliation in thi...BACKGROUND: As a population, college students are known to be at risk for adverse substance use-related events, such as opioid overdose, as they seek relief from academic and social stressors. Sorority affiliation in this population is reputed to be another risk factor for increased substance use and misuse. Many college students are not aware that illicitly made fentanyl is often mixed with other commonly used substances, such as marijuana and cocaine (among others), potentially leading to unintentional overdose and even death. The timely administration of naloxone, an opioid antagonist, can save lives. PURPOSE: This observational pre-post study examined college-age, sorority-affiliated students' knowledge of opioids, opioid toxicity, and opioid overdose response both before and after an educational lecture and hands-on naloxone training. Participants' perceptions about the intervention's effectiveness were also explored. METHODS: Eighty-four participants completed a knowledge-assessment questionnaire prior to receiving a brief lecture about opioids. The investigators then gave a hands-on training, demonstrating proper overdose response procedures and intranasal naloxone administration using a low-fidelity simulation manikin. Participants were then given the optional opportunity to practice and submit a return demonstration, which was scored using a behavioral rubric. A posttest questionnaire identical to the first was administered following this training. Lastly, an intervention effectiveness survey was administered to assess participants' understanding of and comfort level in responding to opioid overdose events. Participant characteristics and perceptions of the training's effectiveness were summarized using descriptive statistics. Paired t tests were used to compare pre- and posttest means. RESULTS: Mean posttest total scores as well as posttest scores for individual components, including opioid knowledge, opioid toxicity, and opioid overdose response, were all significantly higher than mean pretest scores, indicating improvement following the hands-on training. The mean score on the behavioral rubric was 100 out of 100, indicating that of those participants who volunteered to practice and demonstrate responding to a simulated opioid overdose scenario, all responded correctly. CONCLUSIONS: This novel intervention, which combined didactic with hands-on learning methods, led to demonstrated improvements in knowledge of opioids, opioid toxicity, and opioid overdose response among sorority-affiliated college students. Routinely providing opioid education and practical hands-on naloxone training in college settings is recommended, and future studies should investigate students' long-term knowledge retention and real-world application of skills learned.
Helping patients, clinicians, and health care systems make informed ethical decisions.Helping patients, clinicians, and health care systems make informed ethical decisions.
How nurses can engage with the patient experience beyond biomedical instruction.How nurses can engage with the patient experience beyond biomedical instruction.