The reuse of single use medical items is a complex ethical issue that many healthcare providers are faced with, for while recommendations and literature do not advocate the reuse of these items, the reality is that many single use items are frequently reused. Further, many healthcare workers are ethically divided over whether or not to share this information with their patients, or who should reveal this information. While single use items are convenient to use, the reality of the cost to the healthcare system and the environment is being realised. Three distinct issues in regard to reuse of single use items are explored: patient consent, fiscal responsibility and environmental stewardship. Exploring these issues through the ethical frameworks of utilitarianism, contractarianism, and land ethic or holism can offer guidance in attending to the question "is once always enough?" Applying an integrated ethical framework can further assist healthcare providers and stakeholders to make informed, ethical choices in regard to choosing single use medical devices and items. Short, fictionalised narratives based on authentic events are used to illustrate the ethical context of the reuse issue.

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The decades of the 1960s and 1970s were unlike any US society had previously experienced. The order of society was openly challenged, which resulted in diverse viewpoints about what was acceptable behavior and thinking. The effects of scientific discoveries were evident in health care, and demands for options in care influenced the delivery of health services. Many of these influences were felt by nurses in the OR, and OR nursing itself transformed in response to the changes in society. The AORN Journal is used in this article as a source of information to ascertain how changes in society were reflected in OR nursing during the period from 1963 to 1983.

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This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, som e thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer.The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction.In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion.Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand corner and continuing from left to right in equal sections with small overlaps.Photographs included in the original manuscript have been reproduced xerographically in this copy.Higher quality 6" x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. The author has granted a non exclusive licence allowing the National Library of Canada to reproduce, loan, distribute or sell copies of this thesis in microform, paper or electronic formats.The author retains ownership of the copyright in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission.L'auteur a accordé une Hcence non exclusive permettant à la Bibliothèque nationale du Canada de reproduire, prêter, distribuer ou vendre des copies de cette thèse sous la forme de microfiche/fihn, de reproduction sur papier ou sur format électronique.L'auteur conserve la propriété du droit d'auteur qui protège cette thèse. Ni la thèse ni des extraits substantiels de celle-ci ne doivent être imprimés ou autrement reproduits sans son autorisation. Columbia face stressors unique to their practice. This study examined a specific situation (transfer o f trauma patients) in which northern rural nurses encountered stress, and the coping resources applied in managing that stress. A qualitative research design was used. 0-612-62485-4 CanadSData were collected through four focus groups comprised o f emergency nurses, operating room nurses, and critical care nurses. Four types o f situations in which nurses felt stressed were identified and included system problems, lack o f communication and support, visual impact, and professional discord and friction. Inter-rater reliability was established in the analysis phase of categorizing the stressful situations. Nurses described using both problem-focused coping and emotion-focused coping strategies when managing stress.Nurses placed more emphasis on using forms o f emotion-focused coping, in particular, co-worker social support. Lazarus and Folkman's transactional model o f stress was also presented as a...