One of the goals of nursing education is to develop caring and responsible nurses with clinical reasoning skills who are capable of improving outcomes in complex healthcare systems. Using the Model of Situated Learning in Nursing Leadership, generalist entry graduate nursing students at Rush University in Chicago, part of a large academic medical centre with Magnet recognition for excellence in nursing practice, are educated using a curriculum based on the clinical nurse leader (CNL) competencies. This article presents a case study that demonstrates how the model is used to provide experiences for learning the CNL role. The students learn leadership in practice through their involvement in ongoing efforts at the medical centre to improve the care of patients with intellectual and developmental disabilities. The case study provides lessons in teaching CNL leadership competencies through efforts to improve the quality of care for an at-risk group of patients.

Obesity has risen at epidemic rates over the last 20 years. This increase crosses all ages, genders, racial/ethnic groups, and income and educational levels. A variety of genetic, environmental, physiological, psychological, and sociocultural factors influence the development of obesity. Increased morbidity and mortality are associated with obesity. Most health-related problems and the increased risk of death in obesity are due to cardiopulmonary compromise. This paper addresses the physiologic effects of obesity on the cardiopulmonary system and the impact obesity has on the critically ill patient. Suggestions for alterations in cardiovascular and pulmonary assessment techniques are discussed. Nursing practice interventions are presented for maximizing cardiopulmonary function and preventing complications. The advocacy role of the nurse is addressed as a critical component in working to develop a culture of understanding and acceptance for the obese patient.

The Affordable Healthcare Act has, among other changes, created greater incentives to reduce health disparities in lowincome communities across the country, which heightened the importance and expectations of community health workers (CHWs) as part of the clinical care team. These heightened expectations have begun to transition what has historically been a paraprofessional role into one that involves more clearly defined competencies and development needs. In an effort to meet these needs in the city of Chicago, a CHW basic certificate program was developed and launched at Malcolm X college (one of the seven city Colleges of Chicago), in collaboration with several community partners. This article presents the experience of this program, the challenges faced in its implementation, and lessons from this experience that may be relevant to others involved in the professional preparation of CHWs.

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