The purpose of this study was to explore with and empower nurses to create a healing environment. The study’s design was a combination study utilizing both quantitative and qualitative methods. The primary research question was, “How is the healing environment of the critical care units affected by the nurses’ trust and empowerment?” The Gibbs’TORI Self Scale and Gibbs’TORI Team Scale measured trust and Barrett’s Power as Knowing in Participation in Change Tool measured empowerment/power. The qualitative analyses revealed essential structures and a synthesis of unity triangulating with the quantitative results. There are implications for education, practice, and administration.

The purposes of this study of African American women who were family caregivers of persons with end stage renal disease (ESRD) were to: (1) identify their perceived health status and changes in perceived health status since assuming the caregiver role, (2) document the association between objective health status and caregiver age, (3) document the relationship between age and perceived health status, (4) identify demographic and subjective and objective health factors that predict perceived health status, and (5) identify their health promotion behaviors. The design for this study was a cross-sectional, descriptive correlational secondary analysis of data obtained from 75 African American women caring for a relative diagnosed with ESRD. These women participated in a larger study designed to investigate the predictors of health and burden in 120 family caregivers of patients with ESRD. The current study included data collected using the following instruments: The Caregiver Demographic Data Form, Caregiver's Perceived Health Form, Severity of Caregiver's Disease Scale, and the Center for Epidemiological Studies Depression Scale (CES-D). Data were analyzed using descriptive statistics, Spearman's correlation analysis, and stepwise multiple regression analysis. Overall, 28% of the caregivers rated their health as either fair or poor although most reported good health. Caregivers also reported several negative changes in health associated with the caregiving experience including decreases in exercise, energy, time for self, time for family and friends, and the amount/quality of sleep and increases in weight, and worry stress/tension. Forty-nine caregivers had scores of 0-15 indicating no signs of clinical depression; however, three caregivers (4.0%) had scores of greater than 31 which indicated severe distress. The mean body mass index for caregivers was 31.2 % indicating that on average this sample was obese. Reported health problems included hypertension (48%) and diabetes (24%). A significant weak positive correlation was found between perceived health status and caregiver age. Predictors of caregiver perceived health status indicated that five variables-number of prescription medications, number of physician office visits in the past 6 months, number of health problems, caregiver age, and total score of CES-D explained 31% (p=.000) of the total variance. Older caregivers on more prescription medications and with more provider visits, health problems and depressive symptoms reported the lowest perceived health status. The relatively small amount of perceived health status variance explained suggests that there are other factors that influenced the perceived health status of participating caregivers. The most common health behaviors reported by African American family caregivers were nutrition, exercise, modifying stress, spirituality/faith, following physician orders, and taking medication as ordered. Though participants reported multiple physical health problems most reported participating in health promotion acti...

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The operating room (OR) can be a high-stress area for healthcare workers. A great deal of expertise, teamwork, and precision is needed for the area to run smoothly and achieve desired patient outcomes. Incivility in healthcare has been recognized in the literature as a cause of healthcare worker distraction with increased risk of medical errors, reduce collegiality, and employee turnover. A survey was sent to nurses who work in operating rooms in a southern state. Forty-three nurses responded to the survey. It was found that most had experienced incivility in the workplace (85%). Fiftyeight percent stated that they had dreaded going to work due to workplace incivility. Twenty-eight percent said that they had experienced stress-related illnesses due to workplace incivility. Physicians and fellow nurses were found to be the most common perpetrators of uncivil behaviors in the OR, compared with supervisors, patients, or other hospital employees. The study's findings underscored the need for hospitals and healthcare systems to focus on reducing incivility the operating room.

Uncivil behavior leads to low self-esteem, anxiety, sleep disturbance, recurrent nightmares, and depression. This article looks at the perception of incivility among emergency department nurses and the leadership required to implement evidence-based strategies to address this growing problem.