Rationale and key points This article explains intentional silence, which can provide a therapeutic nursing presence that demonstrates compassion and respect for the patient. » Intentional silence can enhance the therapeutic relationship between the nurse and patient. » Intentional silence can be used to reduce the patient's emotional lability by ensuring that they feel listened to. » It is important that nurses are able to respond therapeutically to rhetorical statements and/or those concerning serious or severe clinical circumstances. » The nurse can use intentional silence to support the patient in acknowledging, processing and reflecting on changes in their health. Reflective activity 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article will change your practice. 2. How you could use this article to educate your colleagues. Subscribers can upload their reflective accounts at rcni.com/portfolio.

Nursing staff in long-term care/transitional care (LTC/TC) facilities in the US work in unique environments that can be stressful and demanding. There is much in the literature that describes different leadership styles in nursing, but a limited amount on leadership in LTC/TC environments. This article explores the concept of leading by walking around (LBWA), also known as leadership by walking, to cultivate therapeutic work environments in LTC/TC facilities in the US. It defines therapeutic work environments and describes the specific environment of LTC/TC facilities. It also briefly describes the nursing hierarchy and nurse education in the US. Finally, it describes the cultivation of therapeutic work environments by using LBWA and includes two examples of the concept in action.

A nurse's leader emotional intelligence (EI) is closely linked to his or her ability to therapeutically handle interpersonal confl icts. EI is based on the ability to accurately identify another person's emotions from facial expressions, body language, and speech. Communicating with respect and concern for the other person is a salient way to effectively manage a confl ict. When nurse leaders lack EI, results suffer and team morale plummets. The core themes associated with EI include: gratitude, altruism, compassion, empathy, forgiveness, happiness, and mindfulness. An emotionally intelligent person is able to identify these themes and respond appropriately without great effort.

Dementia is an insidious disease process that prevents an individual from making sense of environmental circumstances. Cognitively impaired patients are at increased risk for falls, skin integrity issues, accidents, and wandering behaviors. Yet, as the understanding of this disease process and the behaviors exhibited by the dementia patient grows, there is a new focus on individualizing care and attempting to manage adverse behaviors in a holistic fashion utilizing mainly nonpharmacological interventions. It has been shown that the evidence-based best practices related to mitigating adventitious behaviors in the geriatric population diagnosed with dementia are associated to nonpharmacological interventions. Utilization of technology in the form of computers to implement music therapy, reminiscence therapy, and occupational recreational therapy was the selected evidence-based best practice to implement. The aim of the work is to show non-pharmacological interventions as an inseparable and complementary method of pharmacological treatment of working with people with dementia. (JNNN 2018;7(1):40-45) Key Words: dementia, nonpharmacological interventions, adventitious behaviors StreszczenieDemencja jest podstępnym schorzeniem, które uniemożliwia chorym zrozumienie warunków środowiskowych. Pacjenci z zaburzeniami poznawczymi narażeni są na zwiększone ryzyko wystąpienia upadków, problemów skórnych, wypadków i zachowań wędrownych. Wraz ze wzrostem zrozumienia tego procesu chorobowego i zachowań przejawianych przez osoby chore, nowe podejście koncentrować się powinno na indywidualizacji opieki i próbach radzenia sobie z niepożądanymi zachowaniami w sposób całościowy, wykorzystując głównie interwencje niefarmakologiczne. Wykazano, że najlepsze praktyki oparte na dowodach, związanych z łagodzeniem przypadkowych zachowań w populacji geriatrycznej z rozpoznaną demencją, wiążą się z niefarmakologicznymi interwencjami. Wykorzystanie technologii w postaci komputerów do realizacji muzykoterapii, terapii wspomnień i rehabilitacji zajęciowej były wybrane najlepszą praktyką opartą na dowodach. Celem pracy jest ukazanie interwencji niefarmakologicznych jako nieodłącznej i uzupełniającej podstawowe leczenie farmakologiczne metody pracy z osobami z demencją. (PNN 2018;7(1):40-45) Słowa kluczowe: demencja, metody niefarmakologiczne, uboczne zachowania

treatment to a focus on the patient's autonomy and participation in their own care. It is important to note that compliance has a universal connotation related to an adhering to a standard. Instead of care being rendered in terms of dictated interventions, a dialogue should be initiated to assess the patient's priorities with regards to their healthcare and overall wellbeing. Concordance is a synergistic collaboration between the provider and patient in which the patient's wishes and intentions are held paramount. Relevance to the nursing field Currently, patient compliance to prescribed plans of care is a subject of great interest to the field. 3 Consequentially, many articles have been written in the pursuit of improving patient compliance as their main objective. 4-6 Lack of compliance to plans of care is noted as being a major factor in rising healthcare costs. 7 When healthcare interventions are not implemented, often medical conditions worsen or result in acute exacerbations. As a medical issue progresses, costs typically become more substantial. The prevailing method of intervention to achieve positive patient outcomes has been focused on improving compliance to evidence-based best care practices.