This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0)If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium. Purpose: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. Methods: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were 'nurse' related factors, 'patient' related factors, 'resource' related factors. The nine categories were 'unpreparedness', 'nursing barriers due to stigma', 'undervaluing and avoidance of psychiatric nursing', 'eroding into the trap of a vicious cycle', 'facing unapproachable patients', 'dealing with unhelpful family members', 'burdening already overburdened staff', 'obstructive environment', and 'isolation of staff with heavy responsibilities'. Conclusion: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

A retrospective cohort study, using the electronic medical records of Kaiser Permanente Northern California (2011)(2012)(2013)(2014)(2015), included 560 robotic and 6785 conventional laparoscopic cases with 1836 "complex" patients (25%). The average operative time was 152 minutes (robotic) vs 157 minutes (conventional) laparoscopic hysterectomy. Complex surgical cases averaged 190 minutes and noncomplex cases averaged 144 minutes. For women with complex disease, the robotic approach, when used by a higher-volume surgeon, may be associated with shorter operative time and slightly less blood loss, but not with lower risk of complications.