Having a better understanding of emergency nurses' perceptions of obstacles and supportive behaviors in providing end-of-life care could help decrease the stress of caring for dying patients. Actions could be taken to decrease the highest rated obstacles and increase the ratings of supportive behaviors that may ultimately result in better end-of-life care for dying patients and their families in the emergency setting.

Along with increasing nursing pay, strategies to consider in decreasing turnover and increasing satisfaction included: providing opportunities for nursing advancement, promoting the value of nursing, creating clinical protocols and enhancing autonomy. This study adds to knowledge about nursing needs and satisfaction in South America.

This article focuses on innovative collaborative steps that were identified in recent research conducted by these authors on the relationship between academia and service. These steps are currently being implemented in the hope of improving the important role that the clinical environment plays in student nurses' education. Few factors in nursing education are as important as the clinical environment in which students do their training. This article elaborates on these steps and offers practical suggestions for improving the relationship between academia and service.

Continuing education for hospital staff nurses is a concern worldwide. Current research shows that continuing education among nurses can positively affect patient outcomes (O'Brien, T., Freemantle, N., Oxman, A, et al., 2002. Interactive continuing education workshops or conferences can improve professional practice and patient outcomes. Journal of Evidence Based Nursing. 26 (5)). Seeing a need for improved patient outcomes among hospitals in Ecuador, we conducted a teaching the teacher program to assist nurse managers to carry-out continuing education in their hospital system. This teaching the teacher program was established through the collaboration between one College of Nursing in Utah, USA and a large healthcare system in Guayaquil, Ecuador. The collaboration has been ongoing for five years, 2003 to present. Initial projects included classes for the nursing staff including technical skills, life-saving techniques, and nursing process and assessment. Collaborators from the US and Ecuador believed that in order to maximize the improvement of nursing care in the hospital system it was necessary to turn attention on the nurse managers and not just the staff nurses. This would allow for meaningful ongoing learning beyond the one-time classroom setting. Continuing education is not common in Ecuadorian hospitals as it is in the United States. The purpose of this paper is to describe the project and provide initial evaluative data on the response to the curriculum; including evidence of managers using the teaching principles they were taught. The underlying aim of the project was to achieve a sustainable impact by teaching the leaders of each unit how to be more effective teachers. In May 2007, a two-day "teaching the teacher" workshop was developed with the needs of the managers in mind. The participants in the course included the chief nursing officer and leaders of various units of the hospital. In May 2008 a follow-up class was taught, along with an evaluation by a verbal and written survey with open ended questions and an observation of an actual class being taught by the participants.

AIM This exploratory, qualitative study was conducted to compare nursing tasks/roles in Ecuador, Finland, Ghana, Navajo Nation, Russia, Taiwan, and Tonga. BACKGROUND The definition of nurse varies internationally, with little description of the specific tasks nurses perform. To better know the profession, nurses must understand what their counterparts do in different parts of the world. METHOD Students and faculty traveled to seven nations to conduct an observational study. Students observed nurses (n = 71) over a period of three weeks using a checklist of basic tasks/skills, advanced skills, critical thinking, communication, public health, and professionalism. RESULTS Similarities in nursing tasks/roles were found, with a few stark differences between countries. Autonomy of practice and communication styles varied; all nurses were found to be effective patient advocates. CONCLUSION Sufficient nursing personnel, resources, patient load, and technology affect nursing tasks/roles.