Ventilator-assisted youth: appraisal and nursing care

Living with a machine: the experience of the child who is ventilator dependent

While there are reports about depression in mothers caring for ventilator-dependent children in the home, little is known about the children's own perspective of living with a machine. The purpose of this phenomenological study was to obtain the first-person perspective of 11 children, ranging in age from 7 to 12 years, who were ventilator-dependent for a minimum of eight hours each day. The children's experience was contextualized by Others, both human caregiver-others and the mechanical-other. Because of the constant presence of these Others, the child is never alone. Three interrelated themes emerged against this contextual ground: "Can/Can't," "Normal/Different," and "I'm Still a Person!" These children exist as an outcome of extraordinary success in health care technology. Their needs, and those of their caregivers, challenge traditional nursing thought. Mental health nurses should be an ongoing part of the care team for these children and their families.

Patient preferences and discharge planning transitions

Discharge planning is an urgently needed nursing intervention. The purpose of this article is to investigate the importance of patient and family preferences and participation for discharge planning and to describe the pilot testing of an instrument to measure patient preferences for discharge planning. The results identified a lack of congruence between patients' and caregivers' preferences, suggesting the need to assess both patients' and families' preferences early and incorporate this in discharge planning that begins at admission to a hospital. The instrument, Patient Participation Preferences Assessment (PPPA), is shown to be a useful, reliable, and valid instrument that can be used in conjunction with the companion instrument, Family Preferences Assessment (FPA), to assist nurses with comprehensive discharge planning for greater effectiveness.