Mary's Medical Center Research Articles

Reference Chart for Commonly Used Antibacterial Agents

Journal Article Reference Chart for Commonly Used Antibacterial Agents Get access Janet A. Hindler, MCLS, MT(ASCP), Janet A. Hindler, MCLS, MT(ASCP) UCLA Medical Center, Los Angeles, CA 90024 (Ms Hindler); and St Mary Medical Center, Gary, IN 46402 (Dr Kelley). Search for other works by this author on: Oxford Academic PubMed Google Scholar Susan G. Kelley, PhD Susan G. Kelley, PhD UCLA Medical Center, Los Angeles, CA 90024 (Ms Hindler); and St Mary Medical Center, Gary, IN 46402 (Dr Kelley). Search for other works by this author on: Oxford Academic PubMed Google Scholar Laboratory Medicine, Volume 17, Issue 8, 1 August 1986, Pages 476–479, https://doi.org/10.1093/labmed/17.8.476 Published: 01 August 1986

A THEORY FOR TIMELY TEACHING

n patient teaching, as in nearly every other endeavor, timing is everything. Many hours of essential instruction are wasted when the information is presented to patients before they are emotionally capable of receiving and assimilating it. In the Cardiac Rehabilitation Program at St. Mary Medical Center in Long Beach, California, we have found that we make the best progress in patient rehabilitation when we design our educational programs around the fundamentals proposed by Jane Lee and Abraham Maslow. Using those principles, we are best able to understand and assess the patient's stage of emotional adjustment and tailor the instruction accordingly. Lee describes four stages of emotional adjustment to trauma: impact, regression, acknowledgment, and reconstruction.* Impact refers to the patient's initial emotional reaction to a problem. At this stage, the patient, fearing that his life is threatened, suffers extreme anxiety. This experience may be his first conscious awareness of his own mortality. The patient feels he has lost control, as if he has no part in the outcome of the situation. Commonly, despair and discouragement reflect emotional energies turned inward, with no insight beyond the now. The impact stage corresponds with the first two levels of Maslow's Hierarchy of Human Needs. (See diagram, page 799.) No teaching should be started at this stage. It is best to deal first with the anxiety, giving the patient support by explaining only what is happening, his environment, tests, and necessary treatments. His fear is greater than his need to know. Regression sets in as the patient becomes physiologically stable. Forced to deal with the reality of the situation, he retreats, in an effort to return to a psychologically more comfortable time. Denial is the major mechanism in this flight from reality. Regression is necessary and should be permitted to allow the patient time to muster his defenses to deal with the cri-

A Theory for Timely Teaching

n patient teaching, as in nearly every other endeavor, timing is everything. Many hours of essential instruction are wasted when the information is presented to patients before they are emotionally capable of receiving and assimilating it. In the Cardiac Rehabilitation Program at St. Mary Medical Center in Long Beach, California, we have found that we make the best progress in patient rehabilitation when we design our educational programs around the fundamentals proposed by Jane Lee and Abraham Maslow. Using those principles, we are best able to understand and assess the patient's stage of emotional adjustment and tailor the instruction accordingly. Lee describes four stages of emotional adjustment to trauma: impact, regression, acknowledgment, and reconstruction.* Impact refers to the patient's initial emotional reaction to a problem. At this stage, the patient, fearing that his life is threatened, suffers extreme anxiety. This experience may be his first conscious awareness of his own mortality. The patient feels he has lost control, as if he has no part in the outcome of the situation. Commonly, despair and discouragement reflect emotional energies turned inward, with no insight beyond the now. The impact stage corresponds with the first two levels of Maslow's Hierarchy of Human Needs. (See diagram, page 799.) No teaching should be started at this stage. It is best to deal first with the anxiety, giving the patient support by explaining only what is happening, his environment, tests, and necessary treatments. His fear is greater than his need to know. Regression sets in as the patient becomes physiologically stable. Forced to deal with the reality of the situation, he retreats, in an effort to return to a psychologically more comfortable time. Denial is the major mechanism in this flight from reality. Regression is necessary and should be permitted to allow the patient time to muster his defenses to deal with the cri-

In Tennessee

MARGARET HEINS, RN. EdD, is the director of nursing education at St. Mary's Medical Center in Knoxville, Tenn., and chairperson of the TNA-PAPIN Committee. ROSEMARY A. BOWMAN, RN. MBA, is executive director of the Tennessee Nurses Association, headquartered in Nashville. Information presented here is taken from protocols and materials developed by the TNA-PAPIN Committee.

Reply

Medical PhysicsVolume 8, Issue 2 p. 250-250 Reply Walter J. Kopecky, Walter J. Kopecky St. Mary's Medical Center, Evansville, Indiana 47750Search for more papers by this author Walter J. Kopecky, Walter J. Kopecky St. Mary's Medical Center, Evansville, Indiana 47750Search for more papers by this author First published: March 1981 https://doi.org/10.1118/1.594871AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume8, Issue2March 1981Pages 250-250 RelatedInformation

Cardiac Vein Myocardial Revascularization: An Experimental Study and Report of 3 Clinical Cases

The feasibility of utilizing the coronary venous system for myocardial revascularization was explored in 18 dog experiments and 3 clinical patients at St. Mary Medical Center. Experimental models were developed using mammary artery-to-coronary vein anastomoses, free vein grafts from the aorta to the coronary veins, and saphenous vein bypass grafts from the aorta to the cardiac veins in the patients. Evaluation of myocardial revascularization was done by one or more of the following methods: (1) electromagnetic flowmeter measurements of graft blood flow; (2) myocardial scanning after injection of radioactive materials; (3) hydrogen electrode evaluation of arteriovenous shunting; (4) coronary cineangiograms; (5) methylene blue injections with visual observation of myocardial staining and collateral venous pathways; (6) pulse-flow tracings; (7) electrocardiographic changes; and (8) myocardial venous capillary response to papaverine and isoproterenol. The experimental studies consistently demonstrated evidence of myocardial revascularization through the coronary venous system. Three patients with intractable angina pectoris and previous unsuccessful revascularization procedures underwent saphenous vein bypass grafting from the aorta to the coronary vein. Postoperative coronary cineangiograms showed patency in 2 of 4 grafts. Myocardial scanning demonstrated radioactivity in the regions served by the patent grafts. All patients survived and were partially or completely relieved of their symptoms.