Cultural diversity continues to increase in many countries around the world. In the United States this diversity has increased significantly over the past decade. It is essential that healthcare professionals provide genomic-focused care in a culturally sensitive manner, recognizing and respecting the cultural values and beliefs of each and every patient. The purpose of this article is to increase healthcare providers' awareness of basic cultural values that can influence the decisions made by members of diverse patient populations. This article will describe the concepts of culture, race, ethnicity, ethno-culture, and genetic diseases in specific populations. In addition, it will discuss ethno-cultural values of Hispanics, African Americans/Blacks, Native American Indians or Alaskan Natives, and Native Hawaiians or other Pacific Islanders that may influence patient and family responses to genomic healthcare, noting the need to incorporate an ethno-cultural lens in assessing patients and providing genomic interventions for them. The article will conclude with recommendations for providing care to diverse populations.

culture --- ethnicity --- ethno-cultural --- genetic diseases --- genomic healthcare --- race

The lysosomal storage diseases (LSDs) are a group of disorders heralding in a new era in the treatment of genetic diseases. Enzyme replacement therapy (ERT) moves the treatment of these disorders from symptomatic management to therapeutic interventions. ERT is not a cure for these disorders, but it can greatly modify or attenuate the phenotype. Treatment for LSDs is lifelong and the diseases affect multiple organ systems. It is possible that nurses in almost every specialty will encounter a patient with one of these conditions. Therefore knowledge of the conditions, the benefits and limitations of ERT, and its effective management are becoming more important for all nurses. This article will describe several LSDs, namely Gaucher disease, Fabry disease, Pompe disease, and the mucopolysaccharidoses. Each disease pathology, signs and symptoms, and effectiveness of ERT treatment will be discussed, as well as the administration of ERT, common side effects, management of the side effects, and nursing implications. Additionally drug costs and insurance concerns will be highlighted.

lysosomal storage disease --- enzyme replacement therapy --- Gaucher disease --- Fabry disease --- Pompe disease --- mucopolysaccharidosis I --- Hurler syndrome --- Hurler-Scheie syndrome --- Scheie syndrome --- mucopolysaccharidosis II --- Hunter syndrome --- mucopolysaccharidosis VI --- Maroteaux-Lamy syndrome

The remarkable advances in genetics and genomics over the last three decades have necessitated initiatives on the part of all healthcare disciplines to assist providers in applying this new knowledge in practice. Nursing has responded by planning and implementing a number of projects that address the challenging issues created by genetic and genomic advances. This article presents an overview of the considerable progress made in sequencing the human genome, progress that has provided the opportunity for the remarkable advances we are seeing in healthcare today. It also describes how various professional healthcare groups and associations are working together to enhance nurses’ understanding of this genomic revolution, thus paving the way for nurses to develop core competencies, and enabling them to incorporate genomic advances into their daily nursing care. The American Nurses Association Code of Ethics for Nurses is presented as a framework for responding to these rapidly occurring changes. Two case studies illustrate how nurses are applying the emerging science and technology in genetics and genomics to advance the nursing profession and provide competent nursing care to patients faced with genetic and genomic healthcare concerns.

ANA Code of Ethics for Nurses --- competence --- genetic --- genetic education --- genomic --- nursing ethics --- nursing challenges --- informed care

Use of a standardized nursing language for documentation of nursing care is vital both to the nursing profession and to the bedside/direct care nurse. The purpose of this article is to provide examples of the usefulness of standardized languages to direct care/bedside nurses. Currently, the American Nurses Association has approved thirteen standardized languages that support nursing practice, only ten of which are considered languages specific to nursing care. The purpose of this article is to offer a definition of standardized language in nursing, to describe how standardized nursing languages are applied in the clinical setting, and to explain the benefits of standardizing nursing languages. These benefits include: better communication among nurses and other health care providers, increased visibility of nursing interventions, improved patient care, enhanced data collection to evaluate nursing care outcomes, greater adherence to standards of care, and facilitated assessment of nursing competency. Implications of standardized language for nursing education, research, and administration are also presented.

communication --- North American Nursing Diagnosis Association --- NANDA --- Nursing Intervention Classification --- NIC --- Nursing Outcome Classification --- NOC --- nursing judgments --- patient care --- quality care --- standardized nursing language

The United States (US) is in the midst of a critical nursing shortage that is projected to worsen unless long term and sustainable solutions are instituted. The hiring of foreign-educated nurses (FENs) has been identified in the literature as one of the practical and realistic solutions to the current nursing shortage. Although small in number compared to U.S.-prepared nurses, FENs play an integral role in the delivery of health care services and contribute to the diversity of the U.S. health care workforce. The literature suggests that successful acculturation of FENs to host cultures leads to work and life satisfaction. Further, there is evidence in the literature suggesting that registered nurses, U.S. or foreign educated, who are satisfied with their jobs and personal lives stay longer in their current jobs and contribute to better patient outcomes. The primary purpose of this article is to discuss several recommendations and strategies that health care agencies and administrators can implement to facilitate a smooth transition of FENs in the U.S. health care system and mainstream society. These strategies and recommendations are derived from the reported experiences and challenges of FENs as they acculturate to host cultures. Further, to better understand how FENs became vital members of the nursing workforce in the US and other countries, a brief history of the hiring of FENs in the US and a brief discussion of the factors that encourage global migration of nurses will be explored. Recommendations for future research will also be discussed.

acculturation --- adaptation --- adjustment --- assimilation --- foreign-educated nurse --- nurse migration --- nursing shortage

Knowledge of the emotional demands facing today’s nurses is critical for explaining how work stressors translate into burnout and turnover. Following a brief discussion of how the experience of burnout relates to the nursing shortage, we examine the scope of nurses’ emotional experiences and demonstrate that these experiences may be particularly consequential for understanding the higher levels of burnout reported by younger nurses. Using survey data collected from 843 direct care hospital nurses, we show that, compared to their older counterparts, nurses under 30 years of age were more likely to experience feelings of agitation and less likely to engage in techniques to manage these feelings. Younger nurses also reported significantly higher rates of burnout and this was particularly true among those experiencing higher levels of agitation at work. We conclude by suggesting the need for increased awareness of the emotional demands facing today’s nursing workforce as well as the need for more experienced nurses to serve as emotional mentors to those just entering the profession.

anger --- age --- burnout --- care work --- emotions --- emotional labor --- emotion management --- nursing shortage --- nurse well-being --- nursing work environment