Nursing operates within the context of globalization which is defined by the transfer of economic, social, political and cultural value across borders. Migration and international recruitment is a prominent feature of nursing over the last decade. The impact of out-migration of nurses on some developing countries is severe. The aim of this article is to review the effects of globalization on health policies, nursing education, migration of health workers and health care.

Inadequate management of pain creates a financial and dramatically burder on the patient and family health care system. With patient controlled analgesia (PCA) systems, patients may receive intermittent boluses of a certain amount of analgesic over a certain time period both of which are predetermined. PCA system is a effective method compared with conventional methods that it reduces amoun of care costs and saves nursing care time, increases of patient satisfaction, keeps opioid serum level within therapeutic range to prevent the peak and valleys of analgesia. This article reviews of using PCA pumps, patient educatior. Possible problems and management.

Level of consciousness is the goldstone of neurological assessment. Level of consciousness directly effects the follow up assessments. Many components of neurological assessment requires patient’s orientation. If it is unavialible to communicate with the patient, it is not possible to complete a full motor and sensory assessment.

In this article, we would like to share the definition of consciousness, different categories of consciousness and Glasgow Coma Scale, as a tool of assessment of consciousness.

In today’s world, there are now automated, semi- automated and manually-controlled defibrillators available. Defibrillation is an internal or external procedure aimed to terminate ventricular fibrillation or pulseless ventricular tachycardia. The shorter the time lapse between the start of ventricular tachycardia or ventricular fibrillation and the application of defibrillation, the higher the success rate of the defibrillation.

Cardioversion can be performed as an emergency or as an elective procedure and is aimed to terminate supraventricular tachycardia, atrial fibrillation and ventricular tachycardia where a pulse is present.

The success of defibrillation may be affected by transthoraxic resistance and the position of the paddles in response to the direct current applied to the chest wall and the lung tissue during the myocardiac defibrillation or cardioversion. It may also be affected by the nature of the current.

Although biphasic defibrillators have advantages over monophasic defibrillators, information on the amount of current to be applied has not so far been included in clinical manuals. AHA reports that, according to present proven indicators, successful defibrillation can be achieved at low energy levels and less myocardiac damage occurs at these lower energy levels.

Acute pain is usually temporary of sudden onset, and easily localized. It occurs as a result of traumatic injury surgical procedure or medical disorders. Acute pain serves a biological purpose. It acts as a warning signal that it can active the sympathetic nervous system.
Signs and symptoms of acute pain are tachycardia, hypertension/hypotension, tachypnea, shallow respirations, agitation or restlessness, facial grimace. Vital signs may be normal in some cases.
Acute pain is greatly undertreated. Acute pain can be harmful if it has not been treated. Inadequate pain control can lead to the stress response involving the cardiovascular, pulmonary, gastrointestinal, metabolic and neuroendocrine systems problems and lipolysis and muscle protein breakdown. Inadequate pain control may increases the lenght of stay in hospital or intensive care unit, morbidity and mortality, and decreases quality of life.
This article reviews symptoms of acute pain, insufficiency of pain management, some scales as a tool for pain assessment and responsibility of nurses for pain control.

OBJECTIVE: The concern over family – witnessed CPR, which is a frequent topic of debate in other countries, there is no report of published study regarding family member presence during CPR in Turkey.
METHODS: The aim of this descriptive study is determine the experiences and opinions of critical care nurses about family presence during cardiopulmonary resuscitation and is to bring this topic into the critical care and the public limelight in Turkey. Study population consisted of critical care nursing staff at four hospitals affiliated with the Ministry of Health, three hospitals affiliated with universities and three hospitals affiliated with SSK (Social Security Agency). Data were analysed in SPSS statistical package.
RESULTS: None of the hospitals that participated in this study had a protocol or policy regarding the family witnessed resuscitation. More than half of the sample population had no experienced of family presence during CPR. None of the respondents had ever invited family members to the resuscitation room. A majority of the nurses did not agree that it was necessary for family members to be with their patient and did not want family members in resuscitation room.
CONCLUSION: In addition, most of the nurses were concerned about the violation of patient confidentiality, had concerns that untrained family member would not understand CPR treatments, would consider them offensive and thereby argue with the resuscitation team. The nurses expressed their concern that witnessing resuscitation would cause long lasting adverse emotional effects on the family members.