The nursing profession faces significant challenges, including high turnover rates, burnout, and job dissatisfaction, with over one-quarter of registered nurses planning to leave the profession within 5 years. Simultaneously, health care organizations spend $38.6 billion annually on regulatory compliance, creating substantial administrative and financial burdens. A dual-role nursing model that combines traditional bedside care responsibilities with regulatory compliance and quality improvement activities can be used as a strategic solution to address both nursing retention challenges and organizational regulatory costs. The proposed model utilizes existing bedside nurses in expanded roles that split time between direct patient care and regulatory activities. Implementation involves comprehensive training on Medicare Conditions of Participation, participation in regulatory councils and committees, and application of Rogers' Diffusion of Innovation theory to promote compliance adoption among peers. The dual role model addresses multiple organizational challenges simultaneously by: reducing regulatory compliance costs through utilization of existing staff rather than contracted services or dedicated positions; enhancing nurse job satisfaction, autonomy, and professional development opportunities; improving regulatory readiness through clinicians who understand frontline care delivery; and supporting the American Nurses Association's Nursing Human Capital Value Model by positioning nurses as capital investments rather than operational expenses.

Decision-making capacity in health care refers to a person's ability to understand information relevant to a decision, appreciate how the decision affects them, make a choice, and communicate that choice. Capacity is essential in ethics and professional nursing practice because it forms the basis of informed consent. Nurses encounter various medical conditions, such as dementia, that can contribute to changes in cognitive abilities and result in diminished capacity. However, having a cognitive condition such as dementia does not necessarily mean a person lacks the capacity to make a specific decision or provide informed consent. This article examines a surgical clinical case involving a patient with diminished decision-making capacity related to dementia and probable delirium who needed a surgical intervention. Using this case study, the authors explore the ethics of substitute decision-making, the best interests standard, and a principled approach to supporting a patient who is incapable of refusing a recommended invasive treatment.

Low back pain is a common and potentially debilitating disorder. Pain due to lumbar facet joint pathology is estimated to occur in 15% to 45% of those with low back pain. Radiofrequency ablation (RFA) is a common interventional pain management procedure used to treat lumbar facet joint disease (LFJD). RFA is available for patients when conservative treatment has been unsuccessful. A major benefit to RFA is the diminished need for the use of opioid and other potentially harmful medications. RFA also has the potential to prevent the need for more invasive treatment. The procedures necessary prior to RFA and RFA itself are performed in outpatient settings and allow patients to quickly return to their normal activities post procedure. This article describes the risk factors, pathophysiology, diagnosis, treatment, and nursing considerations of a patient with LFJD. The steps to an RFA and the RFA procedure itself are also discussed.

In Brief The author, a certified long-term care ombudsman, shares a poignant encounter with a resident at a skilled nursing facility who was reported for regularly panhandling. This experience reminded the author that true well-being in long-term care goes far beyond bingo nights and scheduled activities; it calls for a deeper, more meaningful recognition of residents' dignity and purpose.