This study aimed to clarify the grief process and care needs of bereaved spouses during the period from diagnosis of disease to one year after the death of the partner. Semi-structured interviews were conducted with 10 bereaved spouses to ask about their mental status retrospectively. Data were analyzed by emotions, positive reactions, and negative reactions. A total of 20 categories about emotions and 6 categories and 10 subcategories about care needs were extracted. No specific grief process was observed and each individual experienced their own process by going back and forth the grief process.“Self-encouragement”and “strain”were considered as an emotional factor to facilitate the grief process, and“regret”and “self-reproach”as a factor to inhibit the process. Spouses needed nurses to do their best, provide satisfactory medical care, assist partner’s death with dignity, support family bonds, listen to them, and help them have more support from others. The study suggests that nurses are required to recognize the individuality of grief process and to encourage spouses to express emotions that promote the grief process. In addition, the grief process after bereavement was influenced by the satisfactory treatment and care provided to the partner, and this indicates the importance of providing quality and satisfactory care.

Based on the need for enhancement of clinical skills education, our university extended the term of clinical clerkship（C.C.）from 2017. Using the eYUME system, we compared the student evaluations for practice from 2017（after the extension of the C.C. term）with those of 2016（before the extension）and those of 2014（the start period of C.C.）．In comparison with 2016, the results showed an increase in positive evaluations in all aspects, such as satisfaction, number of patients seen and disease types identified, technical experiences（especially medical history taking），guidance from attending doctors, and respect as role models. In comparison to 2014, positive evaluations were significantly improved in all of the above aspects. Due to the improvement in experiences and learning each year through the efforts of teachers and facilities, the extended term has proved to be a success. In the free description, there were many positive opinions with no new negative opinions offered. As a result, the extension of the C.C. term has achieved some good results, and based on the opinions of students and teachers, and the evaluation of outcomes, we will continue to enhance the content.

Pseudomembranous colitis is one of the antibiotics associated gastrointestinal diseases. The important causal bacterium is clostridium difficile（CD）．We herein report a case of pseudomembranous colitis with septic shock. 79 years old woman who was taking antibiotics by urinary tract infection in previous hospital. She was admitted to our hospital because of abdominal bloating, vomiting and shock. She met the criteria for SIRS and DIC. CT indicated ascites and highly wall thickness from descending colon to rectum. Feces CD toxin was negative. We performed left colectomy and transverse colostomy because of suspicion of pseudomembranous colitis. The resected specimen showed pseudomembrane formation and extensive edema and partial thinness in the colon. Histological examinations revealed pseudomembranous colitis. Severe pseudomembranous colitis suffered from peritonitis, sepsis and shock has a poor prognosis. Severe pseudomembranous colitis patients could require surgical intervention at the appropriate time to improve survival.