Nursing in a technological environment: nursing care in the operating room

Operating room nurses continue to draw criticism regarding the appropriateness of a nursing presence in the operating room. The technological focus of the theatre and the ways in which nurses in the theatre have shaped and reshaped their practice in response to technological change have caused people within and outside the nursing profession to question whether operating room nursing is a technological rather than nursing undertaking. This paper reports findings from an ethnographic study that was conducted in an Australian operating department. The study examined the contribution of nurses to the work of the operating room through intensive observation and ethnographic interviews. This paper uses selected findings from the study to explore the ways in which nurses in theatre interpret their role in terms of caring in a technological environment.     

Professional Development in Nursing Research—A Culturally Diverse Postdoctoral Experience

Given the current shift from culturally-sensitive to culturally-competent healthcare, preparing culturally diverse nurse-scientists beyond the doctorate is crucial to the ability to better understand the healthcare of diverse client populations. The probability of ethnic-minority postdoctoral fellows having mentors of the same race is low. This article describes key issues to consider for culturally integrated professional development experiences between ethnic-minority postdoctoral nursing research fellows and White, non-Hispanic nurse-scientists. The discussion delineates three characteristics that describe a scientific community: communality, colleagueship, and constructive competition. Conclusions are that four factors are critical to ensuring the survival and success of ethnic-minority researchers: instruction, affiliation and mentoring, sustaining ethnic-minority researchers'contributions, and expanding the number of ethnic-minority researchers.     

From language classroom to clinical context: the role of language and culture in communication for nurses using English as a second language: a thematic analysis

Background

This study explores the experiences of internationally educated nurses using English as a second language, recruited by advanced economies to supplement diminishing local workforces, as they progress from language learning programs to clinical settings.

Objective

Understanding the journey these nurses experience as language learners and professionals highlights ways in which they could be better supported in their adaptation and integration into the Australian workforce.

Design and methods

By means of semi-structured interviews, the nurses’ narratives were explored and documented. Thematic analysis was used to interpret their experiences as they move from the English language classroom to the clinical setting.

Setting

The participants had all completed studies in English as a second language in Australia and had experienced working in Australian as part of a competency based assessment program. At the time of the study, conducted in South Australia, six of the nurses had met the English language requirements of the Nurses Board of South Australia and had started working as Registered Nurses in Australia. Four participants were still to reach the mandatory English requirements, among whom three were to return to their home countries due to visa restrictions, and continue their efforts to attain the English language proficiency requirement.

Participants

There were six female participants and four male. Five participants were Indian, four Chinese, and one, Nepalese.

Results

In exploring their experiences, themes of identity and belonging, safety and competence and adapting to new roles and ways of communicating are revealed. In their own words, these nurses reveal the challenges they face as they concurrently manage the roles of language learners and professionals.

Conclusions

The journey from language classroom to clinical setting is a process that goes beyond the notions of language proficiency; these nurses are constructing new cultural and professional identities. Bridging the gap between preparation and practice involves making complex linguistic, cultural and social choices, often unsupported. Understanding their experience will better inform approaches to preparation and facilitate their adaptation and integration.     

Caring in nursing: a multivariate analysis

The dimensions underlying the perceptions of caring among nurses were investigated using the Edinburgh Caring Dimensions Inventory (CDI). Exploratory and confirmatory factor analysis techniques were used. While there was a general caring factor on which the majority of the items in the CDI loaded, there were two separable major dimensions to caring, namely 'psychosocial aspects' and 'professional and technical aspects'. In addition, two smaller dimensions were identified that were both related to self-giving, and it is postulated that these refer, respectively, to appropriate and inappropriate self-giving in nursing.     

Russian Nursing Education Reform Project: New Nurses for a New Russia

Purpose: To describe a 2-year nursing exchange project, 1992–1994, designed to access Russian nursing education and to make recommendations for change.
Results: Nursing education in Russia is at a level similar to vocational schools in the United States and is closely linked to medicine. Russian nurrse educators were assisted in developing a philosophy of nursing, developing definitions for nursing, and incorporating process into practice.
Conclusions: The Russian government and Russian nurse educators are committed to improving the equality of health care and nursing. This exchange toward a process-based baccalaureate model.     

Nursing leadership from the perspective of clinical group supervision: a paradoxical practice

bondas t. (2010) Journal of Nursing Management 18, 477–486
Nursing leadership from the perspective of clinical group supervision: a paradoxical practice Aim Increase understanding of nursing leadership in group clinical supervision (CS). Background Leadership in CS has received little interest besides the theories in use and administrative CS. Method Hermeneutic interpretation of written narratives of 24 clinical nurse supervisors. Results Continuity in structuring, story and mission and reflection in group and leadership processes and theories of nursing and caring characterize leadership in CS. Leadership by inhibiting and creating fear, inapproachability and indistinctiveness were patterns in content brought to CS. Supervision when leadership was involved illuminated a reflexive change in focus from leadership to nursing care, from particular experiences to nursing and caring science, and from the unfamiliar to the well known and the well known to the unknown. Conclusions Continuity and reflective changes using nursing and caring theories seem to be core ideas of nursing leadership from the perspective of CS. The poles of separation and communion show opposites of nursing leadership as it is illuminated in CS. The findings add knowledge to Bondas’ theory of caritative leadership. Implications for nursing management CS is a reflexive practice of support and guidance that seems to have an impact on the trajectory of nursing care and staff development using nursing and caring theories.     

Nursing care of older people: a personal construct theory perspective

This paper outlines the use of the repertory grid technique, with nurses caring for elderly residents, and residents of a nursing home. The method focuses on the individuality of each person's attempt at making sense of her/his caring world. Previous papers have focused on a discussion of the repertory grid technique as a research method and tool for psychiatric nurses, an overview of studies using this technique with nurses and social workers, and applications of personal construct theory (from which the technique is derived) to nursing research. A paper by Rawlinson described content analysis of the role constructs elicited from the nurses. In this study, content analysis of caring constructs elicited by nurses and residents was also undertaken, and the results are presented. Additionally, principal component analysis of the repertory grids was carried out, and three examples are presented. This combined analysis provides an in-depth insight into nurses' perceptions of caring for others; perceptions which guide their caring behaviours. This information can be used by individual nurses to review their caring practice.     

Patterns of Japanese clinical nursing: a historical analysis

One of the distinct patterns in the history of modern Japanese nursing during the past 120 years has been the uncritical acceptance of western nursing with little regard given to Japanese culture. The purpose of this article is to give a critical analysis of Japanese nursing in order to demonstrate how deeply culture influences nursing. I suggest that good communication among doctors and nurses, and among health professionals and patients is the key to the advancement of Japanese nursing.     

Nursing research with refugee clients: a call for more qualitative approaches

BACKGROUND: Nursing research with refugee populations, who lack an understanding of the importance of research, presents unique challenges. These challenges include bureaucratic requirements for gaining permission for research, navigating through camps, identifying potential participants, gaining acceptance, building rapport and trust, maintaining privacy, and respecting participants' status in the camp. Few studies exist regarding Palestinian refugees, with no reported studies that address nursing or healthcare, especially in Jordan. FINDINGS: Quantitative research, which often requires participants who read and write, may be ineffective with long-term refugee populations. Additionally, many research tools are not culturally valid. Consequently, refugees, many of whom are illiterate, are largely unstudied. RECOMMENDATIONS: Qualitative approaches, such as interviewing and observation, allow participants to describe their healthcare concerns, and their management of them. Rapport and trust can then enable the researcher to provide interventions and education.     

Nurses' views of fundamental relational skills used in clinical practice: a cross-sectional pilot study

Objective: Effective communication skills are one of the core competencies of nursing curricula internationally. Nurses are generally regarded as proficient. Despite our complete trust in the profession, deficiencies and gaps exist. However, it is not clear to which extent nurses use key communication skills in practice, and whether or not confident in using these skills compounds environmental issues that occur. This study explored nurse's confidence and application of relational skills competencies in nursing practice.Methods: A 13-item online survey was used to collect data. Results: Being self-aware on key areas where there was more uncertainty. Nurses also lacked confidence in exploring the impact of their personal feelings and values on their interactions. Nurses were also less confident on responding appropriately to instances of unsafe or unprofessional practice and using information and communication systems and technology. Conclusions: Given the potential impact of poor relational skills on quality client care, an increased emphasis on caring and compassion, and the ever-expanding use of communication technologies, there is a need to explore the need for reflective practice to enhance continuous professional development for nurses to enhance their relational skills.     

Emotional care experienced by hospitalised patients: development and testing of a measurement instrument

Aims and objectives. This paper describes the development and preliminary psychometric testing of an instrument that evaluates the emotional care experienced by patients during hospitalisation. Background. Previous qualitative work using the Grounded Theory method identified the characteristics of interpersonal interactions that hospitalised patients perceived to be therapeutic. Three conditions were associated with the patient’s experience of emotional comfort: the patient’s perceived Level of Security, Level of Knowing and Level of Personal Value. Questions relating to each of these conditions were included in this new instrument. Design. Instrument development and psychometric testing. Method. Preliminary psychometric testing was carried out in four phases: construction of the instrument; assessment of face and content validity; testing for clarity and feasibility for use with hospitalised patients; assessment of reliability, construct validity of the tool and assessment of the internal structure. Conclusions. A hospital‐wide survey was carried out and the instrument was completed by a total sample of 132 patients. Two of the three sub‐scales achieved an internal consistency estimate of at least 0·70. The construct validity of the tool confirmed the previously identified characteristics of patients in need of additional emotional care. Exploratory factor analysis established two of the sub‐scales and identified a fourth sub‐scale which was named ‘Level of Connection’. Encouraging reliability and validity estimates were obtained and the instrument was improved. Further testing with larger samples is recommended. Relevance to clinical practice. This questionnaire, which is completed by hospitalised patients, differs from other instruments because it evaluates the interactions of all hospital staff rather than only nursing staff. This instrument can be used to identify patients who may be in need of additional emotional care and to evaluate the effectiveness of interventions directed at improving the emotional well‐being of patients.     

Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beijing, China

Aims. The aims of the study were to develop an understanding of caring in nursing from the perspective of cancer patients and attempt to identify the concept of caring in the Chinese cultural context. Background. Caring as a concept remains elusive, the acceptable definitions of the term care have not been reached. The expressions, processes and patterns of caring vary among cultures, but there is a lack of Chinese culture‐based study about caring in nursing. Methods. A qualitative research design was used and 20 cancer patients were interviewed using a semi‐structured interview guide. A qualitative content analysis was used to identify themes in the data. Results. Three themes emerged from the data, which suggested that caring is delivering care in an holistic way: nurses’ caring attitudes and their professional responsibility for providing emotional support, nurses’ professional knowledge and their professional responsibility for providing informational support and nurses’ professional skills and their professional responsibility for providing practical support. The caring behaviour of nurses as perceived by cancer patients involved the provision of emotional, informational, and practical support and help based on patients’ needs. A model of caring in nursing was formulated. Conclusions. Caring in nursing as perceived by cancer patients involves nurses having qualified professional knowledge, attitudes and skills in oncology and providing the informational, emotional and practical supports and help required by cancer patients. Relevance to clinical practice. Caring is manifested in nursing actions through nurse–patient communication process. Patients have their inner expectation for nurses’ caring behaviour and attitudes and nurses’ performance of caring or uncaring behaviour has a direct influence on the feelings of patients. It is necessary for all nurses to continue improving their oncology professional knowledge, attitudes and skills as well as their abilities of offering informational, emotional and practical support and help for their cancer patients.