A pediatric rehabilitation experience for undergraduate nursing students.

Pediatric rehabilitation is a specialty that will need more nurses in the future. A clinical rotation in this specialty was incorporated into the pediatric experience of junior-year baccalaureate nursing students at the University of Maryland School of Nursing. The experience helped students to learn more about the nursing care involved in pediatric rehabilitation, to appreciate the different disciplines within the specialty, and to view pediatric nursing from a holistic long-range perspective. The experience also strengthened ties between nursing education and practice.     

Learning from experience: differences in how novice vs. expert nurses diagnose why an infant is crying

Diagnosing client health problems is a well-recognized task for nurses. This study examined the effects of nursing education and experience on that problem-solving process by comparing the performance of four groups of nurses. Junior and senior nursing students, nursing students who were parents, and pediatric nurses solved two computer-presented problems. The task involved acquiring information in order to evaluate competing causal hypotheses. One problem concerned why an infant was crying and the other was a control problem. A number of group differences were identified. The experienced groups of pediatric nurses and parents differed from the student nurses by using less information and selecting different information units, such as information about the infant's age, earlier in the problems. Parents were the most accurate; they did not select any incorrect hypotheses. The dual roles of education and experience are discussed and it is proposed that computer-presented simulations can be an important tool for understanding problem-solving processes, as well as for promoting clinical skill development.     

Staff Nurses' Perception of Their Role in a Dedicated Education Unit Within the Intensive Care Unit

The dedicated education unit (DEU), a model for clinical nursing education, is a partnership in which professional nurses are trained to participate in the clinical education of nursing students. This study evaluated the perceptions of staff nurses who acted as clinical teaching associates to senior nursing students in an intensive care unit setting using the DEU model. Other nursing programs may benefit from the outcomes experienced in this application of the DEU model.     

不同年级护生与临床护士评判性思维能力的比较研究

目的 比较分析不同年级护生与临床护士的评判性思维能力,为护理教育、护理实践的改革提供科学的依据.方法 采用评判性思维倾向测量表中文版(CTDI-CV)对本科一、三年级护生共656名和护士287名进行调查.结果 一年级护生的CTDI-CV总均分为(292.82±26.41)分,护士组(290.58±24.87)分,三年级护生组(284.71±26.20)分,组间比较差异有统计学意义.一、三年级护生的开放思想、求知欲、认知成熟度三特质得分均高于护士,而系统化能力、评判性思维自信心比护士弱.结论 现有的护理教育体制需要优化改革,同时还需促进现代临床护理模式的转变.     

对护理专业不同学历学生临床护理带教需求的调查分析

目的通过对护理专业不同学历学生进行调查与分析,了解其对临床护理带教的需求以及差异,为制订有针对性的教学计划提供参考依据方法自行设计调查问卷,便利选取120名护理实习生进行调查。结果本科学生对＂掌握健康教育的技能＂的需求最高;大专学生对＂掌握专科仪器设备的使用＂＂掌握病房管理的方法＂的需求最高;中专学生对带教教师学历、职称、理论水平的需求比本科和大专学生低;不同学历学生一致认为,带教教师最重要的素质是尊重学生。不同学历学生对掌握科研知识、护理文书记录、护理程序的应用的需求情况均不乐观。结论不同学历学生对临床护理带教教师的资格、素质及带教内容的需求不同,因此教学管理者要针对不同学历学生需求的差异,制订切实的教学计划与措施,满足其不同需求。     

Using an Unfolding Simulation With Maternity and Pediatric Nursing Students

Providing appropriate and timely learning experiences for maternity and pediatric clinical rotations can pose challenges for nursing programs. Learning experiences for student nurses may be limited because of a number of variables, including patient availability, the ability to conduct assessments, availability of clinical sites, and number of students allowed. Nursing programs may elect to creatively utilize simulation experiences to promote student learning in specialty areas. This article discusses an unfolding simulation experience with maternity and pediatric nursing students.     

Partnering to educate: Dedicated education units

A current focus of the healthcare industry is centered on addressing the nursing shortage. In the midst of a nursing faculty shortage the Institute of Medicine (2010) recently released a report that calls for increasing the number of baccalaureate prepared nurses to 80% of the workforce by 2020. Therefore, nursing schools are faced with graduating more nurses to meet the demand. Yet, admission to schools of nursing are often limited because of clinical placement sites. The Dedicated Education Unit (DEU) model has been recently introduced to address the challenge of increasing the enrollment of nursing students in spite of a nationwide shortage of nursing faculty. Dedicated Education Units are clinical sites in hospitals where staff nurses serve as preceptors for students in all levels of their nursing education. This model is designed to improve practice education to better prepare students for actual practice while decreasing the number of faculty required at clinical sites. The purpose of this article is to discuss the implications of this model for nursing education, our experience with the DEU model, and issues of deliberation.     

Bullying in undergraduate clinical nursing education

Although a limited number of studies have focused on bullying in nursing education to date, all of those studies demonstrate the existence of bullying in clinical settings, where nursing students undertake a significant amount of their nursing education. The purpose of this study was to examine the state of bullying in clinical nursing education among Canadian undergraduate nursing students (N = 674) in all 4 years of their nursing program. Results suggest that nursing students experience and witness bullying behaviors at various frequencies, most notably by clinical instructors and staff nurses. Third-year and fourth-year students experience more bullying behaviors than first-year and second-year students. Implications for practice include ensuring that clinical instructors are well prepared for their role as educators. Policies must be developed that address the issue of bullying within nursing programs and within health care facilities where nursing students undertake their clinical nursing education.     

Acute care nurses’ attitudes toward nursing students with disabilities: A focused ethnography

Discrimination towards individuals with disabilities is problematic within nursing. There have been calls to increase diversity in nursing and this includes embracing nurses with disabilities. Increasing diversity in nursing requires increasing diversity among nursing students; in this way, nurse educators are gatekeepers to the profession. Clinical education is a crucial element of nursing education, yet there have been very few studies related to the clinical education of nursing students with disabilities. There have been no studies of attitudes of acute care nurse preceptors toward students with disabilities in the United States. This gap is important as the majority of clinical experiences occur in the acute care environment. Utilizing a focused ethnography, semi-structured interviews were conducted with 20 acute care nurses with at least two years’ experience precepting students. While positive feelings about nursing students with disabilities were shared, thoughts and behavioral intentions remained negative. Six themes emerged: safety, barriers, otherness, communicating to meet needs, disclosure, and student versus colleague. Attitudinal barriers are the primary barriers faced by individuals with disabilities in becoming and practicing as nurses. Nurses in practice and education must embrace more inclusive attitudes towards individuals with disabilities.     

护理路径应用于门诊输液患儿健康教育的研究

目的应用护理路径对门诊输液患儿进行健康教育,有效促进护患关系,提高患儿及陪护人对护士综合满意率。方法将88名门诊输液患儿随机分为2组,对照组采用传统的门诊健康教育方法,观察组应用护理路径对门诊输液患儿进行健康教育,以陪护人对护士健康教育的综合满意率,静脉输液一次成功率进行评价。结果观察组陪护人对护士健康教育的综合满意率,静脉输液一次成功率均高于对照组(P<0.05)。结论应用护理路径于门诊输液患儿的健康教育,对促进患儿健康恢复、预防疾病、改善护患关系具有积极作用。     

End-of-life nursing education consortium for pediatric palliative care (ELNEC-PPC)

Pediatric nurses must often care for children with life-threatening illness. Although the child may be a neonate with multiple organ failure, a young adolescent diagnosed with HIV, or a 7-year-old child involved in a serious bicycle accident, pediatric nurses are an essential part of the interdisciplinary team that plans, organizes, implements, and manages the care of these children and their families. To date, more than 600 pediatric nurses have attended a national End-of-Life Nursing Education Consortium-Pediatric Palliative Care (ELNEC-PPC) training program. Many of these nurses have returned to their institutions dedicated to making a difference in the palliative care provided to children and their families. Because pediatric palliative care education is so important, many trainers have incorporated ELNEC-PPC into their nursing orientation, annual competencies, and undergraduate and graduate nursing education. They are developing standards of care and serve on key hospital/hospice committees, such as policy, education, clinical care, and ethics committees. This article showcases various activities of ELNEC-PPC trainers and demonstrates their commitment to improve pediatric palliative care not only in their institutions but also on local, state, national, and international levels.     

A study of diagnostic reasoning in pediatric nurses.

PURPOSE: To examine the data collecting and interpreting phases of the diagnostic reasoning process used by practicing pediatric nurses and to determine: (a) types of information deemed important for planning nursing care; (b) the functional health patterns addressed; and (c) frequency of validation of early hypotheses. METHOD: Thirty-four registered nurses who attended continuing education pediatric nursing workshops were asked to analyze a written simulated case study discussing maternal-infant interaction. Diagnostic cues in the case study were based on a framework that consisted of a clinical nursing model of maternal-infant interaction and selected nursing diagnoses. Open-ended questions were used to examine subjects' attention to and interpretation of these cues. FINDINGS: All subjects identified information related to the child's physical needs and the mother's responsibility to meet those needs as important for planning nursing care. There was less attention given to the interaction of mother and child. The most common response was identification of cues associated with five functional health patterns (29.4% of subjects). The functional health pattern, coping-stress tolerance, was addressed least often, although all nurses identified cues associated with role relationship. Only 38% of the subjects identified the need for validation of early hypotheses. CONCLUSION: The findings support the need for further research on the diagnostic reasoning of pediatric nurses. Recommendations include methods to enhance pediatric nurses' collection and interpretation of data specific to the pediatric clinical setting.     

临床见习护生工作压力源与应对方式、自尊及人际信任研究

[目的]探讨临床见习护生工作压力源及应对方式、自尊水平与人际信任度,以便采取有效的管理措施,引导护生减少或有效应对各种压力.[方法]采用中国护士工作压力源量表、简易应对方式问卷(CSQ)、自尊量表(SES)与信赖他人量表对临床见习的本科护生87人进行集体测查,并与临床护士压力源进行比较.[结果]见习护生的工作压力源得分显著低于临床护士(P＜0.01或P＜0.05),护生前3位的工作压力源是护理工作的社会地位很低、病区太拥挤、没有时间对病人进行心理护理;护生在护理专业及工作方面、管理及人际关系方面的压力感知与人际信任程度呈显著负相关(P＜0.05或P＜0.01),病人护理、管理及人际关系方面的压力感知与消极应对方式呈显著正相关(P＜0.05).[结论]见习护生对护理工作的压力感受有其自身的特点,需考虑护生的应对方式、人际信任等因素,有针对性地进行健康教育.     

A study of nurses'' attitudes towards associate degree nursing students

The purpose of this study was to examine the attitudes of staff nurses towards associate degree (AD) nursing students. The null hypothesis stated there will be no significant difference in the attitudes of staff nurses towards AD nursing students and associated concepts (nursing education, patient, physician, work, nurse.) The staff nurse's value as a role model is held in high regard yet little regard is given to her attitudes towards students. Through better understanding of staff nurses' attitudes, nurse educators can better plan, develop and coordinate clinical activities to provide an optimum learning environment. The findings showed the concept AD nursing student was significantly different from the rest, indicating a less positive attitude towards the AD nursing student than the related concepts. Implications for nursing practice are threefold. Nurse administrators must create an atmosphere and a philosophy which support the educational process within their institution, and recognize nurses' attitudes towards students. Practising nurses should examine their attitudes and willingness to work with students if their hospital offers their agency as a clinical facility. Educators must look closely at the units they assign students to, continually maintaining the lines of communication between staff nurses and clinical instructors. As service and education work together a quality environment can be provided in which there is optimum learning for the student. Both groups then contribute to the future of professional nursing.     

Teaching basic ethical concepts and decision-making: a staff development application

Academic nursing programs are increasing the amount of ethical instruction presented to undergraduate and graduate students. However, nurses who graduated several years ago may find themselves without the background and skills needed to discuss the complex bioethical dilemmas they now face. This article presents the development of a continuing education program to acquaint nurses with basic ethical concepts and bioethical decision-making processes. Presentations were piloted with a small group of nurses from the outpatient department of a pediatric tertiary care hospital.     

A survey of pediatric nurses' knowledge about breastfeeding.

The purpose of this study was to obtain baseline data on pediatric nurses' knowledge about breastfeeding, to inform an education program being developed in a large Melbourne pediatric teaching hospital. A pediatric breastfeeding questionnaire was developed. A random sample of 278 nurses in a variety of clinical units was selected. The questionnaire return rate was 54%. Overall, the difference in the mean percentage knowledge scores between the most experienced and the least experienced nurses was small. The result indicate that an ongoing lactation education program and a Breastfeeding Day-Stay Unit would benefit nursing staff, mothers, and babies.     

An evaluation of nurses' clinical teaching role in Turkey

A study of 91 nurses in Hacettepe University Adult Hospital in Turkey investigated how effective clinical nursing teaching was and analyzed the reasons for their teaching performance. Questionnaires about patient care, management, research, and teaching role were administered to the nurses in the study. The results of the questionnaires were expressed in numerical and percentage terms. Nurses were most effective in providing the patient care materials and equipment requested by students, helping students to adjust to a clinical environment and regarding students as team members. In contrast, nurses were least effective at discussing patients with students and at evaluating the patient care provided by students. The reasons that nurses gave for their clinical teaching performance were those of being overloaded with work, adhering to the view that teaching is not a nursing role, suffering from a lack of equipment, and the problem of students working slowly and hence wasting nurses' time. The nurses' recommendations for improving clinical teaching performance were those of increasing the co-operation between nursing schools and hospitals, the introduction of clinical nurse specialists, placing more emphasis on clinical teaching in nursing education and providing training courses on clinical teaching.     

A unique strategy for pediatric community health nursing for ADN students.

Students were overwhelmingly positive when given the opportunity to evaluate the pilot project and the model of pediatric community health nursing. According to the students, the strong points of the model were the orientation before the community experience, the presence of faculty of the community, the ability to contact faculty when needed, and the postclinical conference. The students' comments confirmed the faculty's belief that a clinical experience in community health nursing must place more emphasis on the specialty of community health nursing to be meaningful for students. To do the of job of educating tomorrow's nurses, ADN faculty should develop new strategies for teaching the pediatric clinical component of community health nursing. Clearly, hospitals are no longer the exclusive sites where students learn about patient and family needs and nursing care delivery. Community-based and community-focused experiences will continue to be required so that nursing students are prepared to practice in a dynamic and changing healthcare environment.     

Assessment of the clinical performance of nursing students in the workplace: Exploring the role of benchmarking using the Australian Nursing Standards Assessment Tool (ANSAT)

Nursing is a regulated profession that requires each nurse to meet requisite standards. Successful nursing registration is reliant on the quality of pre-registration education and assessment. Benchmarking is a systematic, consistent and innovative way to identify areas of improvement. In nursing education, external referencing through benchmarking can identify areas for improvement in nursing education and facilitates equitable performance comparisons between higher education providers. To optimise benchmarking of nursing students’ performance, a standardised, systematic assessment process of all student nurses is necessary. In Australia, the Australian Nursing Standards Assessment Tool is the only scholarly published assessment tool that assesses performance over a range of activities and settings objectively in work-based learning. As such, there is an opportunity to use this tool to determine and benchmark nursing students’ performance in clinical learning environments. By recording and comparing assessment scores, stakeholders including student nurses, clinical sites and higher education providers can explore factors associated with workplace performance. Benchmarking identifies consistencies and discrepancies. Additionally, findings from benchmarking activities provide the impetus for further research in nursing education and clinical performance.