The impact of restructuring on professional nursing practice.

Through the 1990s most hospitals were involved in restructuring. As a result, maintaining professional nursing practice is challenging in these cost-constrained hospital environments. In new models of care, professional nursing practice expectations are often reconceptualized into multidisciplinary care team structures in which the team is empowered and becomes the focus rather than the individual nurse caring for her or his patient. Given that nurses provide the greatest part of patient care in hospitals, professional nursing practice has the potential to differentiate one hospital from another. Consequently, it is in the strategic interest of organizational policy makers to implement initiatives that support professional nursing practice.     

Caring. Core value,currency, and commodity ... is it time to get tough about "soft"?

Consumers of health care expect caring behaviors and become satisfied and loyal customers when their health experience included caring. In today's health care environment, however, caring often takes a back seat to task completion and capital expenditures. Caregivers may feel caring, but they often provide care without regard for how patients prefer to experience caring. Caring theorists provide a framework of patient centered caring to guide professional practice. Stories of caring that occur in spite of diminished resources are inspirational and illustrate these theories. Chief nursing officers share a unique opportunity and imperative to assure that caring stories, the essence of our work, routinely inform decisions made in the executive suite and boardroom.     

Professional nursing care in Tanzania: a descriptive study of nursing care in Ilembula Lutheran Hospital in Tanzania

The purpose of this ethnonursing study is to find new knowledge of the professional nursing care practised in a Bantu cultural context in Tanzania The main questions are How do Bantu nurses describe nursing? What components are there in professional nursing care in Ilembula Lutheran Hospital? The data were collected through participant observation, interviews and personal working diaries in Ilembula Lutheran Hospital Six Tanzaman nurses were interviewed The findings indicated that nursing was based on formal training on one hand, and on a natural mother-child relationship on the other hand The idea of respect towards life, which is central to the Bantu philosophy of life, guided nursing care In professional nursing care there emerged curing and caring components Protection, encouragement and comfort were distinguished as the main constructs of caring     

Strategies to facilitate effective caring for patients in primary health care clinics

BackgroundCaring is described as the innermost core of nursing which occurs in a relationship between the patient and the care provider. Although caring in nursing is associated with maintaining and strengthening of the patient’s sense of dignity and being a person, there seems to be a gap between caring theories in nursing, healthcare policies and caring for patients by professional nurses in primary health care clinics. Developing strategies that will facilitate effective caring for patients by professional nurses in primary health care clinics within an ethical and mindful manner became an area of focus in this study.ObjectivesTo develop strategies to facilitate effective caring for patients by professional nurses in primary health care clinics in South Africa.MethodStrategies were developed based on the conceptual framework developed in Phase 2, which was derived from synthesis of the results of Phase 1 of the previously conducted study and supported by literature. The conceptual framework reflects the survey list of Dickoff, James and Wiedenbach’s practice theory.ResultsThree strategies were developed: 1) facilitating maintaining of the empowering experiences; 2) facilitating addressing the disempowering experiences by professional nurses, and 3) facilitating addressing of the disempowering primary health care clinic systems.ConclusionThe developed strategies, being the proposed actions, procedures and behaviours, could facilitate effective caring for patients by professional nurses in primary health care clinics.     

Turkish nursing students' perception of caring

Although caring is a difficult entity to explain or define, many authors consider that caring is the central and unifying domain of nursing. It is important that nursing students understand what care is in order to be clear about what good nursing care is. This qualitative study was conducted to clarify Turkish nursing students' perception of caring. The sample was 19 last year undergraduate nursing students who volunteered to be involved in this study. Nursing students were asked to write incidents in which they observed nursing behaviours conducted in caring and noncaring ways. Then the students were interviewed to clarify why nursing behaviours that were addressed in their written incidents were considered as caring or noncaring. Data which obtain from students' reports and interviews were analyzed and themes of caring were formed into two groups: professional/helping relationship and technical competency.     

护士关怀能力现状及影响因素调查

目的了解护士关怀能力现状及影响因素,为提高护士关怀能力提供依据。方法对某市3所三级医院共310名护士发放关怀能力量表进行调查。结果护士关怀能力得分（175．70±18．74）分,护士关怀能力较低;其影响因素包括年龄、职称、学历、科室。结论应加强护士关怀能力的培养,可以利用高年资护士的榜样作用带教低年资护士,各层次护理人文关怀教育都应当注重关怀实践,根据各科患者的关怀需求施予关怀。     

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.     

Taking on the challenge of clinical teaching in nursing homes

While the goal of professional nursing programs is to ensure that students have a basic level of competency to care for older adults in a variety of care settings, the greatest challenge is to garner students' enthusiasm about caring for older adults in nursing homes. To increase and strengthen the professional nursing workforce in nursing homes, schools of nursing must ensure that students have appropriately placed, well-designed, and innovative clinical experiences in nursing homes with faculty who are knowledgeable about the nursing home environment and the professional nursing care needs of its residents. Four factors identified as keys to success in developing exemplary clinical experiences for students in nursing homes include: (a) nursing homes with positive reputations and providing quality care, (b) faculty knowledgeable and enthused about nursing homes, (c) committed partnerships between schools of nursing and nursing homes, and (d) creative and innovative clinical teaching strategies.     

Dimensions of caring: a qualitative analysis of nurses' stories

The purpose of this qualitative, phenomenological study is to describe dimensions of caring as they relate to and clarify the practice of professional nursing. Nurses are unique caregivers, and their work at the bedside and in the community matters. What nurses do as they care for patients is multi-dimensional, complex, and essential. Two hundred stories written by nurses were analyzed using Giorgi's methodology for existential phenomenology. Their stories indicate that nursing goes far beyond technical skills. Seven dimensions of caring that define professional nursing practice were found: caring, compassion, spirituality, community outreach, providing comfort, crisis intervention, and going the extra distance. The nurses' stories demonstrate that the dimensions of caring that define professional nursing practice are universal. Documentation of nurse's stories facilitates reflective and thoughtful practice, while clarifying the essential components of nursing.     

《关怀与照护》课程后对学生人文关怀认知行为的调查分析

目的:了解学习《关怀与照护》课程后,学生的关怀知识、态度、行为情况,分析其相关影响因素,使《关怀与照护》课程的教学目标和方法更具针对性和有效性。方法:在《关怀与照护》课程结束后1周,采用问卷调查法对本学期参加本门课程学习的105名本科生进行调查。结果:学生关怀知识、关怀态度、关怀行为得分较高;男女学生、不同年级学生、不同民族学生、是否独生子女学生在关怀知识总分、态度总分和行为总分的评分差异无统计学意义,护理学专业和非护理专业学生在态度维度、知识总分的评分无明显差异,在总分、行为总分方面,护理学专业的评分低于非护理专业;学生知识总分、态度总分、行为总分、总分之间存在着相关性。结论:开设《关怀与照护》课程对本科生树立关怀意识、培养关怀态度和践行关怀行为有积极意义。     

Student attitudes and educational support in caring for older people--a review of literature

The ageing population is currently one of the main issues facing UK healthcare systems. Nurses of the future will be faced with the task of caring for this elderly population. Meanwhile, care standards and government policies have emphasized the need for preparing students to care for the older people. Preparing nursing students to meet the care needs of an expanding ageing population is a challenge for nursing education. Moreover, caring for older people are often not seen by students as an attractive option, a perception that exerts a considerable influence on the values that inform their future professional practice. This paper examines the literature related to the students’ perceptions of caring for older people and suggests the need for specific curricular content, teaching and a structured approach to the educational preparation and support of students for their practice experience. If students are provided with the relevant preparation and support, they can engage in enriched learning experiences, deliver quality care and develop positive attitudes in caring for older people in their professional practice.     

A comparative analysis of lay-caring and professional (nursing) caring relationships

Acceptable definitions of the terms care and nursing have yet to be reached. Some may feel that lack of agreement on the meaning of these concepts is a rather esoteric or academic point: the argument put forward in this paper is that until a clearer perception of the concepts of care and nursing is arrived at, the profession will be limited in its ability to develop its expertise or to set standards related to the quality of care. The paper outlines the extent to which these concepts have been explored and details the developments and some of the limitations of present modes of thought. An alternative perspective is offered, based on a comparative analysis of the professional (nursing care) and lay-caring relationships. By this means, a set of characteristics similar in both relationships, has been identified. Quality of care in the professional caring relationship is thought to relate to the extent to which aspects of caring activities implicit in the lay-caring relationship are carried into the professional nurse-patient relationship and made explicit. The ability of the nurse to do this emerges as one aspect of her therapeutic nursing function.     

ICU护士人文关怀能力与职业认同感现状及相关性研究

目的：探讨ICU护士人文关怀能力和职业认同感现状及其相关性,以期为ICU管理人员采取措施提高护士关怀能力及职业认同水平提供理论依据。方法：采用人文关怀能力量表和护士职业认同感量表对天津市7所医院共218名ICU护士进行问卷调查。结果：ICU护士人文关怀能力总分为（178.06±30.98）分,认知（71.56±13.92）分、耐心（54.54±9.82）分、勇气（51.96±13.37）分各维度均低于国外常模;职业认同感总分为（106.16±22.29）分,处于中等水平。ICU护士人文关怀能力各维度与职业认同感维度均呈正相关（P<0.01）,线性回归分析结果显示,控制人口学变量后,人文关怀能力中的认知和耐心对职业认同感具有预测作用。结论：ICU护士人文关怀能力和职业认同水平均处于较低水平且两者存在联系。护理管理者可以采取措施提高ICU护士人文关怀能力,进而增强其职业认同感。     

A comparative analysis of lay-caring and professional (nursing) caring relationships

Acceptable definitions of the terms care and nursing have yet to be reached. Some may feel that lack of agreement on the meaning of these concepts is a rather esoteric or academic point: the argument put forward in this paper is that until a clearer perception of the concepts of care and nursing is arrived at, the profession will be limited in its ability to develop its expertise or to set standards related to the quality of care. The paper outlines the extent to which these concepts have been explored and details the developments and some of the limitations of present modes of thought. An alternative perspective is offered, based on a comparative analysis of the professional (nursing care) and lay-caring relationships. By this means, a set of characteristics similar in both relationships has been identified. Quality of care in the professional caring relationship is thought to relate to the extent to which aspects of caring activities implicit in the lay-caring relationship are carried into the professional nurse-patient relationship and made explicit. The ability of the nurse to do this emerges as one aspect of her therapeutic nursing function.     

The humanities interface of nursing and medicine.

In the 1970s, the field of medical humanities developed and included ethics, literature, history, integrative medicine, and other topics, most often described from a physician's perspective. During this same period of revolutionary changes in health care, nursing curricula did not seek to emphasize content in humanities, perhaps because stereotypical views of nursing as the "caring profession" made such coursework seem redundant. In 2001, as a result of the Institute of Medicine's call for all health professionals to be educated in interdisciplinary teams, there was a new focus on the importance of interdisciplinary education. Collaborative experiences in the humanities can foster professional relationships that lead to professional growth, promote collaboration, and enhance patient-centered care. The purpose of this article is to describe the relevance of humanities to the interdisciplinary education and practice of health care providers. This article extends the thinking about the value of interdisciplinary education beyond the traditional dimensions of evidence-based practice, quality improvement, and informatics to humanities. Ways to provide nurses and physicians with interdisciplinary humanistic experiences are illustrated through an overview of projects jointly developed by the School of Nursing and the College of Medicine at The Pennsylvania State University.     

Senior nursing students' and professional nurses' perceptions of effective caring behaviors: a comparative study.

Care forms the basic core of nursing actions. Traditionally nurses have described the acts of administering to patients as care behaviors. Many nurses find it difficult to define these caring behaviors. It is important that nurses have insight into the specific behaviors that patients perceive to be most important. Several studies have examined and compared nurses' and patients' perceptions of effective care behaviors. The literature supports an incongruence of what nurses perceive and what patients perceive as effective. This study identifies and compares student nurses' and professional nurses' perceptions of effective caring behaviors. The Caring Assessment Report Evaluation Q-sort (CARE-Q) was used to obtain the data. The participants included senior baccalaureate nursing students (n = 30) at Thomas Jefferson University, College of Allied Health Sciences, and professional nurses (n = 30) with 1 or more years experience. The significance of the difference between the groups was tested using the Mann Whitney U test. Results indicate agreement between the students and the nurses in all categories except trusting relationship (p = .06). The ages within the groups varied from 21 to 47 years. The difference in ages between the nurses and the students is significant (p = .0002). Findings provide a better understanding of student nurse perceptions of caring behaviors and provide implications for further research for nurse educators.