Night shift work experiences among Iranian nurses: a qualitative study

Aim:  To describe the perceptions held by Iranian registered nurses (IRNs) concerning their night shift work experiences.
Background:  Due to the nature of nursing work and the need for 24-h coverage every day, the majority of nurses work night shifts in their professional practice. Evidence from several studies indicates that night working is a challenge for most nurses. This situation can cause many forms of physical and emotional stress.
Methods:  A qualitative design was used with purposeful sampling. Eighteen IRNs from four different general educational hospitals in Iran took part in the study. Data were collected via semi-structured interviews and analysed according to qualitative content analysis.
Findings:  Three main themes were identified from the data: (a) socio-cultural impacts of night work, (b) health-related impacts of night work, and (c) night work as an opportunity for gaining more clinical experiences and learning more.
Conclusion:  The impact of shift work on nurses' daily professional behaviour and adverse health outcomes related to shift work should be well understood and considered when organizing healthcare systems. We need to identify ways to support nurses who work nights and also give attention to the caregiver's needs.     

公共卫生护士胜任力特征的质性研究

目的 探讨我国公共卫生护士所具备的胜任力特征,为我国未来进行公共卫生护士的培养提供参考。方法 采用目的抽样法,对北京市10所社区卫生服务中心的17名社区护士和15名公共卫生医生进行访谈,运用内容分析法对访谈资料进行分析。结果 提炼出知识、技能、能力及职业素养4个主题及25个亚主题。结论 公共卫生护士需要具备的胜任力涵盖知识、技能、能力及职业素养4个方面,可为未来我国公共卫生护士的培养提供参考。     

Providing and funding breast health services in urban nurse-managed health centers

Nurse-managed health centers (NMHCs) are an innovative health care delivery model that serves as an important point of health care access for populations at risk for disparities in health outcomes. This article describes the process and outcomes of clinical breast health services in two NMHCs located in a large Midwestern city. Findings indicate that client's knowledge about breast health was increased after they received breast health services from NMHC nurses. Significant positive changes in behavior related to the early detection of breast cancer were found in the study. NMHCs, identified for expansion in the Patient Protection and Affordable Care Act, offer a unique health care services delivery model that promotes access to care and early identification of breast cancer in very low-income and uninsured women.     

Perioperative nurses’ experiences of communication in a multicultural operating theatre: A qualitative study

AimTo explore the lived experiences of perioperative nurses in a multicultural operating theatre in Melbourne, Australia.BackgroundMulticulturalism has become the norm in the health workforce of several developed countries due mostly to immigration. Within an operating theatre setting where good communication is paramount, the presence of nurses and doctors from multiple cultures and different training backgrounds could pose a major challenge.MethodUsing a qualitative research methodology underpinned by phenomenology, we interviewed fourteen nurses from different sections of an operating theatre.ResultsFrom the lived experiences of the participants, difficulties in communication emerged as the major theme. Difficulties in communication affected patient care and the working atmosphere. In addition, social integration appeared to improve communication.ConclusionsAddressing the needs of patients from culturally and linguistically diverse backgrounds in the operating theatre continues to be challenging. However, developing a sense of camaraderie and fostering good relationships between staff through regular social gatherings can improve communication and the working atmosphere.     

Leadership experiences for baccalaureate nursing students: improving quality in a nurse-managed rural health clinic

Nurse educators need practical, effective methods to help nursing students understand the importance of quality improvement activities and their relationship to the financial viability of organizations. This article describes a project designed to provide students with an opportunity to apply quality improvement principles in a rural, nurse-managed clinic with the ultimate goal of improving potential reimbursement for services through improved documentation. Implications for students, nurse educators, and rural clinics are provided.     

Lesbian women's experiences with health care: A qualitative study

Background

Although the social situation for gay, lesbian, and bisexual people has improved over the last decades, lesbian women still face unique challenges when seeking healthcare services.

Objectives

To explore lesbian women''s healthcare experiences specifically related to sexual orientation to achieve knowledge which can contribute to increased quality of healthcare for lesbian women.

Methods

Qualitative study based on written stories, with recruitment, information, and data sampling over the internet. Data consisted of 128 anonymously written answers to a web-based, open-ended questionnaire from a convenience sample of self-identified lesbian women. Data were analysed with systematic text condensation. Interpretation of findings was supported by theories of heteronormativity.

Main outcome measures

Patients’ histories of experiences where a lesbian orientation was significant, when seeing a doctor or another healthcare professional.

Results

Analysis presented three different aspects of healthcare professionals’ abilities, regarded as essential by our lesbian participants. First, the perspective of awareness was addressed – is the healthcare professional able to think of and facilitate the disclosure of a lesbian orientation? Second, histories pointed to the attitudes towards homosexuality – does the healthcare professional acknowledge and respect the lesbian orientation? Third, the impact of specific and adequate medical knowledge was emphasized – does the healthcare professional know enough about the specific health concerns of lesbian women?

Conclusion

To obtain quality care for lesbian women, the healthcare professional needs a persistent awareness that not all patients are heterosexual, an open attitude towards a lesbian orientation, and specific knowledge of lesbian health issues. The dimensions of awareness, attitude, and knowledge are interconnected, and a positive direction on all three dimensions appears to be a necessary prerequisite.     

Community mental health centres: A qualitative study of professionals' experiences

This article presents findings from a qualitative study of mental health work in community mental health centres with a multiprofessional workforce and aims of active user participation in the service. User participation implies collaborative relationships and different roles than that of expert professionals and dependent patients. How do professionals working in these services experience their work and professional role? This question was explored in order to highlight important aspects of community mental health work. A group of six experienced professionals from three community mental health centres in a Norwegian city were interviewed twice. The informants highlighted the complexity of community mental health work and the need to be flexible when working to support people with mental health problems in their everyday life situation. To see the service users as people and to facilitate social interaction was important. Their work was described as ‘liberating’ compared to working in institutions. However, although in their experience they found that professional knowledge and skills were important in their work situation, all had experienced that this was not always acknowledged by professionals in other services.     

Nurse perceptions and experiences of patient health assets in oncology care: a qualitative study

Health assets, a term that refers to patients' strengths and potentials, has emerged as an important aspect of health care. A conceptual analysis of health assets revealed five core dimensions: mobilization, motivational, relational, volitional, and protective strengths. How nurses experience and use patients' health assets, however, is unknown. In this qualitative study, 26 expert nurses in cancer care participated in focus group interviews. The nurses had a large repertoire of experiences with cancer patients' health assets. When the data were subjected to thematic analysis, three new core dimensions were revealed: cognitive, emotional, and physical strengths. Balancing processes within and among health assets--identified as an overriding theme--appeared to be affected by individual and contextual variations. The nurses realized that patients' health assets could be better used and voiced a need for the clinical and organizational support to do so. New issues about health assets raised in this study may be caused by its novel context (e.g., expert nurses in oncology care). More research is needed on health assets in other contexts, such as patients with different health problems, and of possible strategies to support nurses' use of health assets.     

Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study

BackgroundThere is substantial research about the occupational health of nurses worldwide. However, empirical evidence about the psychosocial health of migrant and minority nurses in outpatient settings in Germany in comparison to that of autochthonous nurses is lacking.ObjectivesThis study aims to identify work-related stressors, resources and the corresponding coping strategies of migrant and minority nurses in comparison to autochthonous nurses.Design24 migrant and 24 autochthonous nurses employed in the German homecare sector were interviewed in qualitative explorative manner while a distinction was made between non-commercial and private-commercial services.SettingsThe interviews took place in the nursing services' premises or in the nurses' private homes.ParticipantsServices were randomly chosen among all homecare providers in the second largest German federal city-state Hamburg. Nurses were invited for an interview, once their management agreed to participate in the study. Registered nurses and nursing assistants as well as those with a foreign certificate but validated or in process were eligible to participate.MethodsRelevant literature findings formed the base for the semi-structured interview guide. Key areas in the interview guide were barriers, resources and coping strategies in the collaboration with colleagues, superiors and clients as well as in the collaboration within a linguistically and culturally diverse team and clients. The conventional approach to qualitative content analysis by Hsieh and Shannon guided the analysis.ResultsRegardless of their origin or culture, nurses perceive time pressure, lifting patients, lack of appreciation or the client's personal fate as burdening. In the intercultural context, the divergent understanding of behavioral patterns as well as of nursing care and a non-functioning communication impede the collaboration within a diverse nursing workforce. Migrant and minority nurses suffer prejudices, verbal and sexual harassment proceeding from their clients. However they keep it to themselves and don't broach it to their supervisors or colleagues. The interaction with humans, the verbal exchange with colleagues and supervisors at eye level as well as the sensemaking of being a nurse helps nurses to cope with occupational stressors.ConclusionsDifferences in language is a main stressor which impedes a functioning team collaboration as well as a positive nurse-client relationship. Migrant and autochthonous nurses share similar coping strategies to master occupational burdens. A good collaboration within the team and having an appreciative supervisor are resources that support migrant and minority nurses as well as autochthonous nurses to face the stressors and to cope with those. Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing commonalities.Contribution of the paperWhat is already known about the topic?

• •The growing demand for care due to the demographic change leads to an increasing trend to hire healthcare personnel such as nurses from abroad.
• •The nurses' workplace is characterized by physically and psychologically demanding tasks leading to musculoskeletal pain and job dissatisfaction.
• •Migrant healthcare workers experience additional stressors like discrimination practices as well acculturative stress.

What this paper adds:

• •Migrant and Autochthonous nurses share similar coping strategies to master occupational burdens
• •Differences in language is a main stressor, which impedes a functioning team collaboration as well as a working nurse-client relationship. More autochthonous than migrant and minority nurses report these differences as stressful.
• •Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing the same destiny – this appears as an important resource for migrant and minority nurses.

     

Factors involved in recovery from schizophrenia: a qualitative study of Thai mental health nurses

Recovery-oriented services increasingly are being called for around the world. These services do not just consider recovery from mental illness as symptom remission, but as individuals' ability to redefine their self and to "live well", even with enduring symptoms. However, little is known about the views of Thai nurses regarding the conceptualization of recovery. This article presents the findings of a qualitative study that explored the perspectives of 24 Thai nurses regarding schizophrenia and recovery. Semistructured interviews were conducted with nurses who were providing care for persons who were living with schizophrenia in both hospital and community settings. A thematic analysis identified the personal and environmental factors that were related to recovery. Illness acceptance, hope, and adherence to treatment were viewed as the facilitators of recovery, while a low level of self-responsibility and illness-related factors were barriers. Environmental factors, such as the presence of a supportive environment and accessibility to mental health services, were described as facilitators, while stigma towards mental health illness and fragmented health services were barriers. The implications of these results in promoting recovery-oriented mental health services in Thailand are discussed.