Envy in a nurse education community

The definition of envy is based on views of anthropology, sociology, psychology and nursing science. According to these definitions, a nurse education community consists of shared values, customs and beliefs common in the nursing community. The purpose of this paper was to describe envy in the reciprocal relations between student nurses in a polytechnic of health and welfare in Finland. The sample consisted of 110 student nurses in one faculty of health and welfare in a Finnish polytechnic. They were selected from among the available (attending classes) students, who had been studying in the same group for 1-3 years in 1996. The response percentage was 85.5 (n=94). The data were processed by various statistical methods. The findings of envy in a nurse education community were defined through the student nurses' views of their sense of self, their relations with their fellow students, the objects of envy and also the influence of the lecturers. The ways of coping with envy were also identified. The most common object of envy was a fellow student who worked part-time while studying. Another object of envy consisted of fellow students successful in examinations and skills, such as listening, friendships and good ideas. The students coped with their envy by sharing their own success and by denying envy. These results highlight some essential points of envy in a nurse education community and underline the need for open discussion, as emotions and envy are important to understand as part of nurse education. If envy is not identified, it may cause learning problems and even problems in patient care.     

老年社区慢性病护理服务能力评价指标体系构建研究

目的 确定老年社区慢性病护理服务能力各级评价指标权重,以构建护理服务能力评价体系。方法 采用文献研究法、政策文件内容分析法、专题小组讨论法初步拟定老年社区慢性病护理服务能力评价指标集合;运用德尔菲法进行专家函询构建各评价指标指标条目,层析分析法构建能力评价模型,并进行确定各层级指标权重的赋值。结果 确定包含3个一级指标、11个二级指标和53个三级指标的老年社区慢性病护理服务能力评价指标体系,各级指标均通过一致性检验。结论 老年社区慢性病护理服务能力评价体系的构建,可用于客观评价老年社区慢性病护理服务能力水平,为社区护理工作者或管理者提供其测量工具。     

Towards (re)conciliation: (re)constructing relationships between indigenous health workers and nurses

Towards (re)conciliation: (re)constructing relationships between indigenous health workers and nurses ¶ Currently in Australia, both Aboriginal and non-Aboriginal Australians are attempting to reconcile themselves with a history of colonization/invasion, which resulted in human rights violations against Australia's indigenous people. Australian nursing has to examine its past in relation to the treatment of Aboriginal Australians. Relationships between nurses and Aboriginal health workers are the most commonly occurring professional relationships between nurses and Aboriginal people and are of key importance to the successful delivery of health services to Aboriginal communities. This qualitative study, grounded in feminism, aimed to explore the professional relationships between Aboriginal health workers and nurses and to develop insights which could assist the Australian nursing profession through a process of reconciliation with Aboriginal Australians. Feminist analysis of narrative text revealed several key themes as being crucial to this process. These were: learning to know and understand; towards workplace equity; and skill sharing — learning from each other. Implications for nursing, in its journey toward reconciliation with Aboriginal Australians, are drawn from this study.     

Cultural approach in nursing care of North African Muslims needing palliative care

Working in a multi-cultural medical establishment, concerning both patients and nursing staff, calls for deliberations regarding the intercultural as well as palliative approach in nursing care. These deliberations are: 1) intra-personal, in questioning the nursing staff on his/her values, beliefs, convictions, personal culture and identity, as well as opinions regarding health, illness and death. 2) Interpersonal, in recognizing the other person through his/her culture, values, individuality, while taking into account his/her opinions on health, illness and death. The goal of this project is to initiate this intercultural approach by first studying the culture from the perspective of North African Muslims currently hospitalized. It will develop in three steps: The first step to consider consists in training health-care professionals. The second step will lead to the preparation of pedagogical support concerning "nursing care and North African culture". The third step should significantly demonstrate the intercultural approach in clinical nursing procedures. In the future, the project's aim should progress towards a health-care collaboration in which each patient feels implicated regardless of his/her condition, culture, beliefs, education or lifestyle.     

The nurse's work at a hospital supply center and his/her place in the care for nursing work

This is a study on nurses' work at central supply units (CSUs) with the aim of analyzing his/her social reality and transforming role in the caring process in health and nursing. It's a strategic research, with speech analysis of CSU nurses. Results show that their main activity is management, in a structured process that confirms the traditional nursing practice, having as object the coordination of medical-hospital material processing used for care. Their work is characterized by indirect care, and is instrumental not only for nurses' work, but for the work of other professionals as well. As a result, it not identified as specific nursing care, nor as care provided by the nurse. Its transforming potential upon relations and new production modes of care in health, and by the nurse, will occur first through his/her competence in the specific knowledge about CSUs than through his/her administrative skills.     

'A heavy and blessed experience': a psychoanalytic study of community Macmillan nurses and their roles in serious illness and palliative care

This paper explores the psychoanalytic ideas of containment as described by Wilfred Bion and applies them to the work of community Macmillan nurses and to the ways in which they might understand and structure therapeutic conversations with people that are seriously ill. Case vignettes show the application of psychoanalytic thinking in context. The discussion offers the idea that the impact of physical illness is such that the emotional issues of patients, their families and fellow palliative care workers can saturate nurses. To protect themselves, nurses and other health workers might assimilate the emotional traumas of others into physical symptoms, and so they are ignored or overlooked in favour of drug therapies, pre-occupations with breaking through silences and other concrete or demonstrable methods of treatment. An environment is needed in which a person with serious illness and his or her family member is helped to make sense of their experiences and so integrate them into a meaningful life continuum. Similar provisions are needed for nurses. Appropriate methods of clinical supervision might help these important provisions.     

Cooperative interventions and the Interaction of Community Health agents within the family health team

This qualitative study examines the social relationships between the Community Health Agents (CHAs) and the Family Health team (FH), highlighting cooperative interventions and interactions among workers. A total of 23 participant observations and 11 semi-structured interviews were conducted with an FH team in a city in the interior of S?o Paulo, Brazil. The results revealed that CHAs function as a link in the development of operational actions to expedite teamwork. These professionals, while creating bonds, articulate connections of teamwork and interact with other workers, developing common care plans and bringing the team and community together, as well as adapting care interventions to meet the real needs of people. In communication practice, when talking about themselves they talk about the community itself because they are the community's representatives and spokespersons on the team. The conclusion is that the CHA may be a strategic worker if his/her actions include more political and social dimensions of work in healthcare.     

Feeling of 'lacking' as the core of envy: a conceptual analysis of envy

The aim of this paper is to explore the subjective experience of envy through concept analysis. Further, the study on which it is based aimed to answer questions about the composition and manifestations of envy. From the viewpoint of nursing science, the analysis of envy is based on a desire to understand human beings from the perspective of subjective health and illness and thus from a health promotion perspective. Envy is conceived of as a dimension of a person's health and illness. The concept is therefore meaningful from the viewpoint of nursing; it describes a phenomenon which enables us to deepen our understanding in a way relevant to nursing science. In the study the hybrid model developed by Schwartz-Barcott et al. was used for conceptual elaboration. In the theoretical phase of the study the subjective experience of envy was explored from the viewpoints of philosophy, religion, Finnish folklore and psychoanalysis, as well as nursing science. As a synthesis of these, a conceptual analysis of envy adapted from Wilson was conducted and a working definition of envy was proposed. In the fieldwork phase, envy was examined by means of an empirical analysis using a phenomenological approach. As a result, a classification describing the experience of envy was presented. The core experience of envy has been defined as a 'lacking', and the object of envy as something good possessed by someone else. Envy manifests itself in both destructiveness and creativity. The trends of development of envy are inflexibility and emancipation, and the essence of envy is multidimensional. Finally, the working definition of the concept was elaborated on the basis of the empirical phase and a new definition reflecting the composition and manifestations of envy was proposed.     

Transformation of admission interview to documentation for nursing practice

The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired by Ricoeur was conducted and consisted of five taped admission interviews, along with the written patient documentation subsequently worked out by the nurse. The findings were presented in four constructed themes: Admission interviews are the nurse's room rather than the patient's; Information on a surgical object; The insignificant but necessary contact; and Abnormalities must be medicated. It is shown how the nurse's documentation was based on the admission interview, the medical record details on the patient (facts that are essential to know in relation to disease and treatment), as well as the nurse's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool that enables her to document what is important to the individual patient and his special circumstances and encounter with the health system.     

Using Roy's model in a special hospital

Using a nursing model to help systematise the care of a young patient in a special hospital resulted in tangible improvements in his behaviour, yet Francesca Miller found that it raised questions about the function and value of nursing for this client group. Her study reveals how she had to cope with her own negative feelings about the nature of her patient's offences and how the use of basic counselling skills, and encouraging the patient to take responsibility for his own care, achieved notable developments in his social skills. But despite this, she is left to ponder, 'at what cost?'     

Student nurses' experiences and perceptions of envy in one nurse education environment in Finland

The aim of this paper is to describe the different definitions of envy in a nurse education environment. Answers are sought to questions concerning student nurses' experiences and perceptions of envy and their ways of coping with envy in one polytechnic of health and welfare in Finland. Conclusions are presented to illuminate the concept of envy based on student nurses' perceptions in one polytechnic, where 64 (N = 100) student nurses were recruited from among the available (attending classes) students in 1998. The research material was collected using an instrument of 15 open-ended questions. The phenomenographic approach was used to analyze the data. According to this paper, envy appears different, depending on whether students are talking about their personal feelings of envy or envy shown by others. Furthermore, envy is described differently at the general level and in health care. Student nurses described their own envy as mild nuances of feelings, while envy at the general level was described as consisting of aggressive feelings. The most general way of coping with envy is rationalization. These findings can be used to help student nurses identify envy as a concept and also to recognize emotions as part of personal knowledge.     

Brief simultaneous couple hypnotherapy with a rape victim and her spouse: a brief communication

This paper presents a case involving a rape victim and her emotionally affected spouse. Although the assault occurred before the couple met, the husband was too upset to concentrate when the victim wanted to share her rape-related feelings, nor could he provide the much needed empathy and support. This, apparently, was due to his difficulties in handling his own rage. Simultaneous couple hypnotherapy was used to allow the victim to share her experience under conditions safe for both her and her spouse. As he imagined in trance the rape account described by his age-regressed wife, he learned to identify his emotions and experience them in a controlled manner. During subsequent sessions, the husband was encouraged to include himself in his wife's abreaction and reshape the traumatic scene for both of them. The husband's rescuing behavior and the expressions of violent anger towards the perpetrator had several positive consequences. Not only did they change the abandonment component of the victim's traumatic memory, but they also helped the husband deal in better ways with his own feelings of anger. It also provided the couple with a helpful coping mechanism they later effectively applied under different circumstances.     

Exploring and encouraging through social interaction: a qualitative study of nurses' participation in self-help groups for cancer patients

Self-help groups are a growing phenomenon across national borders. Current sociologic empirical evidence shows that nurses and other healthcare professionals have become an integral part of self-help groups. The aim of the study is to describe and highlight the experiences of patients with cancer (n = 21) and oncology nurses (n = 12) with self-help groups. These experiences are drawn on to illustrate the characteristics of professional involvement in self-help groups for patients with cancer. Data were obtained by individual qualitative interviews. The results show that the nurse functions as a social networker and uses her contextual competence by consciously encouraging relationships between fellow patients. Furthermore, the study illustrates that the nurse's involvement with self-help groups for patients with cancer serves as a complementary dimension to the traditional nursing discourse. It is concluded that when individualized care is supported through social practice and when personal issues are exchanged and negotiated, the nurse facilitates a milieu of togetherness in self-help groups for patients with cancer. The concept of self-help groups is a valuable contribution to new theories and service development in psychosocial care and complies with the understanding of the postmodern individual, who viewed as primarily responsible for negotiating, socializing, and making his or her own decisions.     

The relationship between personal traits and job satisfaction among Taiwanese community health volunteers

Aim. The purpose of the study was to understand the relationship between job satisfaction and personal traits in health volunteers in one community in Taiwan. Background. Among different kinds of community resources, the human resource is most essential for the process of developing healthy communities and cities. However, it is not easy to keep voluntary workers as part of health programmes even though they have been trained. Previous research has shown that to increase the job satisfaction of such a person, the volunteer needs to improve effectively his/her need to achieve. The need to achieve is an important part of a person's personal traits. Methods A cross‐sectional survey design was used to interview 317 health volunteers in various community health centres in I‐lan county, northern Taiwan. The research instruments of this study included the ‘locus of control orientation scale’ for personality measurement, the ‘achievement orientation scale’ and the ‘job satisfaction scale’. Results. Most of the sample volunteers were female with an average age of 49·55 years; the majority was married and living with their spouses. In terms of the volunteers’ personal traits, most of them are internal control orientation. The job satisfaction of the volunteers who took part in this research was extremely high. Significant variables correlating with job satisfaction in this study were gender, educational level, religious preference, participation in training, working to promote community health, the willingness to work, the frequency of participating in job training, and cooperation with other volunteer partners. The explainable variance for the prediction of job satisfaction from a combination of achievement orientation and the frequency of collaboration with other people was 9·1%. Relevance to clinical practice. The results suggest that there is a need to strengthen cooperative relationships among volunteer by initiating well‐planned volunteer training programmes and growth groups with the aim of enhancing their interpersonal relationships.     

Managing distressed and disturbed patients: the thoughts and feelings experienced by Italian nurses

ACCESSIBLE SUMMARY: ? The aim of the research was to examine the thoughts and feelings experienced by Italian nurses when caring for distressed and aggressive patients in acute psychiatric settings. ? Fear was the prevalent feeling experienced by nurses: fear of being harmed by the patient and fear of harming the patient and fear of damaging the therapeutic relationship. ? When managing distressed and aggressive patients, the nursing team have to share similar feelings and be emotionally in tune with each other. ? The paper offers clear explanations of nurses' feelings, the reasons for their fear and the importance of effective team working during a crisis. ABSTRACT: This paper reports on a qualitative study to identify Italian nurses' feelings and emotions towards the management of distressed and disturbed psychiatric patients in acute inpatient settings. Four focus groups were carried out involving 33 nurses from seven acute psychiatric services in a region of Italy. Data were analysed using content analysis. Findings highlight that fear is the prevailing feeling experienced by nurses in the management of distressed patients. This includes both fear of being physically harmed and concerns about doing harm or damage to patients. The unpredictability of aggressive behaviour from unknown patients was described as especially frightening. Known patients, namely those previously admitted to the unit, induced less fear, as their behaviour was considered more predictable. Patients with dual diagnosis were also a worry for many nurses, who considered themselves lacking in the personal relational skills needed to manage an individual in crisis. Nurses reported that they try to understand the reasons for a patient's aggressive behaviour and are empathetic to his or her suffering. When such empathy is lacking, nurses experience conflicting feelings of counter-aggressiveness. The paper concludes by emphasizing the need to increase availability of education related to patient management, in particular team working and its internal relationships.     

Community health care nursing in Rajasthan. A registered nurse's perspective

This study focused on the great shortage of registered nurses (RNs) in primary health care in Rajasthan, India. It dealt especially with the nurses' own opinions about working in primary health care and their reasons for not working in it. Nurses at different levels in the health care organization were interviewed. The study was based on interviews with six RNs individually, three groups of six to eight nursing students each, and three policy-making chief nurses individually. The Minister of Health in Rajasthan also participated in the study. The study showed that the reasons for the lack of RNs in community health care were as follows: a government policy decision to place less educated nurses in the communities; the great shortage of nurses in general; the system whereby a nurse is not able to choose her/his place of work; unwillingness on the part of the nurses to work in community health care because of the great security problems; lack of support from authorities and lack of equipment. In general, community health care nursing as a work area was despised by society at large in Rajasthan.     

Never good enough--part 2: Clinical implications

This paper is the second part of two papers that explore the affect of shame and its role in the manifestation of symptoms that could be regarded as evidence of mental disorder. The clinical implications for nursing a person with an overwhelming shame response are discussed in this paper. It is proposed that a discursive approach to nursing care may assist mental health nurses to provide care that best meets the needs of people experiencing these symptoms. The paper suggests that this nursing care involves recognizing the impact of shame; making connections between how the person has learned to cope with shame and their current mental distress; situating shame in its socio-cultural context; focusing on subject-object differentiation and promoting acceptance of difference and exploring alternative subject positions for managing feelings of shame. The focus of these interventions is to encourage awareness of interactions with others, how the person positions her or his self in relation to others, and the communication patterns that perpetuate feelings of shame. It also involves helping the person to integrate the ideal image of her or his self with subject positions that are more flexible.     

Feelings of oncology patients about being nursed in protective isolation as a consequence of cancer chemotherapy treatment

This qualitative research explores the feelings of oncology patients nursed in protective isolation following high-dose chemotherapy. Five patients described their feelings about the isolation experience during audio-taped interviews lasting between a half and one hour. Tapes were transcribed and analysed, with emergent themes considered in relation to the other interviews and to the literature. The research findings indicate that cancer patients have specific concerns with regard to their experience in the isolation environment, which fall into four distinct categories of: 'being shut in'; 'coping with the experience'; 'being alone'; and 'maintaining contact with the outside world'. In addition, patients have concerns with regard to the experience of having cancer, that impinge upon the isolation experience. These are: 'having cancer'; 'suffering chemotherapy'; 'knowing what to expect'; and 'developing relationships with the health professionals'. The core variable is 'something that I have to go through'. The nature of the relationship between the categories led to the development of an integrative model for exploring the feelings of cancer patients nursed in isolation. Most of the informants coped well with the isolation experience and described feeling supported by the nursing staff. Their overriding concern in fact, reflected a desire to receive information about their disease and reassurance regarding their treatment. Being in isolation appears to inhibit communication about these issues.     

A psychoanalytically informed conversation with a woman and her husband following major surgery for cancer of her neck and torso

AIMS OF THE PAPER: This paper explores psychoanalytic ideas of containment as described by Wilfred Bion and applies them understanding the concerns of a woman with serious illness and her husband. A case vignette shows psychoanalytic thinking in context. The paper explores verbatim exchanges that took place in a room just off a hospital ward and offers a psychoanalytically informed analysis. RATIONALE: This discussion suggests that the impact of physical illness is such that there is potential for the seriously ill to saturate health workers in anxiety and raw feelings. To protect themselves, nurses and other health workers could sometimes unconsciously overlook the emotional care of people in favour of routines, physical aspects of care and other demonstrable methods of treatment. CONCLUSIONS: Drawing on the work of Isabel Menzies Lyth, the discussion concludes by recommending that environments are needed in which a person with serious illness or family member can be helped to make sense of his or her experiences and so integrate them into a meaningful life continuum. Similar conditions are perhaps needed for nurses or other health workers. Appropriate methods of work discussions in clinical supervision might conceivably provide these important requirements.