Building the knowledge of the nursing student: an ethical-social approach

This study aimed at knowing the relation between ethics and self care facing the construction of knowledge of nursing undergraduate and to identify values that conduct that construction. Data were collected through interviews and analysed under social phenomenological and the interviewee'speeches showed the following categories related to motivation for: lecture'posture in the construction of knowledge of student; project to become nurse; relationship between theory and practice; commitment with professional formation. Motivations because: construction of knowledge based on life experiences and self care supported by autonomy Theoretial and practical knowledge of nursing undergraduate was built up through of new challenges.     

Empirical ethics in action: Lessons from two empirical studies in nursing ethics

Despite the burgeoning of publications in nursing ethics, only more recently has empirical evidence on nursing ethics been published. How nursing ethics can be empirically studied as well as enriched by empirical data will be the focus of this paper. Two empirical studies will be briefly presented and their contribution to ethics discussed. The first one is a quantitative research project about nurses' ethical behavior in daily practice. Using an adapted version of Kohlberg's theory of moral development, this study tried to describe and explore nurses' responses to ethical dilemmas in daily nursing practice. The second study attempted to describe the specificity of residential palliative care. A qualitative approach was used to explore and describe the processes that take place on an inpatient palliative care unit, and the experiences of patients, relatives and palliative care team members. The analysis of the value of both research projects for ethics underlines the power of empirical understanding in the relationship between research and ethics. The need for integration of both qualitative and quantitative research methodologies is argued.     

Undergraduate students in orthopedic nursing care

This study identifies some undergraduate nursing students' imaginary manifestations concerning themselves and care delivered to patients with orthopedic and/or trauma disorders. The Social Poetics method was used and the research group was composed of 15 undergraduate students. Only the categories and subcategories exclusively related to the "student" are presented in this paper. Data revealed that care provided by orthopedic nursing students is the result of a care relationship that emerges from their sensitivity toward patients and their own knowledge, skills and attitudes. The orthopedic treatment, equipment and procedures, to which patients are submitted, cause important emotional distress for students, empathic behavior and encourage them to search for ways to minimize their patients' pain. All the aspects that permeate care provided by orthopedic nursing students should be identified in order to enable reassessment of the teaching-learning process.     

Narrative ethics in nursing for persons with intellectual disabilities1

Abstract Both in the Netherlands and in Britain, practices of ‘life story work’ have emerged in nursing for persons with intellectual disabilities. The narrative approach to care and support may at the same time be considered as an attempt to compensate for the ‘disabled authorship’ of many persons with intellectual disabilities and as a sign of controversy with standard practices of diagnosis and treatment that tend to neglect the personal identities of both clients and care givers, their particular historical and relational contexts and their spiritual needs. This paper argues that narrative ethics not only offers an appropriate moral framework for practices of life story work, but that these practices are a narrative ethics in action. Starting with an account of the concept of ‘life story work’ as it has been introduced in nursing practices in the field of intellectual disability, the paper explains its relationship with key characteristics of narrative ethics. The teleological dimension in narrative ethics and in practices of life story work sparks off a dialectic process of understanding of the client and self‐understanding of the care giver. It also invites a respect for life in its openness toward the future and presupposes an openness toward other possible versions of the life narrative. The phenomenological and hermeneutic‐interpretative methodologies in narrative ethics aim at a ‘sudden moment of intimacy’ in relationships of nurses and clients. The ‘epiphany’ of this essential moment of recognition, insight and engagement cannot, however, be brought about by methodology.     

Evaluation of patients with chronic pain in nursing consultations: Proposal of an instrument for nursing diagnosis

This article describes the tool used to collect data for nursing evaluation of patients with chronic pain patient in the League Against Pain of the University of S?o Paulo at Ribeir?o Preto Faculty of Medicine, Brazil. The aim is to identify the patients' nursing care needs. The nursing diagnoses proposed by the North American Nursing Diagnosis Association (NANDA) were used to point out the patients' nursing care needs. The Human Response Patterns, in which the nursing diagnoses are classified by NANDA, were used as a framework to construct the tool. The way it is used by nursing undergraduate students, members of the League Against Pain, is also described.     

Relational autonomy in informed consent (RAIC) as an ethics of care approach to the concept of informed consent

The perspectives of the dominant Western ethical theories, have dominated the concepts of autonomy and informed consent for many years. Recently this dominant understanding has been challenged by ethics of care which, although, also emanates from the West presents a more nuanced concept: relational autonomy, which is more faithful to our human experience. By paying particular attention to relational autonomy, particularity and Process approach to ethical deliberations in ethics of care, this paper seeks to construct a concept of informed consent from the perspective of ethics of care which is here called relational autonomy-in-informed consent (RAIC). Thus, providing a broader theoretical basis for informed consent beyond the usual theoretical perspectives that are particularly Western. Care ethics provides such a broader basis because it appeals to a global perspective that encompasses lessons from other cultures, and this will help to enrich the current ideas of bioethics principles of autonomy and informed consent. This objective will be achieved by exploring the ethics of care emphasis on relationships based on a universal experience of caring; and by contrasting its concept of autonomy as relational with the understanding of autonomy in the approaches of the dominant moral theories that reflect rational, individualistic, and rights-oriented autonomy of the American liberalism.     

Perspectives for the teaching of bioethics in undergraduate nursing

The education of ethics and bioethics in schools of nursing in Brazil has presented strictly conceptual and deontological approaches, which often bear little relation to future professional practice. So the goal of this study was to present a proposal for teaching of ethics and bioethics in the integrated curriculum in undergraduate nursing Federal University of S?o Jo?o Del Rei, MG, Brazil. The results show that the content is provided in all units curriculum of the course covering the classical dilemma in the practice of care in all stages of the life cycle. Furthermore, this approach provides students with the development of autonomous and reflective attitudes, confronting culture and values with the biopsychosocial aspects.     

Work process of professional nurses: perceptions of undergraduate nursing falculty

The purpose of this study was to explore perceptions of undergraduate nursing faculty about the work processes of professional nurses, particularly, nursing care and competency - from ways of learning, knowing, and doing, which were developed during their undergraduate nursing education. Focus groups among fifteen undergraduate faculty members were conducted to collect data for this qualitative study. Content analysis was used to analyze the data. Six categories have emerged: Technical skills are fundamental to provide nursing care; Complexities of technical skills and nursing care; Differences in the process of providing nursing care; Competency from ways of learning, knowing, and doing are essential for providing nursing care; Learning to be a nurse is understood by different perspectives; The need of undergraduate faculty to discuss about nursing technical care.     

Concepts of health in nursing education in undergraduate schools of Brazil and portugal

This article represents an extract of my PhD research regarding the concepts of health present in undergraduate schools of nursing of Brazil and Portugal. The objective of this research was to comprehend how the concepts of health are explicit in the documents of undergraduate courses and how they are expressed in the discourses of the nursing professors and students. For this, thematic content analysis was used to analyze the professional education of the nurses and the concepts of health present in the nursing courses. The presentation of the results was performed using the Collective Subject Discourse technique. The results showed that in the state of Santa Catarina in Brazil, the concepts of health follow the National Curriculum Guidelines and there is an emphasis directed towards reflection on the Brazilian National Health System (SUS); while in the city of Porto, in Portugal, these concepts follow the Study Plans of the Nursing courses and emphasize nursing care both for the healthy and the sick person. The data also reveal a concern in the construction of the concept of people-centered healthcare.     

Hospitalized child: care sharing between mother and nursing

This research aimed to verify at what moment, in what kinds of care and in what way mothers are included in care to the hospitalized child and to verify how care is negotiated between nursing team and mothers. The field research was carried out through participant observation of everyday care at a pediatric hospital unit, as well as interviews with mothers and the nursing team. The inclusion of the mother in care has taken place in a subtle way. The mother has taken on procedures that had been part of nursing competence before, concentrating information on the therapeutic process. The lack of a collective therapeutic project from the perspective of family-centered care is one of the obstacles to the involvement of mothers in care. Results demonstrate that the relation between mothers and the nursing team reveal to be complex and influenced by the exercise of power, which results in the need to construct shared care.     

Competencies for educational activities in nursing

The focus of this study is the interface between nursing education and nursing care in its educative dimension. OBJECTIVE: To develop a profile of competencies for nursing care education from the perspective of the subjects involved. METHOD: Historical and dialectical materialism was used as the theoretical and methodological framework. Competence was addressed as the conceptual category, as defined by Perrenoud, based on healthcare concepts and on instrumental knowledge as advocated by Mendes-Gon?alves. RESULTS: the analysis of empirical material resulted in the creation of 10 core competencies for nursing education activities. CONCLUSION: The need to give a new meaning to education action from the perspective of Popular Education implies the development of pedagogical opportunities during their undergraduate studies in order to enable students to use their knowledge and skills to develop a dialogical attitude of recognition of the subjects of nursing care.     

Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel

Objectives

Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems.

Methods

This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992–95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095).

Results

The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care.

Conclusions

The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.     

Glimpsing undergraduate research from the view of the advisors of Nursing scholarships

This research aimed at understanding the meaning of undergraduate research for supervisors of Nursing scholarship students in a university in the South of Brazil. The methodological reference used was the Grounded Theory, by the means of interviews with seven undergraduate research scholarship advisors forming two sample groups. The phenomenon "glimpsing undergraduate research activities of research groups coordinated by nursing advisors, the basis of competency formation in research of the scholarships" emerged form the interrelation of six categories. To be a advisor and researcher of human resources in research form undergraduation requires pedagogical, instrumental, and managerial competencies associated to research policies of nursing and health.     

Neonatal nursing: undergraduate nursing students' knowledge

The present study was carried out at the Municipalities of S?o Paulo and Guarulhos with undergraduate nursing students and aimed at evaluating their knowledge regarding neonatal nursing and, if necessary, to contribute to the program reformulation. Thus, we would be able to improve nurses knowledge on the full-term new born care. In order to develop a structured questionnaire to be used as an instrument to measure the studied variable, aspects of the theoretical content related to the most common care procedures at the neonatal unit were selected. Authors found that students' theoretical knowledge on the theme was regular.     

Fundamental nursing: predicatives and implications

This work aims at describing and analyzing the concept of fundamental nursing, with the purpose to clarify the constitutive elements that can be applied to understand and expand this termination. In spite of being created in the 1970s at the Anna Nery School of Nursing, this concept was adopted by other Schools of Nursing in the country to designate a teaching program or a department. The author states in favor of this termination as a theoretical abstraction that is maintained in the practice dimension as an essential component of nursing understood in its totality. The author affirms that what is fundamental is not only the basic, but general, including professional actions of providing care to people and human groups. Fundamental is the character of "uniqueness" that transcends nursing in its totality, independently of the several categorizations, sectors and sceneries of professional action. It also represents the consolidation of nurses meeting with their clients in health or disease situations. The personal view is applied to elucidate predicatives and implications regarding the use of this concept in teaching and research.     

The future nursing voice

Based on some articles in the journal Nursing Ethics, the author outlines some of the areas of major importance for nursing in the future. These areas--the care of elderly people, long-term home-based care, genetics, international research and conflict and war--demand a new voice of nursing, which is a political voice. The rationale for a political voice is the ICN Code of ethics for nurses and the fourfold responsibilities laid on nurses: to promote health, to prevent illness, to restore health, and to alleviate suffering. Some indications are given on how nurses can engage in political work.     

Parish nursing and hospitals

Parish nursing is an emerging area of specialized professional nursing practice that focuses on health maintenance and health promotion for parishioners and the community. Health care occurs across a continuum along which hospitals provide a key function. There is a role for hospitals in relation to parish nursing and faith-based health care organizations have a greater obligation than secular ones to partner with parish nursing programs. Faith-based health care facilities, like secular ones, are institutions that bring health care professionals together to apply their knowledge, judgment, and skills to provide care for those in need of such services. But faith-based facilities differ from others in sharing a holistic perspective of health intended to benefit the individual and society, particularly those who are marginalized. This obligation to serve enables God's work because caring for those in need is essential for a just and beneficent society. It seems reasonable to assume that partnering with parish nurse programs is a fitting role for faith-based hospitals. In such circumstances, the facility may choose to introduce the parish nurse concept to the community by hosting a town hall meeting or a workshop with community partners. The facility may also fund parish nursing exhibitions at community events and conferences. The notion of "partnering with," although it carries no theological implications, is in the health care context somewhat akin to the Catholic notion of "sponsorship." The church's sponsorship of health care facilities should be seen as a ministry in itself, and such an approach would "shift the focus from preservation to enhancement, from being a guardian to being a creator, from a sense of diminishment to one of empowerment." Faith-based health care organizations have a responsibility to focus on holistic health for both the individual and society at large, particularly the health of people who are marginalized. It is not only logical that faith-based health care organizations should partner with parish nursing programs--it is imperative that they do so.     

Towards a strong virtue ethics for nursing practice

Abstract  Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse–patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions , nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.