Egalitarian consultation meetings: an alternative to received wisdom about clinical supervision in psychiatric nursing practice

Clinical supervision (CS) has become a watchword for psychiatric nursing. Yet, there are contradictions and controversies in academic and professional discourse in relation to the nature of CS, both structure and process, its effectiveness and how this is ascertained, the preparation of supervisor and supervisee, and the quality of the supervisory relationship. The perception of such discord encouraged the authors of this paper to step outside the debate and enact a different kind of CS, which came to be known as egalitarian consultation (EC). Egalitarian consultation meetings (ECMs) were established with the postmodern turn in psychiatric nursing as a reference point. A space was created in which participants could construct their particular version of CS. The authors and six G-grade community psychiatric nurses engaged with each other for six videotaped meetings. The data from the recordings were analysed using a hermeneutic grounded theory approach (Strauss & Corbin 1994), in keeping with the style of the research, which combined the roles of researcher and practitioner for the authors. The aim was to produce local knowledge of CS. The ECMs were characterized by a sense of freedom in relation to existing rules about hierarchy and truth. The participants, each as expert in her/his own case world, produced engrossing narratives about and for practice. The group developed a cohesiveness based in closeness and this encouraged radical talk and action--a questioning of practice systems. However, for some group members, radical equated to dangerous in terms of the watchful organization and a return to 'real' work (case supervision) was observed. Innovation in relation to CS may benefit from a change in institutional culture.     

An experience nursing an ambulatory pediatric surgery patient and his mother: the practice of caring

A seven-year old child was scheduled for excision of hemangioma under local anesthesia. Utilizing the concept of caring, we provided pre- and intra-operative support to both the patient and his mother. Before the operation, we effectively established the self-confidence of the patient by providing sufficient disease-related information and encouragement in a child-oriented approach, in order to enable the patient to overcome fear and pain. This caring approach proved effective during the operation since the patient was fully aware of each surgical step and the levels of pain to be experienced. The mother was also involved throughout the process. She was therefore not only emotionally pacified, but also actively involved in the psychosocial support process. Traditionally, almost all surgical procedures in pediatric patients have been performed under general anesthesia. This report indicates that under appropriate care some of the less invasive surgical procedures in school-age children can be carried out under local anesthesia to avoid the risks involved in general anesthesia.     

An obstetric simulation experience in an undergraduate nursing curriculum

Educators face the dilemma of conveying didactic information in concise, creative ways that evoke critical thinking. In addition, high patient acuity, coupled with a growing nursing shortage, requires assimilation of didactic knowledge into sound clinical judgment in a timely manner. Human simulation offers a creative teaching modality that allows transference of textbook knowledge into a real-life situation where nursing students can function in their role without untoward effects to their clients. The author illustrates the use of a human birthing simulator, Noelle, in an undergraduate nursing program as a creative and effective teaching strategy.     

RehabNurse-L: an analysis of the rehabilitation nursing LISTSERV experience.

Computer-mediated discussion is a form of communication via the Internet through groups known as listservs, chatrooms, bulletin boards, newsgroups, or discussion forums. An increasing number of professionals are using these forums to ask and answer common concerns about their practices. Deeper meaning lies within messages that is broader than just an individual posting or a simple communication thread. The messages can have far-reaching effects. Our purpose in this qualitative research was to understand why RehabNurse-L LISTSERV (RehabNurse) participants use the listserv, describe their RehabNurse experiences, how they used information from postings, and their perception of the value of using RehabNurse for their practice. The Rehabilitation Nursing Foundation funded this study. Nurses identified the RehabNurse as a means of "keeping up," sharing, learning, problem solving, and support within their practice. They appraised the information posted on RehabNurse in search of credible entries as well as experiences similar to their own. Nurse respondents described their RehabNurse involvement in terms of community and connectedness, identifying roles familiar to the participants. Rehab-Nurse postings not only were shared within the discussion group, but also extended to their work environment--team members, peers, administrators, patients, and families.     

Implementation of evidence‐based nursing practice for diabetic patients: An Iranian experience

Evidence‐based nursing is recognized as an indicator of quality in nursing practice, a basis for accountability and the gold standard of professional nursing care. The aim of this study was to explore nurses’ experiences and perceptions about evidence‐based nursing practice in giving care to patients with diabetic foot ulcers. A qualitative research design was adopted, and content analysis was used to analyse data. Semistructured interviews were held with 19 bachelor‐degree nurses working in a teaching hospital in an urban area of Iran. During data analysis, two main themes developed: ‘structural backgrounds of the organization’ and ‘empowerment’. Accordingly, it was concluded that successful implementation of evidence‐based nursing requires the reconfiguration of the administrative structure in the hospital. In addition, it requires the support of nurse leaders to facilitate the implementation of evidence‐based nursing in the practice.     

An experience nursing an organic psychiatric patient with vertigo

This study documents the nursing of an organically mentally disordered patient with chronic vertigo. The subject suffered a head injury in a traffic accident, resulting in impairments to his cognitive abilities as well as symptoms of recurring vertigo, which hampered his work and family activities. Holistic nursing assessment revealed four areas of nursing concern: risk of falls, impaired self-care ability, caregiver role strain, and powerlessness. Care provided to the subject concentrated on: (1) preventing him from falling again, (2) regaining his ability to care for himself, through gradual training exercises; (3) training his spouse in caring for herself and the subject; (4) establishing his self-assurance by means of cognitive-behavior therapy and vestibular rehabilitation.     

An island nursing experience

ABSTRACT:

This article gives an overview of a veterinary nurse's experience volunteering at the Esther Honey Foundation Animal Clinic in the Cook Islands. It highlights the daily routine for the clinic and staff on the tropical island and how it differed from working in a western type of environment, the amount of patients that were cared for and the type of treatments.     

An analysis of a typology of family health nursing practice

In this article, Colin Macduff analyses the construction and testing of a typology of family health nursing practice. Following a summary of relevant methods and findings from two linked empirical research studies, more detailed analysis of the conceptual foundations, nature and purpose of the typology is presented. This process serves to exemplify and address some of the issues highlighted in the associated article that reviews the use of typologies within nursing.     

Best practice in nursing: A concept analysis

BackgroundSince the early 1990s a shift has occurred in the understanding of what constitutes quality healthcare. This is evidenced by the emergence of new concepts in the nursing literature, including best practice. Although authors have analyzed the concept of best practice in the healthcare sector, further analysis is required to distinguish the concept's unique meanings, and significance for the nursing discipline.ObjectivesThis paper seeks to clarify use of the concept of best practice in the nursing literature over the last two decades, and contributes to explaining its defining characteristics, applicability, and significance. It also distinguishes the concept's unique meanings and usefulness in comparison to other related terms.MethodsAn evolutionary concept analysis method was selected for this analysis. First, a representative sample of nursing sources was obtained utilizing the CINAHL database. This database was searched for sources in English, during the years 1993–2013, with both best practice and nursing in the title. Data was then collected from the sample of retrieved literature on attributes of best practice, antecedent and consequential occurrences, variations, and empirical references. The following related concepts were also explored for purposes of comparison and to situate the understanding of best practice in-context: practice development, evidence-based practice, and standard of care.FindingsUse of the concept of best practice in the nursing literature may be categorized into four distinct domains: educational, administrative, clinical and theoretical/conceptual. Exploration of defining attributes revealed that best practice may be characterized as: directive, evidence-based, and quality-focused. Antecedent occurrences in the sample sources were most commonly related to identification of a specified need or problem, somewhat defined by the domain. The implied consequential occurrences were ultimately better outcomes.ConclusionBest practice is more than practice based on evidence. It represents quality care which is deemed optimal based on a prevailing standard or point of view. Specific best practices in nursing are significant because they serve to direct nurses regarding solutions to identified problems/needs. Continued analysis of the concept of best practice is required to further distinguish it from related concepts, and to expand our understanding of the relative meaning of best from multiple perspectives.     

Nursing leadership in academic nursing: The wisdom of development and the development of wisdom

The purpose of this article is to discuss insights derived from adult cognitive developmental theories and relate the insights to vertical leadership development in academic nursing contexts. Equipped with developmental understanding, academic leaders are in a better position to support the vertical leadership development of one's self, faculty, peers, and colleagues. From a cognitive developmental perspective, the authors' reason as leaders develop, grow, and evolve, sense making becomes more sophisticated and nuanced resulting in the development of wisdom. Leadership wisdom is a function of horizontal (acquisition of information, skills, and competencies) and vertical development (the development of more complex and sophisticated ways of thinking). Ways to enhance vertical development, and sense making to cultivate wisdom are discussed. Principles and practices that promote vertical development in self and others deepens performance expectations of those in the academy and supports personal professional development and organizational success.     

Politics and nursing: an elective experience

The case for enhancing the political awareness of nurses is reviewed, examining the need for the inclusion of political issues in nurse education programmes A brief review of the available literature from North America reveals that some schools of nursing have made progress in including aspects of politics in nursing curricula, either as part of a course on health policy or as a separate elective course Topics addressed in these courses, and experiences offered, aim to raise awareness and equip nurses with the knowledge and skills necessary to engage in politics at a variety of levels An account is offered of the experience of running a 4-week theoretical elective course entitled 'Politics and nursing' as part of the Common Foundation Programme of a Project 2000 course in a college of nursing based in North London, England