Voices of internationally educated nurses: policy recommendations for credentialing

SINGH M.D. & SOCHAN A. (2010) Voices of internationally educated nurses: policy recommendations for credentialing. International Nursing Review 57 , 56–63
Background:  The authors advance general policy recommendations for credentialing Internationally Educated Nurses (IENs) who migrate to practice nursing in developed, high-income countries. While examples are drawn primarily from a qualitative study exploring IEN experiences in Canada, the suggestions presented have broader application to any nursing, or midwifery, internationally educated professionals wanting, or needing, to practice outside their home country of education. Examples of credential processing are drawn from Australia, the European Union, New Zealand, the UK and the USA.
Methods:  This study was guided by a biographical narrative (qualitative) research methodology. A convenience sample of 12 IENs volunteered to participate.
Results:  The IENs offered recommendations based on their personal experiences, all of which have policy implications to make transparent, standardize and harmonize the credentialing processes both prior to, and upon arrival in their destination country. Suggestions are offered to make relevant the content of IEN integration programmes.
Conclusions:  The authors also suggested that national immigration agencies and nursing regulatory bodies could better coordinate their activities when processing potential IEN migrant applications.     

Portfolio evaluation for professional competence: credentialing in genetics for nurses.

The use of professional portfolios, comprised of a wide variety of materials and evidence to profile the scope and depth of a clinician's practice competence, is gaining popularity. The usual methods of showing professional competence via paper and pencil/computerized testing, oral presentations, or performance observations provide a picture of competence at a given point in time based on didactic content recall. Portfolios present an opportunity for presentation of a larger number of competency evaluation points. Although examinations can be validated with psychometrics, providing accuracy and reliability of evaluation of portfolios is a more complicated matter. This article discusses the experiences of the Credentialing Committee of the International Society of Nurses in Genetics as they created and validated the evaluation of professional portfolios to provide a quality credential for nurses in genetics.     

病房护士长在医院评审中的作用

充分发挥病房护士长的管理职能 ,把质量、安全、服务的落实、规范、绩效作为临床护理管理的重要内容常抓不懈。在应对医院评审工作中 ,充分重视 ,全面落实 ,找出差距 ,积极整改 ,最终达到促进护理工作、保障病人安全、提高服务质量的目的 ,是评审达标的基础     

Orienting British Isles nurses to the American Health care system

The unique needs of British Isles nurses warrants the nurse educator to design an orientation program that contains specific content and issues common to the American health care system.     

Reflection: a challenging innovation for nurses

The concepts of reflection and reflective practice have been widely embraced by the nursing profession despite some apparent ambivalence highlighted in the literature. On the one hand, reflection is reported to be a valuable and powerful educational process; it is claimed to develop practice-based theories, encourage practitioners to evaluate their practice, promote learner self-awareness, narrow the theory-practice gap, challenge habitual practice and identify tacit knowledge. On the other hand, commentators point out that there is insufficient empirical evidence to support these claims and that its unstructured implementation can have deleterious effects on practitioners' psychological well-being and the outcomes of nursing education. It will be argued in this paper that the realisation of the benefits claimed to accrue from reflective practice together with the avoidance of its potential deleterious personal and educational outcomes hinges on three factors. These are: firstly, that the frameworks or protocols introduced to promote reflective practice are consistent with the purposes it seeks to achieve; secondly, that the essentially political nature of reflective practice is recognised and addressed; and thirdly, that the resourcing requirements for introducing and maintaining reflective practice in clinical units are also recognised and addressed.     

不同ICU护士对北京市专科护士资格认证理论培训需求的调查分析

[目的]了解不同ICU科室背景护士对北京市专科护士资格认证理论培训内容的认可程度,以期对今后改善ICU专科护士认证培训提供一定的参考依据.[方法]采用自设问卷,对参加北京市第8期ICU专科护士资格认证培训的82名护士进行问卷调查.[结果]综合ICU护士认为难度最高大的培训内容为“循环动力学监护”和“水电平衡与代谢系统护理”;外科ICU护士认为难度最大的培训内容为“循环动力学监护”“循环系统疾病护理”和“多器官功能障碍综合征护理”;内科ICU护士认为难度最大的培训内容为“中枢神经系统监护”和“神经外科系统疾病护理”.内科ICU护士更希望增加“中枢神经系统应用解剖生理”培训学时（P=0.003）,认为“中枢神经系统监护”和“神经外科系统疾病护理”的内容更有难度（P＜0.05）.[结论]建议培训机构针对护士理论培训中的难题与需求,评价培养模式、培训学时、课程设计以及师资配置等,借鉴、学习其他国家和地区专科护士培养的模式和经验,以期更新ICU专科护士培训工作.     

The APNG(c): A preliminary look at credentialing nurses through portfolio review

Recently, the International Society of Nurses in Genetics (ISONG) was the first nursing organization to award the Advanced Practice Nurse in Genetics credential, APNG(c), through portfolio review to 13 nurses. While the literature review shows that portfolios have been used to evaluate students in nursing education curriculums, the American Nurses Credentialing Center is using the ISONG portfolio review model to determine its applicability as an evaluation tool in other areas. In addition to an overview of the ISONG portfolio review process, testimonies from four of the APNG(c) recipients gave insight to the ISONG portfolio review model's advantages, disadvantages, as well as areas of improvement. Based on the findings from ISONG's experience, portfolio review may present a more cost-effective option to recognize and reward expertise than traditional exams for other emerging specialty organizations. Copyright 2002, Elsevier Science (USA). All rights reserved.     

What nurses want: diffusion of an innovation

We investigated the usability of personal digital assistants (PDAs) to improve research utilization and timely access to electronic practice information to assist in clinical decisions. Nurses used a decision support tool on a PDA to collect point-of-care outcomes data. Follow-up interviews documented usability. Nurses liked the portability and size of the PDA, as well as ease of use of the PDA software. Electronic decision support tools at point of care have the potential to improve nurses' research utilization and quality of care.     

循环培训模式在PICC资质认证中的应用

目的 探索PICC资质护士的培训模式.方法 采用理论与实践相结合的循环培训模式,对55名护士通过摸底考试→理论知识学习→操作演示→答疑→模拟练习→临床实践→再测评等循环式学习步骤进行.结果 培训后护士理论成绩、技能成绩、临床综合能力均有所提高,差异具有统计学意义（P＜0.01）.结论 循环培训模式可使护士理论、技能、临床综合能力得到全方位训练,有助于提高护士学习的积极性和主动性,从而提高PICC专科护理质量.     

Addressing the turnover issue among new nurses from a generational viewpoint

Aim To investigate the relationship between dimensions of the psychosocial work environment and the intent to quit among a new generation of nurses. Background As a new generation of nurses enters the workforce, we know little about their perception of their current work environment and its impact on their intent to stay. Method A self‐administered questionnaire was distributed to 1002 nurses. Results The nurses who intended to quit their positions perceived a significant effort/reward imbalance as well as a lack of social support. The nurses who intended to quit the profession perceived a significant effort/reward imbalance, high psychological demands and elevated job strain. Conclusion The balance between the level of effort expended and reward received plays an important role in young nurses’ intent to leave. Implications for nursing managers Nurse Managers must offer Nexters, from the beginning of their career, a meaningful work and supportive environment. Without the efforts of the organization to improve the work environment and support nurses, this generation may not feel valued and move to another organization that will support them or another career that will offer fulfilment.     

Certification in nephrology: credentialing issues

Credentialing with certification does not ensure pay raises or well-known initials, but it does verify personal knowledge and skills needed to practice in a specialty area. This documentation of special knowledge is a starting point for nursing to take control of its practice and for its members to become autonomous and collaborative practitioners. Unification and standardization of the present system will only bring more power and prestige to the credentials. Documenting quality patient care delivered by certified nephrology nurses is the next step in the nephrology field. Lastly, nurses need to unite and support each other during the certification process as it evolves into a well-respected institution.     

Occupational changes in nursing: the situation of enrolled nurses

BACKGROUND: The move to one level of qualified nurse in the United Kingdom (UK) is, in part, a consequence of professionalizing strategies. Registered nurses now undertake technical work previously performed by doctors. The role of enrolled nurses, and their career intentions, have not been considered in light of these changes, despite the fact that many still work in the National Health Service. AIM: This paper considers the pursuit of professionalization by nurses, illustrating the argument with findings from an empirical study of conversion to registered nurse by enrolled nurses. METHODS: The paper is based on a secondary analysis of a large data set, originally used to explore ethnic inequalities in nursing. Data from 2968 respondents were analysed to answer a number of research questions relating to the characteristics of different groups of enrolled nurses and predictors of conversion to registered nurse. These included demographic characteristics, markers of career orientation, career progression and job satisfaction. STUDY LIMITATIONS: This study used secondary analysis of data and, therefore, exploration of issues was limited, not least because the data were 10 years old. Also, the design was cross-sectional and respondents' experiences related to different stages of the phenomenon under study and the same group was not studied over time. FINDINGS: Enrolled nurses who had converted to registered nurse were more likely than those who had no intention of converting to: be male, be younger, have been nursing longer, not be working on elderly care wards, have a high career orientation, not have taken a career break, and work full-time. Most of these factors predicted likelihood to convert. Although nurses who converted to registered nurse were more likely to anticipate career progression, they were less likely to be satisfied with their work. CONCLUSION: In attempts to define rewarding nursing work, the importance of ensuring that qualified nurses continue to retain basic nursing care skills should be acknowledged. This may offer an uncomfortable view to those seeking to further the professional status of nursing.