Nursing students' use of a psychopharmacology game for client empowerment.

Theoretical support is evaluated for nursing students' use of an innovative educational intervention, the Psychopharmacology R.A.C.E. (Wissman and Tankel, Kansas City, MO) game, as an empowerment tool with mental health clients. Based on mutual trust and respect, the interpersonal process occurs between an individual or group (e.g., client, student) with a desire for competency growth (e.g., knowledge, proactive health behaviors, negotiation), and development of a sense of control and self-determination and another individual or group (e.g., nurse) who serves as an enabler, supporter, and resource mobilizer. A review of empowerment literature identifies: (1) support of education as an empowerment tool; (2) identification of specific teaching methods and behaviors that promote empowerment; (3) empowerment as an outcome of involvement; and (4) support of the empowerment value of group participation. Preliminary clinical observations reveal strong support for nursing students' use of the Psychopharmacology R.A.C.E. game as a method to empower mental health clients.     

加强临床教学管理提高护理教学质量

临床护理教学是护生将基本护理理论与临床护理实践紧密结合的关键环节,是使护生获得专业护士所必需具备的专业技能、态度和行为的重要途径.高度重视临床护理教学工作,合理组织安排教学计划,认真把握临床实践环节,及时更新带教手段,全面加强临床护理教学管理,对提高临床教学质量、帮助护生顺利实施角色过渡和尽快适应现代护理工作具有重要意义.     

Toward a mid-range theory of nursing presence

BACKGROUND. Presence is widely accepted as a core relational skill within the nursing profession. Nurse educators are challenged to ensure that the humanistic aspects of client care are included in the Bachelor of Science in Nursing (BSN) curriculum. Introducing and teaching presence skills early in the BSN curriculum will ensure the essential value of relational engagement with clients. Nursing literature, however, notes presence is a challenging concept for BSN students. Articulating a mid‐range theory of nursing presence will facilitate students' conceptual understanding of presence and guide nurse educators to teach presence skills. AIMS. To propose a mid‐range theory of nursing presence. Within the theoretical model, identify development opportunities to improve student nurse use of presence as a relational skill. METHODS. An extensive literature review was conducted. Materials were synthesized and the mid‐range theory was developed. DISCUSSION. Kim's nurse‐client domain provided the perspective that guided the parameters of the theory. Professional nursing presence is dependent upon the combination of five variables: individual nurse characteristics, individual client characteristics, shared characteristics within the nurse‐client dyad, an environment conducive to relational work, and the nurse's intentional decisions within the practice domain. The variables are described and the relationships among variables depicted in the model. Specific nurse‐sensitive points during a nurse‐client interaction determine or influence the nurse presence intervention and dose. Areas designed to teach or improve relational skills are identified for the BSN educator. CONCLUSION. A mid‐range theory of presence contributes to our understanding of the relational aspects of nursing practice within the contemporary healthcare environment. Identifying strategies to teach BSN students presence skills will facilitate the incorporation of the humanistic aspects of client care in the undergraduate curriculum.     

Teaching core nursing values.

Nursing is a caring profession. Caring encompasses empathy for and connection with people. Teaching and role-modeling caring is a nursing curriculum challenge. Caring is best demonstrated by a nurse's ability to embody the five core values of professional nursing. Core nursing values essential to baccalaureate education include human dignity, integrity, autonomy, altruism, and social justice. The caring professional nurse integrates these values in clinical practice. Strategies for integrating and teaching core values are outlined and outcomes of value-based nursing education are described. Carefully integrated values education ensures that the legacy of caring behavior embodied by nurses is strengthened for the future nursing workforce.     

Teaching for creativity.

Although nurse education programs state that creativity is a valued attribute of the nursing student, some programs do not stimulate creative nursing approaches in their students. The author applies the psychophysiological theory of brain hemisphericity to nurse education to identify teaching approaches that model and encourage the development of creativity. Teaching methods that encourage right-hemisphere divergent thinking are emphasized to facilitate creative nursing care in nursing practice.     

A comparison of clinical evaluation tools in hospitals and baccalaureate nursing programs

This study compared nurse educators' and hospital administrators' expectations of graduating baccalaureate students by analyzing the content of clinical evaluation tools in two settings: the last medical-surgical rotation and the beginning staff-level position. Ten baccalaureate nursing programs and 10 large university hospitals were studied as pairs. Evaluation tool criteria were divided into six role categories: care giver, client teacher, manager-team member, communicator, investigator, and professional. The study yielded data regarding similarities and differences regarding behaviors expected by schools and hospitals. The highest rates of similarity were found in the care giver and professional roles. The greatest difference was found in the manager-team member role with hospitals including many more of the behaviors. Few behaviors in the investigator role were included by school-hospital pairs, but schools included more of the behaviors than hospitals.     

Pedagogical content knowledge for nurse educators: An intersection of disciplines

Pedagogical content knowledge (PCK) is the proverbial bar over which novice nurse educators must leap. However, relatively few nurse educators receive the formal graduate pedagogical training needed to smoothly transition from bedside nursing or advanced practice roles to the nurse educator role. Novice nurse educators who lack pedagogical preparation may experience frustration and failure when attempting to clear those bars and therein lays a problem. Novices nurse educators bring their own expectations to the teaching endeavor. They expect their clinical knowledge and experience to have equipped them with all that is necessary to teach nursing. Faculty are content experts but not yet experts of teaching, excelling only in providing or directing client care and providing clinical supervision to students. The lack of PCK creates a sometimes insurmountable disconnect between bedside nursing practice and nursing academia. Such dissonance often leaves the nurse educator in unfamiliar territory teaching by trial and error.     

Cultural negotiation: a constructivist-based model for nursing practice.

Combining abstract concepts from grand theories with the pragmatics of nursing practice presents a dilemma for nursing that is being addressed with the emphasis on middle-range theory. The philosophical perspective of constructivism is the foundation for a middle-range theory that links the nursing process to holism through the respective worlds and knowledge of the nurse and client. The nursing process is situated in the context of the cultural worlds of the nurse, client, and health care system and in the greater social context. This model allows the nursing process to be recast in new language that captures the interdependence of the client-nurse interaction. This model accommodates the social values and beliefs of both the health care system and the social context.     

A nurse's story. The journey of a staff nurse

This article describes the professional growth of a nurse who journeyed from being a staff nurse to becoming a coordinator of a national program. The critical turning points that fostered this nurse's development are detailed. The guidance and support of the nursing and hospital administration as well as the mentorship of fellow professionals were key in this developmental process. The communication of this story contributes to the varied tapes-try of professional nursing.     

Invitational teaching behaviors in the associate degree clinical setting

Teaching in the clinical area provides some unique problems for the nurse educator. An effective clinical instructor is one whose teaching behaviors promote learning. This study investigated the relationship between the attitudes associate degree nursing students have toward their clinical learning experiences and their perceptions of the Invitational Teaching behaviors of the clinical instructor. The Invitational Teaching Survey and the Student Affective Outcome Measure (Amos, Purkey, & Tobias, 1984) were adapted to describe teaching behaviors in the clinical setting. Reliability studies were conducted on the revised instruments. The total scores and subscores yielded 15 relationships which were compared using Pearson Product Moment Coefficients. The correlations coefficients ranged from .39 to .69 and all were statistically significant at p less than .01. The results of this study indicated a strong relationship between students attitudes toward their clinical experience and their perceptions of the inviting teaching behaviors of their clinical instructor. The study yielded a reliable tool which can be used by instructors to identify the students' perceptions of their Invitational Teaching behaviors in the clinical setting.     

Cognitive therapy integrated with life review techniques: an eclectic treatment approach for affective symptoms in older adults

Background. An important aspect of nursing theory development has been the adaptation of theory from other disciplines within the metaparadigm of nursing. This eclectic approach to theory development enhances the broad humanistic theory base on which effective, professional nursing practice is based. Aims and objectives. The aim of this article is to describe the process of integrating two distinct psychotherapeutic approaches into one coherent mental health nursing intervention for the treatment of affective symptoms in older adults. Guidelines for using this integration process in psychiatric mental health nursing clinical practice are presented and illustrated through the case study approach. Methods. A case study is presented describing a clinical situation in which life review techniques were used to enhance the outcomes of a cognitive therapy experience for older adults enrolled in outpatient psychotherapy treatment for acute adjustment disorder with an affective component. Conclusions and relevance to clinical practice. The advanced practice psychiatric mental health nurse who approaches psychotherapeutic interventions with older adult clients from an eclectic approach can achieve successful outcomes by having a clear understanding of (i) the dynamics of the various psychotherapeutic approaches, (i) the skill level of the practitioner, (iii) the psychosocial sophistication of the client, and (iv) the pathology being treated. In addition, active involvement by the client in a treatment process that matches his/her psychosocial skill and coping resource level will contribute to effective resolution of pathology. A cognitive therapy approach supplemented by life review techniques is an excellent example of an effective, eclectic treatment approach of affective disorders in older adults.     

本科毕业护士轮转临床护理教学管理的做法与体会

目的:提高本科毕业护士临床护理教学管理能力。方法:选择有一定工作经验的本科毕业护士有计划地在护理部轮转临床护理教学管理,轮转内容主要包括:护士执业注册管理、在职护士培训、进修护士管理、实习生带教、教学文件管理、护理科研论文等。轮转期间安排至少1次外出培训。结果:培养和提高了本科毕业护士的教学意识和教学管理能力,有助于其明确个人职业发展方向,也有利于护理部教学人才的选拔和培养。结论:轮转临床护理教学管理对本科毕业护士确立自身发展方向和各级护理管理者对人才的全面评价均有重要意义。     

The client as educator: learning about mental illness through the eyes of the expert

Increasingly, educators are asking clients who have a mental illness to make a contribution to nursing students' learning as a way of informing their attitudes towards persons experiencing mental illness and thus enhancing care delivery. The nature of clients' involvement in the classroom and the quality of learning by students through this approach has rarely been questioned. This paper discusses a model of client/nurse educator collaboration in a mental health course with undergraduate nursing students. It draws on the nursing education experiences of the first author, and the personal views of the second author, a user of mental health services. Specifically, it addresses positive features of collaboration as perceived by students, client, and nurse educator and analyzes some of the challenges/issues for the nurse educator. In addition, it outlines helpful aspects of the collaborative process for both nurse educator and client, in particular, its impact on the client's personal well being. This kind of analysis is essential if we are to develop education models of such collaboration that are beneficial for all partners in the learning process.     

Teaching nursing research to minority students.

Teaching nursing research can be a challenging role for nurse educators. Even when the nurse educator is equipped with a large arsenal of teaching strategies designed to promote student interest, that students will leave the class with a basic understanding of the research concepts is not guaranteed. It is important to know the audience, which in this case are the students, so that the nurse educator can select teaching strategies that will assist the students in achieving course objectives. The purpose of this article is to describe the use of two teaching strategies that have been effective in teaching nursing research to minority students.     

The importance of nurse caring behaviors as perceived by Swedish hospital patients and nursing staff

The present study identified patient (n = 81) and nursing staff (n = 105) perceptions of the most and least important nurse caring behaviors. Using a Swedish version of the CARE-Q instrument, patients ranked as most important competent clinical know-how, while the nursing staff ranked expressive/affective behaviors as most important to make patients feel cared for. The results show significant differences (p less than 0.05) between the two groups in the rating of 29 of the instrument's 50 specific behaviors and in five out of six subscales combining individual items. Thus, patient perceptions of important nurse caring behaviors differ from staff perceptions. These results are similar to those from other studies of hospitalized patients' perceptions of caring. The staff's results are in accordance with studies of professional nurses' perceptions of caring. The findings support conclusions by other authors.     

Managing Vulnerability : Nursing Treatment for Heroin Addicts

Grounded theory methodology was used to study nursing interventions in a methadone maintenance clinic. Participant-observation as a clinic stay nurse over four months was the principal method of data collection. A substantive theory called "managing vulnerability" was developed to describe nursing treatment of heroin addicts during methadone maintenance. Managing vulnerability has three parallel stages for the client and nurse. These stages are (a) learning to be vulnerable, (b) living with vulnerability and (c) beyond vulnerability. Basic conditions for this process are dispensing (giving) medication; therapeutic neutrality, which is the attitude assumed by the nurse; effective staff communication and clear clinic policy. Managing vulnerability illustrates the complexity of a therapeutic psychological nursing process.     

ICU护士职业风险与防护

目的:分析ICU护士的职业风险及防护策略。方法:通过职业调查观察和自身工作经验,对ICU护士的职业风险和防护策略进行研究。结果:ICU护士职业风险主要来自护理过程、护理环境和工作心理等。ICU护士可从护理规范、人性管理、心理疏导、劳动智能化、优化程序等途径来防护风险。结论:ICU护理是一种高负荷、高风险的工作,ICU护士需要高标准的职业素质和人文精神,也需要对职业风险加强防护,从而健康科学的从事ICU护理。     

The impact of a nurse externship program on the transition process from graduate to registered nurse: Part II. Qualitative findings.

This article reports the qualitative findings from a focus group interview conducted with six currently registered nurses who participated in a summer nurse externship program. It is Part II of a three-part study that examined the influence of nurse externship programs on the transition process from graduate to professional nurse. The focus group explored the perceptions of former nurses about the impact of the externship program on their transition into the professional nurse role. In the role of nurse externs, individuals were able to view, experience, and, consequently, come to understand the culture of nursing in an acute healthcare system without being full-fledged members of it. Three themes induced from the analysis of the findings were as follows: (1) being a part of the real scene; (2) figuring out the environment; and (3) gaining awareness and becoming frightened.     

Four senses for a full skin assessment. Observation and assessment of the skin.

Skin assessment and observation are vital nursing responsibilities. To be effective, nurses need to develop their observational powers, but remember that tact and sensitivity will make the task easier for nurse and client.