Arching the flood: how to bridge the gap between nursing schools and hospitals

A gap persists between what nurses can do and what they are employed to do, between the education nurses obtain and the work design of hospitals. Despite agonizing over standardization, current nursing education reflects the pluralistic nursing workforce, and nurses hold accountability for it. But nurses have not been proportionately or effectively involved in restructuring the hospital workplace. The result is that nurses are both overworked and underused. Fortunately, this gap may be bridged with a number of short- and long-term policy solutions.     

A profile of the inactive nurse. One solution to the shortage?

The reasons why short-staffed hospitals should consider attracting inactive nurses back to practice are clear: they are an excellent potential source of staff, and there are nearly 400,000 of them. How to attract them back, however, is not as evident. A North Carolina health-education agency surveyed approximately 430 inactive nurses, asking them what made them leave and what would bring them back.     

Chemical occupational risks identified by nurses in a hospital environment

Hospital nursing workers are exposed to occupational chemical risks. This quantitative study aimed to identify what chemical substances nurses have contact with in their activities, what substances cause health problems and what alterations correspond to possible problems caused by the chemical products they mention. A self-administered data collection instrument was answered by 53 nurses, who mentioned exposure mainly to antibiotics and benzene (100%), iodine (98.1%) and latex-talc (88.7%); the main problem-causing substances mentioned were antineoplastic substances (86.7%), glutaraldehyde (79.2%) and ethylene oxide (75.5%); the described health alterations were: eye watering; allergic reactions; nausea and vomiting, while other health problems that can be caused by the above listed products were not mentioned. These workers need further information on occupational chemical risks, which they could have received in undergraduate or permanent education courses.     

Occupational Health Nursing In Scotland

A study of the situation, qualifications and responsibilitiesof three hundred and nineteen occupational health nurses inScotland is described. Of the 319, 18 (6%) had an OccupationalHealth Nursing Certificate, 253 (79%) were registered, and 66(21%) were enrolled. The majority of nurses were in their firstoccupational health post (71%) and 48% of these had been inpost for four years or more. Two-thirds of the nurses said theywere employed full occupational health nursing, but there isevidence that they did not all realise what is involved in this.Responsibilities varied and over 70% of the nurses had onlyfour hours or less medical supervision weekly. In the establishmentswhere the nurses were employed the total number of workers wasover 300,000 and half of these were engaged in engineering.The study shows that employers require considerable guidanceon the duties they should expect from the occupational healthnurse.     

Understanding the private worlds of physicians, nurses, and parents: a study of life-sustaining treatment decisions in Italian paediatric critical care

This study's aim was to describe: (a) How life-sustaining treatment (LST) decisions are made for critically ill children in Italy; and (b) How these decisional processes are experienced by physicians, nurses and parents. Focus groups with 16 physicians and 26 nurses, and individual interviews with 9 parents were conducted. Findings uncovered the 'private worlds' of paediatric intensive care unit (PICU) physicians, nurses and parents; they all suffer tremendously and privately. Physicians struggle with the weight of responsibility and solitude in making LST decisions. Nurses struggle with feelings of exclusion from decisions regarding patients and families that they care for. Physicians and nurses are distressed by legal barriers to LST withdrawal. Parents struggle with their dependence on physicians and nurses to provide care for their child and strive to understand what is happening to their child. Features of helpful and unhelpful communication with parents are highlighted, which should be considered in educational and practice changes.     

Psychiatric nursing consultation and liaison: how do nurses understand this activity?

This research aimed at identifying the knowledge of nurses working in medical and surgical clinics and with burned patients as to psychiatric nursing consultation by means of a semi-structured interview. Care situations considered to be difficult were related to instrumental resources and provision of psychological support. Most of the nurses try to listen to patients' complaints, but they do not know what else they could do. Whenever they need help, they think of colleagues, bosses, psychologists and psychiatrists. They know the specialty of the psychiatric nurse and believe that this professional can help with emotional support to the patient and the nursing team. They consider consultation and liaison to be an evaluation of the patient by another specialist.     

How can employment-based benefits help the nurse shortage?

During a labor shortage, employment-based benefits can be used to recruit and retain workers. This paper provides data on the availability of benefits to registered nurses (RNs), reports on how health care leaders are approaching the provision of employment-based benefits for nurses, and considers what nurses have to say in focus groups about benefits. Because of the ongoing nurse shortage, many employers are trying to enhance the benefits they offer to support recruitment and retention efforts. We offer recommendations for health care leaders that follow from our findings about the current state of nurses' employment-based benefits.     

Nurses' perceptions of hospice palliative care volunteers

A total of 50 nurses (hospital and home care) responded to a survey designed to measure: (1) their attitudes toward, and knowledge of, hospice palliative care volunteers; (2) the types of tasks they felt it was appropriate for volunteers to perform; and (3) how valuable they felt different members of the hospice palliative care team are. In addition, they were asked to respond to some open-ended questions (eg, "Do you feel that it is appropriate for hospice palliative care volunteers to know patient medical information?"). The nurses' responses to the "Attitude/Knowledge" part of the survey revealed that they generally held positive attitudes toward volunteers. The majority of the nurses felt that it was appropriate for volunteers to perform most of the tasks listed, except for hands-on patient care. Nurses rated the value of nurses, family members, doctors, and pharmacists significantly higher than volunteers. Fifty-three percent of the nurses felt that volunteers should know patient medical information, and 77% thought that volunteers should have the opportunity to provide input regarding patient care. Also, 75% of the nurses felt that volunteers made their jobs easier, and 56% felt that volunteers should be included in team meetings. When asked to list the topics covered in a hospice palliative care volunteer training program, 73% of the nurses indicated that they were not sure or did not know what topics were covered, indicating a lack of knowledge regarding volunteer training.     

A career open to the talents—Nurses’ doing and focus during the history

Based on a historical and a contemporary fieldwork at a Danish hospital, this article offers a genealogical and philosophical exploration of the development of nurses’ doing and focus within a hospital setting from the 1800 s to the present day. This exploration finds that nurses’ doing has changed during history, which is reflected in their focus. Thus, nurses’ focus has developed from, what the Danish philosopher Uffe Juul Jensen refers to as a situation-oriented, to a disease-oriented practice, and while new values are established, the conception of care as a core value in nursing seems to have receded. This article also argues that today's nurses are doing what doctors did in the 19th century. The French philosopher Michel Foucault discusses how things repeat themselves in new ways and new contexts. The nursing profession has become ‘a career open to the talents’ where nurses with the appropriate skills and talents are able to build a career, within which they provide status, position and legitimacy. The conclusion of the article discusses the significance of this development for patients and the nursing profession.     

Parent knowledge and opinions of school health services in an urban public school system

Health services, provided through schools for more than 100 years, increasingly have expanded to meet preventive as well as acute health care needs of children. This article reports on a survey of parents of third-grade children in an urban public school system. The authors examined what parents know about school health services, what value they place on the services, and what barriers exist to health care access. Results indicated parents place a high value on health services offered in schools, but they know little about service availability and use. Parents often were unaware their children received many of the services listed, such as review of school health records, vision and hearing screening, and health education by school nurses.     

The graphical user interface

The systems are getting better, but they are not perfect yet. With physicians, health information managers, nurses, and software engineers working together to more accurately define what these systems can do, should do, and will do, better and even more elegant GUIs will be developed.     

Nursing in Bangladesh: rhetoric and reality

In the past decade concern has been raised through independent channels that nurses in Bangladesh do not provide active hands on care directly to patients as envisioned when the British nursing model was first introduced decades ago. The objective of the study was to observe the activities nurses engaged in during their working hours on major medical and surgical wards. A total of 24,587 min of nursing activities were recorded by three observers in 18 hospitals between the hours of 05.00 and 23.00 h over a 3 month period. These were compared with reports of the nurses about their activities, and indirectly with the activities outlined in the nursing curriculum. Nurses in government hospitals spent only 5.3% of their working time in direct contact with their patients. Paperwork and indirect patient care occupied nurses for 32.4% of their time while 50.1% fell under the category of unproductive time such as time away from the ward and chatting with other nurses. Hospital support workers and patients' relatives acted as nurse surrogates. When asked how they spent their day, nurses reported what the curriculum specifies but not what was observed. As a consequence policy decisions have not consistently reflected this reality. By contrast, nurses in the hospitals outside the government system were found to spend 22.7% directly with patients. A deeper understanding of nurse's behaviour on the wards is required to determine the desired role of the nurse that will, in turn, feed into nursing policy and decisions related to resource allocation.     

Children with diabetes: perceptions of supports for self-management at school

Diabetes affects many children. Researchers know little about children's perceptions of what type of support they need at school, which was a focus of this study. Group interviews and surveys examined children's perceptions of support in caring for their diabetes (type I diabetes) from school nurses, teachers, and friends. Results indicated the children felt supported at school, but improved flexibility by teachers and nurses (e.g., let me keep my meter with me always) and individualized care plans may improve their ability to manage their diabetes at school. Participating in after-school activities may be difficult for middle school youth. Children reported they needed additional help and support to cope with hypoglycemic episodes.     

Interdisciplinary expectations of the medical social worker in the hospital setting.

Nearly 500 physicians, nurses, and social workers affiliated with four general hospitals participated in a mailed questionnaire survey designed to compare interprofessional expectations of the medical social worker role in the hospital. As hypothesized, physicians and nurses expect the exclusive role of the social worker to be more limited to working with families, resolving social-environmental problems, and providing referrals than social workers expect of their role. In general, physicians and nurses do not disagree with medical social workers on what social workers expect to do in the hospital setting; rather, they disagree more on what social workers expect to be their exclusive role. Furthermore, it does not appear that other groups discredit either the biopsychosocial health care model or social worker competency. Instead, these groups perceive the special focus of the medical social worker in the hospital as enhancing the environmental support and resources of the patient, viewing the patient's family as part of that support system. These other groups may not understand or accept the person-in-environment focus of social work.     

Nurse retention strategies: advice from experienced registered nurses.

PURPOSE: The purpose of the paper is to explore the insights of experienced nurses regarding initiatives they believe would effectively retain nurses like themselves in the nursing profession. DESIGN/METHODOLOGY/APPROACH: As part of a qualitative investigation into the perceptions of nurses regarding issues affecting their profession, experienced nurses were asked to describe what retention strategies they would recommend to policy-makers. A total of 16 semi-structured interviews were conducted with long-term nurses in a health region in western Canada. FINDINGS: The paper found that seven retention strategies were commonly mentioned by the participants. The qualitative mode of inquiry allowed the nurses to convey the context, attitudes and feelings behind their recommendations. RESEARCH LIMITATIONS/IMPLICATIONS: The work environments and accompanying retention policies experienced by nurses vary widely according to the specific employment context As is typical with qualitative research, the findings of this study cannot be considered as generalizable to all nurses in all health care settings. PRACTICAL IMPLICATIONS: The results of this paper provide a deeper understanding of the attitudes, emotions and contextual issues behind the nurse retention strategies seen as most appropriate by the target audience of long-term nurses. ORIGINALITY/VALUE: While there is much literature advocating the implementation of nurse retention strategies, very little evidence has been presented from a qualitative lens. It is necessary to directly listen to the voices of those impacted by policies in order to better appreciate how such policies are perceived from a bottom-up perspective.     

Social representations of nurses on the integral care available to women through Brazil's basic healthcare network

Brazil's Basic Healthcare Act establishes the principle of integral care in terms of networking between services and professional practices, to which we add a dimension: the configuration of public policies. Nurses were selected for this survey as they handle the initial contacts with women and also because we believe they are endowed with an across-the-board view of integral care during the various phases in the lives of this population. This paper examines the social representations of nurses on the scope of the integral care available to women through Brazil's Basic Healthcare Network, explored through qualitative interviews with ten nurses in Mato Grosso do Sul State. These data were analyzed through the Collective Subject Discourse (CSD) approach, based on the Theory of Social Representations. The findings are presented in seven Collective Subject Discourses that describe the main ideas identified during the interviews. This leads to the conclusion that nurses have a fragmented view of women's healthcare, still guided by physical complaints; they cannot define integral care, repeating the discourse of the holistic approach without understanding what this really means; they work on an individualized basis, feeling that this area is not structured to offer integral care.