Ideas of caring in nursing practice

In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses can use self‐reflection to create an awareness of nursing, caring and ethical inner values in caring.     

Evidence-based practice and the management of risk in nursing

This paper examines how nurses manage research evidence of risk in practice policy. Groups of specialist nurses were observed during the construction of consensus guidelines for three common nursing tasks. The process of interpreting and using research evidence included perceiving and prioritizing outcomes, evaluating their likely impact for patients and staff, and determining an acceptable balance of risk, cost and benefit for multiple contexts and stakeholder groups. The study illustrates some of the unarticulated rules of risk management in nursing, which were powerful mediators in the uptake and interpretation of research. The implications of these frames of reference are discussed in relation to the promotion of evidence-based nursing practice.     

Representations of nursing history in the current daily practice

This study presents a historical analyses on the links between the nursing practice and the influence which it receives from various religious orders/asssociations throughout the times. The professional nursing which was pioneered by Florence Nightingale in the XIXth century, was influenced directly by the teachings of love and fraternity. In addition, other contributions from the religious orders/associations were the concepts of altruism, the positive value of an adequate environment for the care of patients, and the division of work in nursing.     

Physician practice patterns in nursing homes

This review of the literature describes models of physician practice in nursing homes including the barriers to increasing physician workforce in nursing homes and the impact of various physician practice models on quality of care in nursing homes. Traditional nursing home practice is first described followed by a review of the literature pertaining to nurse practitioners and physician assistants in nursing home practices, closed staffing models, managed care, and nursing home specialist models. Literature describing barriers to increasing the physician workforce in nursing homes is then presented including training, reimbursement, and malpractice insurance for physicians who work in nursing homes. Finally, the impact of physician practice models on quality of care is reviewed with a focus on frequency of visits, hospitalizations, cost-effectiveness, communication, and patient satisfaction.     

Opportunities for advance practice nurses in the nursing facility

Advance practice nurses (APNs) have emerged as valuable members of the nursing facility interdisciplinary team. They function in a variety of roles, including clinical care, administration, nursing consultation, and education. Positive outcomes in key indicators of care and reduction in costs to the healthcare systems have been attributed to their practice. Barriers to implementation of the role include regulatory issues, facility resistance, and difficulty adapting to the environment. Facilitation of the role is enhanced by collegial relationships and role negotiation. There is strength in the APN-physician collaborative model. The APN is likely to concentrate on prevention, restoration, maintenance, and palliative care, allowing the physician to concentrate on complex medical problems. There is a need for APN practices to identify APN-sensitive outcomes, collect and analyze data, and disseminate findings.     

Transforming nursing practice: clinical systems and the nursing unit of the future

The healthcare industry has historically focused information system expenditures on financial systems. Finally, enabling the practice of clinicians through information systems is beginning to be viewed as a strategic initiative for hospitals and health systems. Vendor applications are now better able to support clinician workflow. Infrastructure is better able to support mobile devices, which bring information to the bedside. Implementation of nursing applications provides a unique opportunity to redesign inefficient and redundant documentation, thereby enabling greater efficiency. Healthcare organizations can jump-start nursing automation by setting a finite and clear tactical plan for initiatives to be rolled out within a year in a single location. The single location enables the organization to experience how well the initiatives integrate to support optimal delivery of care. This article explores nursing information technology initiatives planned to be deployed at a 1,000-bed teaching facility through the use of a Nursing Unit of the Future.     

Alasdair MacIntyre and the professional practice of nursing

Abstract In his attempt to explain and draw together disparate aspects of the tradition of the virtues MacIntyre develops a complex and specific concept that he terms a practice. By a practice he means to describe certain types of activities in which excellences can be pursued and that offer those engaged in a practice access to the goods internal to that practice. Sellman and Wainwright have both suggested that there are advantages to be had in understanding nursing as a practice in this MacIntyrean sense. This paper suggests that nursing should be considered as a particular type of MacIntyrean practice, and I have used the term a professional practice to identify this species. This paper also considers some of the implications of such a perspective and suggests that one benefit of thinking of nursing as a professional practice is that it may offer a route by which the virtues necessary for nursing can be identified.