Accountability in nursing: reflecting on ethical codes and professional standards of nursing practice from a global perspective

The concept of accountability is a concept closely aligned with public trust and confidence with a healthcare discipline. It is of vital importance to the discipline of nursing to define and examine the obligations and duties of professional nurse. The term is referred to and often defined through international and national professional codes of nursing and in standards of nursing practice documents. This column will begin exploration of the concept with offering a definition from a humanbecoming perspective.     

Connections and lingering presence as cocreated art

Parse described nursing practice as a performing art where the nurse is like a dancer. Just as in any dance performance, unplanned events may occur. When a nurse is artistically living, unique and meaningful performances might emerge from unplanned events. In this practice column, the author describes how shifting experiences surfaced with unforeseen connections and lingering presence during her study of feeling confined. In her study she was in true presence with men living in prison, who were diagnosed with severe mental illness. The humanbecoming school of thought was the nursing perspective guiding the research study.     

An ethical exploration of quality and safety initiatives in nurse practice

Current professional healthcare literature is filled with the call for quality and safety initiatives in the provision of healthcare. The popular media frequently reports on the need for healthcare reform and the need for cost-saving measures as healthcare costs skyrocket. Reported medical and nurse errors are on the rise and the discipline of nursing is responding to the call with interprofessional quality and safety initiatives that are intended to reduce errors and promote safety in cross-disciplinary healthcare practices. This column begins an ethical exploration on the topic from a humanbecoming theoretical perspective regarding the need for theory-guided nurse practice and possible meanings and implications for future disciplinary nurse practice.     

What Is Not Yet: cultivating the imagination

In this column, the author describes imaginative capacities that encourage imaginative thinking and creating anew. Concepts from the nursing theory of humanbecoming are presented to further explore the applicability of focusing on cultivating the imagination in nursing curricula. A nursing seminar is proposed, entitled What Is Not Yet, that could foster the creative potential of nurse leaders.     

Using Parse's humanbecoming theory in Japan

In this paper the authors discuss the use of Parse's humanbecoming theory in Japan. Elements of the theory are used in the nursing approach to an 88 year-old Japanese man who had complications following surgery. Process recordings of the dialogues between the patient, the patient's wife, and the nurse were made and considered in light of the three methodologies of Parse's theory; illuminating meaning, synchronizing rhythms, and mobilizing transcendence. The theory is seen as useful in Japan.     

Teaching-learning in community: the metaphor of nurse as guest

Metaphors are creative learning devices that may illustrate novel and different meanings in teaching-learning situations. In this column, the author discusses possible meanings of the metaphor of nurse as guest in nurse-community relationships from a humanbecoming theoretical lens. Humanbecoming teaching-learning essences, paradoxes, and processes are used to illustrate potential ethical meanings and implications for nurse practice.     

Cultivating a culture of research in nursing through a journal club for leaders: A pilot study

Aim

To describe whether an action learning‐inspired journal club for nurse leaders can develop the leaders' self‐perceived competences to support a research culture in clinical nursing practice.

Background

Development of clinical research capacity and nurse leaders with the requisite competences are key factors in evidence‐based health care practice. This study describes how nurse leaders at a large regional hospital took part in a journal club for nurse leaders, with a view to developing their competences to support a nursing research culture in their departments.

Methods

A pilot study using a multimethod approach to evaluate the journal club for nurse leaders. Four nurse leaders participated in the journal club for nurse leaders. Content analysis on the data was performed.

Results

Data revealed that participation in journal club for nurse leaders gave the leaders a feeling of increased competences to support nursing research culture in their departments. They stated that the action learning approach and the competences of the facilitator were key factors in this outcome.

Conclusions

An action learning‐inspired journal club for nurse leaders can be useful and meaningful to nurse leaders in developing leadership competences.

Implications for nursing management

As an approach in journal club for nurse leaders, action learning can develop nurse leaders' competence to support a research culture, and thus ensure evidence‐based nursing is practised.     

Clinical coaching: a strategy for enhancing evidence-based nursing practice

PURPOSE: The purpose of this article is to describe how clinical nurse specialists can promote the development of knowledge and skills in nurses as one step toward making evidence-based nursing practice the norm in all patient care settings. BACKGROUND: The need for the use of evidence in nursing practice has been highlighted for several decades. Moving evidence more quickly into practice requires that nursing use many strategies. DESCRIPTION OF STRATEGY: The strategy of clinical coaching is proposed in this article for the development of skills in nurses specifically to promote evidence-based nursing practice. Clinical coaching is a relationship for the purpose of building skills. This strategy is aimed at increasing foundational staff nurse knowledge and skills. CONCLUSION: The achievement and maintenance of evidence-based nursing practice take continuous attention from clinical nurse specialists. Clinical coaching is only one part of a comprehensive approach for establishing and sustaining evidence-based nursing practice.     

The genesis of a phenomenological approach to advanced nursing practice

This paper describes how participation, as a co-investigator, in a phenomenological study of the high-risk perinatal experience led to the development of a new approach to advanced nursing practice for a maternity clinical nurse specialist Prior to implementation of the study, nursing was practised based in a structured, conceptual framework, but, as a result of conducting interviews with study subjects, analysing data with a research team and gaining a better understanding of the high-risk perinatal experience, a new style of nursing practice based in a phenomenological approach emerged, which permeated all aspects of clinical nurse specialist practice     

Practicing women's health with a simultaneity worldview in a medical model world

Practicing from a humanbecoming perspective is challenging and rewarding for the nurse clinician. In this column, the author discusses the challenges faced when working as a women's health nurse practitioner, with a simultaneity worldview, in a medical model world.     

Human dignity: a cornerstone of doctoral education in nursing

Human dignity is foundational to nursing ethics in both the practice and educational arena. It is implicitly and explicitly woven throughout all ethical dialogue. This column offers insight into the ubiquitous nature of human dignity as it surfaced during a doctoral level ethics course. These examples are shared in light of the humanbecoming human dignity ethical tenets: reverence, awe, betrayal, and shame. The prevalence of dignity in ethical discussion serves as a reminder for nurses to carve out time for meaningful discussions regarding its importance to the nursing profession as a whole.     

Undergraduate psychiatric nursing education at the crossroads in Ireland. The generalist vs. specialist approach: towards a common foundation

This paper provides a critical overview of undergraduate educational preparation for psychiatric nursing and proposes the use of a model, which may equip psychiatric nurses to adapt to current and future directions in psychiatric nursing practice. It contends that mental health nursing is a distinct scope of practice and as such requires specialty undergraduate education. A major difference between educational preparation for psychiatric nursing in the Republic of Ireland and the UK, and distinct from most other developed countries, is the existence of separate, specialized pre-registration programmes that, upon graduation, allow the nurse to register as a psychiatric nurse. In other countries such as, Australia, the integration of pre-registration nurse education into the university sector resulted in the wide-scale adoption of a generalist approach to nurse education. In light of the recent changes in pre-registration nursing education in Ireland, and the integration of nursing into higher-level education, this paper examines the generalist vs. specialist approach to nurse education. It contends that neither the generalist nor the specialist model best serve the nursing profession in preparing safe and competent practitioners. Rather, it argues that the use of a model which incorporates both generalist and specialist perspectives will help to redress the imbalance inherent in both of the existing approaches and promote a sense of unity in the profession without sacrificing the real strengths of specialization. Such a model will also facilitate psychiatric nurses to adapt to current and future directions in psychiatric nursing practice.     

Nurse teachers' attitudes to research: a phenomenological study

This research project looks at nurse teachers' attitudes to research. It addresses the question of how nurse teachers view their responsibilities and abilities to promote nursing research. The requirement for nursing practice to be founded upon a firm basis of research is increasing. It may be argued that nurse teachers are highly influential and may provide the linchpin to the future of nursing research in the clinical environment. This research, using a phenomenological approach, attempts to reveal what nurse teachers think and feel about their role in research.     

The ethics of nurse migration: an evolution of community change

International nursing migration, or the movement of people across international boundaries, has enormous implications for the discipline of nursing. This column focuses on ethical assumptions and possible implications for community change as individual or group. Discussion follows with the illumination of community change paradoxes, implications for policy development, nursing education, and nursing practice from the nursing theoretical perspective of the humanbecoming school of thought.     

Acting faithfully in community

The phenomenon of acting faithfully in the nurse-person relationship is an important ethical topic of interest to the discipline of nursing. It may also be conceptually defined and illuminated in nurse-community relationships. This column begins an articulation of what it potentially means to have straight thinking about nurses' obligations with persons in community. The language of nurse science from the humanbecoming school of thought will be used to explore the phenomenon.     

Evidence-based nursing in clinical practice: implications for nurse educators

To improve patient outcomes currently and in the future, it is important that an evidence-based approach to nursing care be incorporated into clinical practice settings. Nurse educators and clinical nurse educators have a mandate to model and facilitate evidence-based nursing through learning activities. Unfortunately, issues present within clinical practice settings have made this approach difficult for registered nurses to fully incorporate into practice. This article outlines issues inhibiting evidence-based nursing, such as time factors, access to information and resources, nurses' research knowledge, skills, and learning opportunities, and the current nursing culture. Strategies for change that can be used by clinical nurse educators to enhance the use of evidence-based nursing in clinical practice areas are also described.     

Moral learning in nursing education: a discussion of the usefulness of cognitive-developmental and social learning theories

The preparation of students for ethically sound practice is an essential concern for nurse educators. The theories of cognitive development and social learning theory are discussed as explanations of moral learning. The implications of the application of each of these theories to nursing education are discussed and the usefulness of each theory to nurse educators is reviewed. It is argued that neither theory is entirely satisfactory for application to nursing education and it is concluded that a pragmatic eclecticism is desirable in the approach to moral education in nursing.     

Development of a critical care nursing research strategy: a tripartite approach

The building of nursing research capacity is important, as it improves the quality of nurse education, the talent of nurses and the standard of patient care. A local critical care nursing research strategy was developed using a tripartite model applied to practice. This was a collaborative approach to critical care research as a model to direct, deliver, facilitate and support nursing research in practice through planned and protected investment in nursing research time. The tripartite model was evaluated and recommendations made with the aim of sharing findings so that other nurses can utilize these experiences to set up similar secondment opportunities for the promotion of nursing research.     

New graduate RNs in a float pool. An inner-city hospital experience

Nurse managers and nurse educators alike have historically discouraged hiring new graduate RNs into a float pool and have preferred experienced nurses with multiple clinical skills. With a nursing shortage and changing marketplace, we need different strategies for recruitment and retention and ways to improve our clinical practice. A new graduate RN offers a nursing service an opportunity to employ a motivated, ready-to-learn, educationally prepared and intellectually stimulated nurse who happens to have limited clinical experience. The authors present a program for training new graduate RNs to practice nursing in a float pool. The training program focuses on their clinical practice needs and on transitioning them to the RN role. This program resulted in a 96% retention rate. The program offered our medical surgical units a strong clinical support float nurse, our managers a staffing solution in times of need, and the new graduate RN a broad range of clinical experiences making them more valuable members of the healthcare team. This training model is one approach to increasing recruitment and retention and can be replicated in other institutions.