The role of the enrolled nursing auxiliary in a selected health care administration

The purpose of the study was to determine the contribution of nursing auxiliaries towards health care services, against their scope of practice. The sample consisted of nursing auxiliaries in the Gazankulu area, in the Northern Transvaal. The findings revealed that nursing auxiliaries are presently an essential component of nursing services rendered in Gazankulu, but that apart from their prescribed role, they are also engaged in activities which should be performed by enrolled and professional nurses, and general assistants. A need for education is apparent for all categories of nursing staff regarding the scope of practice of nursing auxiliaries.     

Organizational support in the recruitment and transition of overseas‐qualified nurses: Lessons learnt from a study tour

The migration of nurses has been a global phenomenon, and the integration of overseas‐qualified nurses within host countries has led to debate worldwide. Evidence suggests that support provided by organizations can vary and that there is minimal information on the nature and extent of organizational support required to enhance a smooth transition of overseas‐qualified nurses into nursing practice. This explorative study tour examined the organizational support provided to enhance overseas‐qualified nurses' transition into the nursing workforce in two countries. The various support mechanisms provided to overseas‐qualified nurses in different organizations include transition, acculturation, mentoring programs, and initial settlement assistance. The successful transition of overseas‐qualified nurses into a host country is a complex issue. A robust support system for these nurses should be based on ethical considerations and a team approach that is linked to strong leadership. In addition, education and support for existing staff is essential for a successful transition of overseas‐qualified nurses into practice. Lessons learnt from this study tour might also be relevant to the transition of other overseas‐qualified health professionals, such as doctors and allied health professionals, in host countries.     

Retaining a viable workforce: a critical challenge for nursing

Nursing is facing a crisis nationally and internationall, with Australia, the United States, New Zealand, Canada, the United Kingdom and Western Europe experiencing critical shortages of nurses. Problems with recruitment, retention and an ageing workforce means that attempts to ensure a viable nursing workforce must be placed at the top of the professional agenda. Strategies currently used to manage the crisis, such as overseas recruitment, are not sustainable and are ethically dubious. The demographic timebomb is ticking and up to half the current nursing workforce will reach retirement age by 2020. It is vital that there are adequate numbers of skilled and qualified nurses to take their places. Nursing and nurses are facing unprecedented challenges and pressures in the workplace. Job satisfaction is threatened as nurses are pressured to do more with less, Nursing productivity has increased phenomenally over the past ten years in response to increased demands and decreasing numbers of staff. The nursing workplace has disturbingly high levels of occupational violence, and many nurses operate within a culture of blame and scapegoating. There is evidence that organizational change is imposed upon nurses with little or no consultation and the literature reveals that this has a direct and negative effect on job satisfaction and on retention of nurses. This paper explores some of the critical issues that nursing must confront to be successful in establishing and maintaining a vigorous, dynamic and viable workforce.     

Staffing in acute hospital wards: part 1. The relationship between number of nurses and ward organizational environment

This paper is one of two that explores relationships between nursing staff resources, ward organizational practice and nurses' perceptions of ward environments. Here we examine relationships between staff numbers, care organization and nursing practice. A subsequent paper examines the effects of grade mix and staff stability. The data were collected in the mid-1990s from a nationally representative sample of 100 acute hospital wards and 825 nurses. Our analyses provide important insights for managers seeking to achieve the strategic aims set out in Working Together, and subsequent National Health Service (NHS) policy placing emphasis on making the best use of nurses, focussing on mobilising their knowledge, skills and talents within the context of extended work roles. Findings show that number of nurses is associated not only with ward organizational systems but also with a range of care processes and staff outcomes which hitherto have been linked only to ward organizational systems. The latter have been identified as providing different opportunities for developing multidisciplinary working and nurses' autonomy but the central importance of having an adequate number of staff to achieve these aims has been largely overlooked in research. Having fewer nurses was associated with both hierarchical ward organizational structures and hierarchical attitudes to care provision, denoting lower standards of nursing practice. A larger nursing complement was significantly associated with devolved organizational structures but no link was established between more staff and higher standards of nursing practice. When there were more staff there was a positive association with nurses' perceptions of multidisciplinary collaboration, their ability to cope with workload and job satisfaction. Employing an adequate number of nurses to provide care is clearly beneficial for nurses themselves. Patients are also likely to benefit from a lower incidence of 'hierarchical practice' associated with having a low nurse/bed ratio within a ward.     

感动式护理工作模式在优质护理服务中的应用

目的优化护理人员梯队合作,深化优质护理内涵,提高患者满意度。方法构建肝胆外科感动式护理工作模式。结果护士对感动式护理工作模式反馈量表认同率为85．5％;实施前后在特护、一级、基础护理检查得分[（91．86±1．64）比（98．00±0．97）分],患者满意度与调查信回复率（20．0％比50．0％）,护士观察病情、沟通及急救能力考核合格率（60．0％比90．O％）方面比较,差异有统计学意义（t=14．56;X2分别为22．82,8．10;P〈0．01）。结论感动式护理工作模式以患者为中心,提高了患者满意度,同时使护士工作能力得到全面提升,团队协作能力得到加强,护士层次使用得到很好的体现,深化了优质护理的内涵。     

Challenges for Australian nursing in the International Year of Older Persons

Some of the major issues challenging gerontic nursing in Australia are addressed in this article. The broad context of change that has been introduced by successive Australian governments is presented briefly. The problems of attracting and keeping qualified nurses in aged care exacerbated by a trend toward employers actively seeking to replace qualified nurses with unregulated staff are discussed. Education and work practice changes are proposed as minimum responses required from nursing if the profession is to remain relevant and central to aged care into the 21st century.     

The nursing auxiliary service and the care of elderly patients

Although nurse auxiliaries comprise a large and rapidly expanding part of the district nursing service, nursing research has largely neglected this group of nurses and the people they see. Using a patient-centred approach, which is a key element of the research, we studied the characteristics of patients who were either physically handicapped, frail elderly or elderly mentally infirm, who make up a large majority of the patients. We found that auxiliaries' patients fell into a typical 'at risk' group; they were older and more likely to be living alone than qualified nurses' patients, and yet they received less frequent visits. Motives for providing and continuing the service to patients were not always related to nursing need, and while recipients were grateful for the service, both they and auxiliaries themselves identified areas of potential improvement. The need to continue to monitor and improve the overall quality, effectiveness and efficiency of the service to patients and potential patients, demands that practitioners, managers and researchers systematically review referral to the service and the work of the nurse auxiliary using a patient-focused approach.     

监控视频回放法在手术室护理质量管理中的应用效果

目的探讨监控视频回放法在手术室护理质量管理中的应用效果。方法选择2018年1—12月我院手术室一线护士85名,利用监控视频回放法,截取护理人员在手术室工作中的缺陷片段,进行问题的总结反馈以及原因分析,同时加强核心制度的学习。比较实施该方法前后手术室护士护理质量合格率。结果实施监控视频回放法后护理人员的手卫生、安全核查、物品清点合格率均高于监控视频回放前(P<0.05)。结论监控视频回放法提高了护理质量合格率,有利于促进护理质量的持续改进,规范护理人员的工作流程,促进全员参与质量控制,从而有利于临床护理质量整体提升。     

Primary nursing: opinions of nursing staff before and during implementation

The aim of this investigation was to consider the opinions of the nursing staff concerning the effects of primary nursing before and after the transition to this mode. Data were collected using a self-administered questionnaire which was answered by 62 registered nurses and practical nurses before the introduction of primary nursing and 58 such nurses five months after its introduction. The nursing staff reported both more favourable and detrimental effects during primary nursing than beforehand, the former including the improved opportunities for nurses to get to know their patients and to provide individual care, and the latter the increase in paperwork. The role of the primary nurse was mainly felt to be positive, but sometimes difficult and laborious.     

优质护理服务示范病房不同学历、职称、工作年限护理人员工作现状调查分析

目的:调查山东省三级综合性医院优质护理服务示范病房不同学历、职称、工作年限护理人员工作现状。方法:采用问卷调查法,对山东省6所三级医院优质护理服务示范病房546名护士工作现状进行调查。结果:优质护理服务示范病房护理工作的主力是大专学历、初级职称及工作年限1～3年的护士,夜班护理工作主要由大专学历、护士职称及工作年限1～3年的护士承担;不同学历、职称、工作年限护士从事各护理项目有所侧重,差异有统计学意义(P<0.001),但均从事所有工作项目。结论:不同学历、职称、工作年限护士任职标准、岗位职责不明确,应构建合理的优质护理服务示范病房护理人员能级体系,确保护理质量的持续改进。     

Congruence of perceptions among nursing leaders and staff regarding missed nursing care and teamwork

The objective of this study was to test the congruence of the perceptions of unit-based nurse leaders (managers, advanced practice nurses) and nursing staff members (registered nurses, nursing assistants, unit secretaries) in acute care hospitals as to the extent and type of missed nursing care and nursing teamwork. Based on the leader-member exchange congruence framework (LMX), nursing staff and nursing leaders completed the MISSCARE Survey, and a segment of the participants completed the Nursing Teamwork Survey. The findings of this study show a lack of LMX congruence between leaders and nursing staff members. Nursing staff report less missed care and lower teamwork than do leaders, and nursing staff list more problems with having adequate material and labor resources than do leaders. LMX congruence has been associated with positive organizational outcomes.     

Gynaecological nursing

This paper shows how gynaecological nursing is perceived by nurses working in this specialism. To gain an emic perspective a qualitative study was conducted with 12 qualified nurses working in a gynaecological unit. Data were obtained by means of in-depth interviews and the use of paradigmatic cases. Analysis showed the nurses to identify many aspects to their work that could be shared with nursing in general. However, the specific nature of gynaecological nursing indicated a special focus on interpersonal work related to the private and sensitive nature of gynaecological disorders, with social, psychological and emotional implications for sexuality, reproduction, future life and relationships.     

Developing a career pathway within community nursing

There has been much anxiety regarding the levels of competence and confidence of newly qualified nurses. This article will describe the developments within one primary care trust of newly qualified student nurses through to the development of a robust career pathway. Within this PCT previous recruitment into community nursing posts had been unpredictable and some newly qualified nurses had found the transition from pre-registration to qualified nurse within primary care very difficult, often choosing to pursue an alternative career pathway. This resulted in a high turn over of staff. It therefore became imperative that the organization reviewed not only its placement experience but ensured a robust comprehensive career pathway that supported and mapped out for nurses the clinical experience they could expect and support continuing professional development.     

护士组织支持感与组织支持需求的调查

目的了解护士组织支持感现状及护士对组织支持的需求情况,为提高护士组织支持感提供理论依据。方法采用组织支持感量表,对山西省5所三级甲等医院的442名护士的护士组织支持感与组织支持需求进行调查。结果护士组织支持感得分为（2.900±0.770）分,护士对组织支持需求得分为（4.359±0.607）分。护士组织支持感与组织支持需求在情感性支持、工具性支持及总分上比较,差异具有统计学意义（均P〈0.001）。不同医院护士组织支持感比较,差异具有统计学意义（P〈0.01）。同一医院护士组织支持感与组织支持需求比较,差异具有统计学意义（均P〈0.001）。护士对组织支持需求排在前3位为医院关心我的福利、医院重视我的贡献和当我在工作中遇到困难时医院尽力帮助我。结论护士组织支持感水平相对较低,护士对组织支持的需求非常强烈。医院应采取各种对策,提高护士组织支持感,从而调动护士工作积极性,促进护理工作的发展。     

Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses.

BACKGROUND: High levels of stress and the challenges of meeting the complex needs of critically ill children and their families can threaten job satisfaction and cause turnover in nurses. OBJECTIVE: To explore the influences of nurses' attributes, unit characteristics, and elements of the work environment on the job satisfaction of nurses in pediatric critical care units and to determine stressors that are unique to nurses working in pediatric critical care. METHOD: A cross-sectional survey design was used. The sample consisted of 1973 staff nurses in pediatric critical care units in 65 institutions in the United States and Canada. The following variables were measured: nurses' perceptions of group cohesion, job stress, nurse-physician collaboration, nursing leadership, professional job satisfaction, and organizational work satisfaction. RESULTS: Significant associations (r = -0.37 to r = -0.56) were found between job stress and group cohesion, professional job satisfaction, nurse-physician collaboration, nursing leadership behaviors, and organizational work satisfaction. Organizational work satisfaction was positively correlated (r = 0.35 to r = 0.56) with group cohesion, professional job satisfaction, nurse-physician collaboration, and nursing leadership behaviors. Job stress, group cohesion, job satisfaction, nurse-physician collaboration, and nursing leadership behaviors explained 52% of the variance in organizational work satisfaction. Dealing with patients' families was the most frequently cited job stressor. CONCLUSIONS: Job stress and nursing leadership are the most influential variables in the explanation of job satisfaction. Retention efforts targeted toward management strategies that empower staff to provide quality care along with focal interventions related to the diminishment of stress caused by nurse-family interactions are warranted.     

A study of nurses'' attitudes towards associate degree nursing students

The purpose of this study was to examine the attitudes of staff nurses towards associate degree (AD) nursing students. The null hypothesis stated there will be no significant difference in the attitudes of staff nurses towards AD nursing students and associated concepts (nursing education, patient, physician, work, nurse.) The staff nurse's value as a role model is held in high regard yet little regard is given to her attitudes towards students. Through better understanding of staff nurses' attitudes, nurse educators can better plan, develop and coordinate clinical activities to provide an optimum learning environment. The findings showed the concept AD nursing student was significantly different from the rest, indicating a less positive attitude towards the AD nursing student than the related concepts. Implications for nursing practice are threefold. Nurse administrators must create an atmosphere and a philosophy which support the educational process within their institution, and recognize nurses' attitudes towards students. Practising nurses should examine their attitudes and willingness to work with students if their hospital offers their agency as a clinical facility. Educators must look closely at the units they assign students to, continually maintaining the lines of communication between staff nurses and clinical instructors. As service and education work together a quality environment can be provided in which there is optimum learning for the student. Both groups then contribute to the future of professional nursing.     

A pilot study of the prevalence and psychological sequelae of sexual harassment of nursing staff

Summary

• ? A pilot study of nurses and nursing auxiliaries was carried out to determine the prevalence and psychological sequelae of sexual harassment.
• ? Thirteen nurses and 22 nursing auxiliaries were interviewed.
• ? Sixty per cent reported having experienced sexual harassment on at least one occasion.
• ? The results showed that the predominant experience typically occurred:

• – to female nursing staff;
• – by male patients;
• – on the wards;
• – often while washing patients.

• ? There was minimal reporting of the incident.
• ? The overriding emotion felt was embarrassment which was perceived as resulting in impaired work performance.

     

Job satisfaction in psychiatric nursing

In recent years, mental health services across Europe have undergone major organizational change with a move from institutional to community care. In such a context, the impact of change on the job satisfaction of psychiatric nurses has received little attention in the literature. This paper reports on the job satisfaction of psychiatric nurses and data were collected in 2003. The population of qualified psychiatric nurses (n = 800) working in a defined geographical health board area was surveyed. Methodological triangulation with a between-methods approach was used in the study. Data were collected on job satisfaction using a questionnaire adopted from the Occupational Stress Indicator. A response rate of 346 (43%) was obtained. Focus groups were used to collect qualitative data. Factors influencing levels of job satisfaction predominantly related to the nurses work location. Other factors influencing job satisfaction included choice of work location, work routine, off duty/staff allocation arrangements, teamwork and working environment. The results of the study highlight to employers of psychiatric nurses the importance of work location, including the value of facilitating staff with choices in their working environment, which may influence the recruitment and retention of nurses in mental health services.