Living with grey: role understandings between clinical nurse educators and advanced practice nurses

Professionalization efforts in nursing have opened up new opportunities for nurses to develop the roles in which they work. One of these roles is advanced nursing practice. However, the development of the advanced roles, with their aims of making an advanced contribution in education, administration, research and practice, results in role overlap and confusion. This paper presents the findings of a qualitative study that explored the ways in which nursing educators understand, value, utilize and interact with nurses in the advanced practice role. Data were collected among nurse educators and advanced nurse practitioners in an urban, acute care setting. The findings demonstrate how nurses in potentially conflicting roles differentiate themselves and define their job duties. Organizational supports for implementing clear advanced roles are suggested, adding to the knowledge upon which nursing administrators can base their strategic human resources decisions.     

Expanding educational opportunities in disaster response and emergency preparedness for nurses

The past few years have witnessed a dramatic increase in the number of large-scale disaster events and the ubiquitous threat of weapons of mass destruction. These events have heightened recognition of the role of the nurse in disaster management and response. Enhanced capacity to respond to disasters and other public health emergencies will require a nursing workforce that is clinically experienced and possesses the knowledge and skills necessary to respond with confidence and authority. This article reports on how American schools of nursing have begun to address the challenge of workforce development and nurse preparedness. The University of Rochester Leadership in Health Care Systems in Disaster Response and Emergency Preparedness Program is described in detail.     

Competency standards and educational requirements for specialist breast nurses in Australia

There is substantial evidence that Specialist Breast Nurses (SBNs) make an important contribution to improved outcomes for women with breast cancer, by providing information and support and promoting continuity of care. However, a recent study has identified significant variation in how the role functions across individual nurses and settings, which is likely to contribute to varied outcomes for women with breast cancer. The project reported in this paper illustrates how a set of competency standards for SBNs were developed by the National Breast Cancer Centre. The competency standards were developed through a review of published literature and consultation with key stakeholders. The resulting SBN Competency Standards reflect the core domains and elements of SBN practice seen as integral to achieving optimal outcomes for women with breast cancer. This project identifies the SBN as a registered nurse who applies advanced knowledge of the health needs, preferences and circumstances of women with breast cancer to optimise the individual's health and well-being at various phases across the continuum of care, including diagnosis, treatment, rehabilitation, follow-up and palliative care. The five core domains of practice identified are: Supportive care; Collaborative care; Coordinated care; Information provision and education; and Clinical leadership. A variety of education programs are currently available for nurses who wish to learn about breast cancer nursing. The majority of stakeholders consulted in this project agreed that a Graduate Diploma level of education is required at minimum in order for an SBN to develop the minimum level of competence required to perform the role. The evidence supports the view that as an advanced role, nurses practising as SBNs require high-quality programs of sufficient depth and scope to achieve the required level of competence.     

New opportunities for nurses as patient advocates

OBJECTIVES: To define the role of nurses as patient advocates and to explore new strategies for the future. DATA SOURCES: Review articles, research studies, education and communications materials, and personal experience with oncology professionals, patients, and family members. CONCLUSIONS: Cancer nurses' roles in patient advocacy have progressed and grown as the profession of oncology nursing has itself matured. As resources continue to diminish, nurses need to consider the power of their roles as change agents, coordinators, and directors as well as interventionists. IMPLICATIONS FOR NURSING PRACTICE: There are many needs for research in this area as well as new roles for nurses who care for patients. Nurses need to be aware of ongoing research in areas such as health communications and consider partnering with persons in these other disciplines to enhance productivity and to use their time most efficiently.     

Voluntary assisted dying in Australia and New Zealand: Exploring the potential for nurse practitioners to assess eligibility

BackgroundThe enactment of laws that permit voluntary assisted dying reflects community views about end-of-life choices for those who are suffering and dying and includes a commitment to equitable access. Australian and New Zealand voluntary assisted dying frameworks are embedded in healthcare and authorise medical practitioners to assess whether a person meets prescribed eligibility criteria for access to voluntary assisted dying.AimIn this article, we argue that including nurse practitioners as assessing practitioners in Australian and New Zealand voluntary assisted dying frameworks can promote equitable access.MethodWe demonstrate that nurse practitioners have the required education and skillset to assess eligibility, eligibility assessment is within their scope of practice, and recent evidence demonstrates that they may be more likely to participate in voluntary assisted dying than medical practitioners. Reviewing information relied on by lawmakers, we highlight the cursory consideration given to roles for nurse practitioners, and that their exclusion from assessing eligibility has not been justified.ConclusionAs new voluntary assisted dying laws are implemented in health services across Australia and New Zealand, research on the actual and potential contribution of nurse practitioners must be undertaken and reported. This will make it more likely that there is evidence to inform decisions about whether including nurse practitioners as assessing practitioners is feasible and necessary as laws are reviewed.     

Collaboration between nurses and doctors in clinical practice

Several authors have identified collaboration between nurses and doctors as problematic. Benner (1984) stressed that teamwork and collaboration between the disciplines was crucial for both patient care and team morale. The purpose of this article is to evaluate critically and discuss the research studies which have been conducted into the dynamics of the nurse/doctor relationship. A number of characteristics are significant in influencing the collaborative process. These include excellent communication skills, respecting the value of colleagues' roles, the ability to share points of view and trust.     

构建护士长与护士和谐关系新思维

护士长与护士的关系是一种工作关系,也就是所谓上下级关系。要建立良好的协调的上下级关系,要解决一个认识问题,充分认识上下级的重要性:上下级关系的好坏,在很大程度上制约和解决着管理者工作