护理管理者对护士实施人文关怀的举措与效果

目的探讨护理管理者对护士实施人文关怀的举措与成效。方法采用学习培训等方式提高护理管理者关怀能力,成立关爱护士小组,建立人文关怀链,对护士实施关怀与心理咨询,各病区护士长根据具体情况制订并实施关怀护士计划和举措,护理部加强关怀护士管理工作的落实与督导。结果护士对工作总体满意度及团队协作、本职工作、职业生涯展望3个维度满意度提高(P0.01或P0.05)。结论护理管理者对护士实施人文关怀的举措可以提升护士总体工作满意度,对稳定护理队伍和提高优质护理服务质量起到积极作用。     

The influence of standardized languages on nurses' autonomy

AIM: To investigate the influence of standardized languages on nurses' autonomy. BACKGROUND: The uses of standardized languages are expanding. These languages unify communication across health care settings. Autonomy is a favourable concept for nurses. The use of standardized languages may hinder nurses' autonomy; however, these languages may also promote nurses' autonomy. EVALUATION: Review of the literature. KEY ISSUES: The key issue discussed in this paper is whether the use of standardized languages affects nurses' autonomy. CONCLUSIONS: Nurses should use standardized languages in every day practices as it reflects a mastery over their own work. Having control over practice is an important attribute of nurses' autonomy.     

The effect of structural empowerment and perceived organizational support on middle level nurse managers' role satisfaction

BACKGROUND: The restructuring of Canadian health care organizations during the past decade has reduced the visibility of nursing leadership. This has resulted in job conditions that have disempowered nurse managers and influenced their ability to create positive work environments, mentor potential nurse leaders, and gain satisfaction in the leadership role. These conditions threaten the retention of a cadre of high quality nurse leaders in today's chaotic health care setting. OBJECTIVE: The purpose of this study was to examine the relationship between structural empowerment and perceived organizational support and the effect of these factors on the role satisfaction of middle level nurse managers. METHOD: A secondary analysis was conducted as part of a larger study of 126 middle level nurse managers working in Canadian acute care hospitals, randomly selected from the Ontario provincial registry. Eighty-four nurse managers responded to a questionnaire mailed to their home addresses. RESULTS: Structural empowerment was positively associated with middle level nurse managers' perceived organizational support. The combination of empowerment and perceptions of organizational support were significant predictors of middle level nurse managers' role satisfaction. CONCLUSIONS: The findings support R.M. Kanter's (1977, 1993; Men and Women of the Corporation. Basic Books, New York) contention that empowering work conditions have an impact on employees' feelings of support and sense of accomplishment at work. Positive perceptions of organizational support may play an important role in retaining current middle managers, and possibly attracting future leaders to management positions.     

Professional nurse autonomy: concept analysis and application to nursing education

Professional nurse autonomy, an essential attribute of a discipline striving for full professional status, is often confused with personal autonomy, work autonomy or aggregate professional autonomy. Using Walker & Avant's (1995) model for concept analysis, this paper presents an analysis of professional nurse autonomy. Professional nurse autonomy is defined as belief in the centrality of the client when making responsible discretionary decisions, both independently and interdependently, that reflect advocacy for the client. Critical attributes include caring, affiliative relationships with clients, responsible discretionary decision making, collegial interdependence, and proactive advocacy for clients. Antecedents include educational and personal qualities that promote professional nurse autonomy. Accountability is the primary consequence of professional nurse autonomy. Associated feelings of empowerment link work autonomy and professional autonomy and lead to job satisfaction, commitment to the profession, and the professionalization of nursing. A student-centred, process-orientated curricular design provides an environment for learning professional nurse autonomy. To support the development of professional nurse autonomy, the curriculum must emphasize knowledge development, understanding, and clinical decision making.     

减少护理人员医院感染危险因素的思考

减少护理人员医院感染的发生 ,是现代医院管理的重要内容之一 ,也是护理管理不容忽视的课题。为了提高护理人员对医院感染危险因素的认识和防护能力 ,通过对护理工作中医院感染危险因素的客观分析 ,探讨有效的护理干预和防护措施 ,以保证护理人员的安全     

Role transition from staff nurse to clinical nurse specialist: a case study

? Over the last decade, nursing in the United Kingdom has witnessed a major development and expansion in the number of Clinical Nurse Specialists. ? These nurses are considered to be experts in their own specialities, have in-depth knowledge and provide a service for patients, relatives and staff. ? There is, however, a paucity of literature relating to role transition from experienced Staff Nurse to Clinical Nurse Specialist. ? Using Nicholson's (1984) model of work-role transition and Wanous' (1992) four-stage model of organizational socialization, this study explores the transition of two nurses from experienced Staff Nurses to novice Clinical Nurse Specialists.     

Governmentality, student autonomy and nurse education

Title. Governmentality, student autonomy and nurse education. Aim. This paper is a report of a study to explore how governmental practices operated in nurse education. Background. Since the 1980s nurse education internationally has been strongly influenced by educational theories that aim to promote student autonomy by encouraging self‐direction and critical thinking. Newer curriculum models advocate transformative approaches leading to greater emancipation, social equity and inclusion. Although these changes have been positively evaluated there had been limited critical research on how student behaviour is governed. Method. A discourse analytic study was conducted from 2000 to 2004 using interviews (n = 30) with a purposive sample students and teachers in one United Kingdom university. Data were also collated from the course curriculum and student handbook for the students’ programme. Data were analysed to identify how student behaviour is governed. Findings. Two governing practices are described: control and technologies of the self. These practices contribute to an overall system of governing student behaviour that creates tension between the avowed progressive empowerment discourse and taken for granted everyday educational practices. Students are subjected to a range of governmental and disciplinary strategies and, through a process of normalization, ultimately become their own supervisors within the system. Conclusion. The tensions between the demands of a professional outcome‐based nursing programme and notions of empowerment and student autonomy have not been resolved. Instead, present educational practice is characterized by normalizing discursive practices that aim to produce a specific version of a student subject as autonomous learner. Thus, discourses of both empowerment and professional behaviour govern students.     

The impact of nurse empowerment on job satisfaction

Title. The impact of nurse empowerment on job satisfaction. Aim. This paper is a report of a study conducted to test Kanter’s organizational empowerment theoretical model specifying the relationships among demographics, structural empowerment, and job satisfaction. Background. Empowerment has become an increasingly important factor in determining nurses’ job satisfaction in current restructured work environments in China. Methods. A correlational, cross‐sectional design was used to test Kanter’s organizational empowerment model with a sample of 650 full‐time nurses employed in six Chinese hospitals in 2007, with a response rate of 92% (n = 598). The instruments used were the Demographic Data Questionnaire, Conditions of Work Effectiveness Questionnaire‐II, and Job Satisfaction Scale. Results. The three lowest scoring items for Conditions of Work Effectiveness Questionnaire‐II were resources, opportunity and informal power. The job satisfaction items revealing most dissatisfaction were workload and compensation, professional promotion, amount of work responsibility, work environments, and organizational policies. A statistically significant positive correlation was found between empowerment and job satisfaction (r = 0·547, P < 0·01). The demographic factors influencing empowerment were work objectives and age. The influencing factors for job satisfaction were work objectives and education level. Conclusion. The results provide support for Kanter’s organizational empowerment theory in the Chinese nurse population. Nurses who view their work environments as empowering are more likely to provide high quality care. Enhancing empowerment in a supportive environment would allow nurses to experience satisfaction with their jobs.     

Preferences for Decision-Making Autonomy

Nurses' lack of autonomy has been identified as a leading cause of job dissatisfaction, but attempts to increase satisfaction by increasing autonomy have not always been successful. This survey of 356 randomly selected staff nurses and 130 head nurses from 16 hospitals extends previous work by identifying the preferred level of involvement in 21 patient care and 21 unit operation decisions. Staff nurses agreed on 60 percent of the decisions and, in general, preferred independent decision-making for patient care decisions and shared decision-making for unit operations. Head nurses indicated that staff nurses should have a higher level of autonomy than the staff nurses indicated for themselves .     

Global nurse migration today.

PURPOSE: To examine emerging trends in global nurse migration and those effects on nurse workforce planning and development efforts in select donor and recipient countries. DESIGN AND METHODS: This integrative literature review is an analysis of current literature (journal articles, media, and press releases) and data from various sources (PUMS, NSSRN, CGFNS, Nurse & Midwifery Council) to explicate new trends in nurse migration. FINDINGS: Rapid changes in nurse migration are significantly challenging nurse workforce management efforts in both donor and recipient nations. CONCLUSIONS: As the market demand for nurses around the globe escalates, the changes and consequences associated with nurse migration are increasingly in need of policy solutions that indicate the needs and motivations of all stakeholders.