军队医院护理管理者任职培训需求调查

目的调查军队医院护理管理者任职培训现状及其培训需求,为军队护理管理者规范化培训提供依据。方法采用自行设计问卷,调查42所军队医院的72名护理部主任和护士长。结果(1)所有护理管理者认为任职培训有必要;培训师资学历要求本科以上,培训形式要求脱产。(2)培训最佳组织单位要求是总后勤部和军区卫生部。(3)护理部主任所需的培训知识需求依次为护理新政策与法规、护理学科理论与新进展、人力资源管理、科研方法与管理、经济成本核算;能力培训需求集中在概念技能和人际技能;护士长培训知识需求依次为:质量管理、安全管理、法规制度、人力资源使用;能力培训需求集中在概念技能和技术技能。结论针对军队护理管理者的培训需求,改善培训形式和培训内容,尽快制定统一规范的任职培训标准。     

Control Addicts: A 12-Step Program for Nurse Managers

Many ineffective nurse managers are control addicts, resulting in battered nurse syndrome in subordinates and creating a control cycle that is a barrier to becoming effective nurse managers. This article discusses the origins of control-addict RNs and identifies some common characteristics. RNs and identifies some common characteristics. The author provides "A 12 -Step Program for Control Addicts." When completed, the program provides a foundation for control addicts to become effective nurse managers.     

Future Responsibility and Requirements for First-line Nurse Managers in New South Wales

Changes to the structure and funding of hospitals in Australia are progressing at a rapid pace. Decentralized organizational structures based on a product concept have increased the responsibility and managerial skills needed of first-line nurse managers. The purpose of this study was to determine a profile of first-line nurse managers in hospitals in New South Wales. Data related to education, experience and career plans were obtained from 318 respondents in 34 hospitals. The results indicate a lack of experience and educational preparation in management which has implications for the role of more senior nurse managers.     

Physician attitudes toward physician extenders: a comparison of nurse practitioners and physician assistants.

A survey of all physicians in the Eighth District Medical Society (Western New York) was conducted in 1975 to determine physician attitudes toward employment of and task delegation to nurse practitioners. The results of this study and one other similar study of nurse practitioners are compared to results of two previous studies examining physician attitudes toward physician assistants. It appears that physicians are somewhat more willing to employ and delegate tasks to a physician's assistant. Some correlates of physician attitudes toward each of the two types of physician extenders are also compared and discussed.     

A path to greater inclusivity through understanding implicit attitudes toward disability

Individuals with visible disabilities are underrepresented in nursing and have been denied admission to nursing education and discriminated against based on their disability, although nurse educators have been found to hold positive explicit attitudes toward disabled individuals. This study examines nurse educators' implicitly held attitudes toward individuals with disabilities through the use of the Disability Attitude Implicit Association Test. Findings demonstrated that nurse educators are strongly biased toward individuals without disabilities (N = 132, D = 0.76, SD = 0.46) and demonstrated a stronger preference than the general population (N = 38,544, D = 0.45, SD = 0.43). Study results suggest the need for a timely critique of the continuing focus on physical abilities as a prerequisite for admission to nursing programs. In addition, faculty in schools of nursing and practicing nurses must engage in discussions of attitudes toward individuals with visible disabilities for the discipline to be more inclusive.     

Rural Nurse Managers’ Perspectives into Better Communication Practices

The aim of this qualitative study was to describe the communication perceptions of nurse managers in rural areas. Prior research in tertiary settings was the impetus for studying viewpoints in other settings. Grounded theory methods were used to collect and analyze interview data with nine managers from regional, critical access hospitals, and home health settings in central Pennsylvania. Nurse Managers associated successful communication with job satisfaction, work efficiency, and employee retention. Circumstances influencing communication involved discussion tones, techniques, resources, and environmental factors. Recommended techniques included regular conversations, diverse messaging, and conferencing huddles to improve information dissemination and workflow in rural settings.     

Recognizing and Assisting the Impaired Nurse: Recommendations for Nurse Managers

The impaired nurse places the client, her/himself, and all members of the healthcare community at risk. As members of the nursing profession, the priority of all nurses is to protect clients and adhere to professional standards of practice. In light of the statistics validating increased abuse by nursing professionals, the author believes that Peer Assistance Programs and Employee Assistance Programs are necessary and should be supported. To do less is to continue a "conspiracy of silence".     

Nurse practitioners' behavior regarding teaching testicular self-examination

PURPOSE: To test a model derived from the theory of reasoned action and to determine the behavior of nurse practitioners (NPs) regarding teaching testicular self-examination (TSE). DATA SOURCES: A cross-sectional, explanatory design was used to survey a random sample of 1,490 members of the American Academy of Nurse Practitioners. CONCLUSIONS: NPs had positive attitudes toward teaching TSE and were engaged in such teaching. They perceived that other NPs, physicians, and patients also value TSE teaching. The theoretical model was supported. IMPLICATIONS FOR PRACTICE: The results have implications for research, practice, and education. The theory was shown to be useful as a framework for the study of NP behavior. The results highlight the importance of including strategies to promote positive values as components of nurse preparation. For practice, patient adherence to illness detection activities may be fostered by positive attitude, perception that significant others also value these activities, and belief that failure to do so may result in personal loss.     

How Do Nursing Students Perceive Substance Abusing Nurses?

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30 years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest–posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education.     

Predictors of occupational stress and well-being in First-Line Nurse Managers: A cross-sectional survey study

BackgroundFirst-line nurse managers have a pivotal role in the organization of health care but have to deal with significant job-related issues and problems in a changing and challenging health care environment. As their new roles are complex and often unclear, it might be expected that these professionals are at risk for occupational stress.ObjectivesThe objective of this study is to analyze and describe relationships between job characteristics, and also interdisciplinary conflicts with physicians as potential predictors of occupational well-being (job satisfaction, psychosomatic distress, turnover intention, work engagement and burnout).Designthis study had a cross-sectional design and used a web-based survey.MethodsThis study was conducted in 2015 in 11 Belgian (Flemish) hospitals. All First-line nurse managers were eligible (N = 481) and 318 respondents (66.1%) agreed to take part in the survey. A hierarchical regression analyses was applied to analyze relationships between predictors and outcomes.Resultsjob demand and job control measures were predictive of all outcomes. Collaboration with doctors only predicted job satisfaction and turnover intention. Social support from management was predictive of turnover intention. Social support from colleague- first-line nurse managers was not predictive. Social support from the staff members (team) was however a strong predictor of all stress outcomes.ConclusionsJob demands, job control and social support of the team and management were all important predictors of occupational well-being in first-line nurse managers. All of these variables can be influenced by hospital management to improve the work conditions of this professional group in order to retain their workforce.     

Modeling attitudinal antecedents of nurses' decisions to report impaired colleagues

Nurses whose professional functioning is impaired due to substance abuse represent a threat to the health and safety of patients, other health care staff, and themselves. The major means for identifying impaired nurses is nonimpaired coworkers. Yet, only 37% of nurses who have had experiences working with impaired colleagues reported them to supervisors. A cross-sectional correlational research design, employing structural equation modeling, was used to explicate the relationships among the latent attitudinal constructs: permissiveness, morality, treatment efficacy regarding substance abuse, and punitive attitudes toward impaired nurses. The influences of these attitudes on perceived severity of impairment in fictitious coworkers and subsequent intentions to report these coworkers to nursing supervisors were modeled in a sample of 126 nurses. Permissiveness and positive attitude toward treatment were significantly related to intentions to report nurses. Moralistic attitude was not related to intention. Moralistic attitude was, however, strongly associated with a punitive attitude toward impaired nurses.     

Acts of caring: nurses caring for nurses

Caring behaviors displayed toward nurses by nurse managers and nurse peers play a significant role in establishing relationships that promote a healthy work environment. A qualitative study was done to identify behaviors perceived to be caring toward nurses. The theoretical background used for the study was Nursing as Caring by Boykin and Schoenhofer. Data were collected from focus groups consisting of registered nurses currently employed in the practice setting. Content analysis was used for the analysis. The overarching category that was identified was tending to a caring environment. The following emergent categories were also found: caring through helping and supporting, caring through appreciating, and acknowledging unappreciated caring. The findings suggest that nurses demonstrate caring behaviors toward their colleagues by coming to know them on both a professional and a personal level. These behaviors form the foundation for an environment that supports a consistent demonstration of caring.     

Nurse practitioners' and students' attitudes towards people with disabilities.

This article reports the results of assessments of nurse practitioners' and nursing students' attitudes toward people with disabilities. Findings of three projects that used the Interaction with Disabled Persons Scale suggest that Australian nurses' and nursing students' attitudes are more positive than those of the general population and that nurse education strategies are effective in promoting positive attitudes. These findings contrast with the results of overseas studies which indicate that health professionals' attitudes toward people with disabilities are negative and unaccepting.     

Emergency Physicians' Attitudes Toward the Emergency Nurse Practitioner Role: Validation Versus Rejection

A qualitative grounded theory approach was used in this study, which examined the attitudes of a group of emergency physicians toward collaborative practice with emergency nurse practitioners. Interviews were conducted with five physicians who were not currently working with nurse practitioners. Responses were coded, and a substantive theory model of dependent collaboration emerged. The physicians supported the emergency nurse practitioner role on the grounds that it be supervised in the traditional fashion by the physician. Concerns regarding education, trust, liability, and capability were identified. Deficits in knowledge regarding training and the role/function of nurse practitioners were also identified.     

Nurses' Attitudes Toward Impaired Colleagues

This study describes the attitudes of Oregon nurses toward substance abuse, substance abusers in general and impaired nurses in particular. Questionnaires were mailed to 500 randomly selected nurses, and 396 replied. Overall, nurses' attitudes, as measured by Chappel's Substance Abuse Attitude Survey (SAAS), were positive, as were their attitudes toward impaired colleagues. Regarding alcohol-impaired nurses, 77 percent of the respondents were willing to confront them, 67 percent favored their return to practice and 85 percent would accept them as co-workers if hired. Corresponding percentages for drug-impaired colleagues were 76 percent, 54 percent, and 73 percent. Nurses less approving of treatment interventions, more optimistic about treatment, employed for fewer years and with a baccalaureate or higher degree were more positive and supportive of impaired nurses than were their counterparts.     

Nurse managers' conceptions of quality management as promoted by peer supervision

AIM: The aim of the study was to describe nurse managers' conceptions of quality management in their work as promoted by peer supervision. BACKGROUND: Quality management is one of the topical issues in a nurse manager's demanding and changing work. As first-line managers, they have a key role in quality management which is seen to create the system and environment for high quality services and quality improvement. Despite the official recommendations and definitions of quality management, several published reports have shown that there is no single solution for quality management. Peer supervision or the support provided by it to nursing managers have rarely been a subject of study. This study was carried out at Tampere University Hospital between 1996 and 1998. The peer supervision intervention was organized once a month, 2 hours at a time and in closed supervisor-led groups of nine nurse managers. METHODS: Data were collected by themed interviews. Fifteen nurse managers participated in the study. The data were analysed using the phenomenographic method. FINDINGS: Two main categories were formed of nurse managers' conceptions. The first described supportive and reflective characteristics of peer supervision. This main category was described by horizontal, hierarchical categories of support from peer group and reflection. The second main category described nurse managers' conceptions of individual development of leadership during peer supervision. This main category was also described by three horizontal categories: personal growth, finding psychological resources and internalization of leadership. CONCLUSION: The finding of this study show that peer supervision benefited nurse managers in quality management through reflection and support. The reflective and supportive characteristics of peer supervision promoted the nurse managers' individual development, but also that of leadership. It can be concluded that peer supervision promotes quality management in nurse managers' work.     

The public's view of physicians' assistants and nurse practitioners: a survey of Baltimore urban residents.

This study of public attitudes toward physicians' assistants and nurse practitioners finds that the public regards the two groups of health workers as remarkably similar. A telephone survey of 2,583 households in the Baltimore, Maryland, metropolitan area indicates that about half the population have heard of a PA or NP, though only 4 per cent report receiving care from such workers. In this urban sample, respondents accepted the principle that important medical care functions can be delegated, as long as the PA or NP is considered assistant to the physician. The public reported more acceptance of tasks performed by nurse practitioners than by physicians' assistants, though the differences are small.     

Nurse managers: role expectations and job satisfaction.

The purpose of the study was to assess the relationships among nurse managers' perceived job stress/job satisfaction, time allocation, and role expectations. The dependent variable was job satisfaction. The sample consisted of 72 nurse managers who responded to a self-administered questionnaire. It was found that nursing supervisors are satisfied with the actual time allocation of nurse managers, whereas physicians and nursing staff believe that more of the nurse managers' time should be given to direct patient care. When discrepancies occur about the allocation of nurse manager time, the nurse manager is apt to have lower job satisfaction.     

Examining Nurse Consultant connectivity: An Australian mixed method study

The nurse consultant (NC) role in Australia is a senior classification of advanced practice nurse has been described as enhancing health care outcomes largely through extensive collaboration with consumers, nurses, and other health professionals. However, little is known about the actual nature, amount, and quality of NC interactions. This study examines the connectivity of the NC role across metropolitan and rural contexts, using a mixed method sequential design with an online survey and focus groups with NCs and other stakeholders. Results demonstrated that NCs most commonly have high density connectivity patterns with other nursing colleagues, medical staff, patients/clients, and administrative staff. Position grade (1, 2 or 3) influences density of connectivity, as does location, with those based in metropolitan roles engaging significantly less with other clinicians. Findings demonstrate that many NCs are highly collaborative and predominantly embedded into interprofessional practice models. This study provides valuable insight into the diverse and often complex NC role and the way in which NC expertise and influence is deployed and integrated across a large local health district.