The health styles of nurse practitioners

PURPOSE: To examine the formal and informal health care beliefs, behaviors, and practices of nurse practitioners (NPs). DATA SOURCES: A self-administered questionnaire with a primarily closed-ended format was distributed over a 3-day period to a convenience sample of 321 NPs attending a national NP conference. CONCLUSIONS: The overall health status and health practices of NPs were found to be fairly good, but there was room for improvement, particularly with regard to nutrition, health responsibility, physical activity, and stress management. IMPLICATIONS FOR PRACTICE: Respondents were more likely to self-diagnose and self-treat minor illnesses and largely received their primary health care from physicians. The majority of NPs indicated a willingness to receive health care from an NP; however, the nonavailability of NPs restricted this option.     

Interactional styles of nurse practitioners and physicians regarding patient decision making

The purpose of this study was to describe interactional styles used by nurse practitioners and physicians in their attempts to influence patients' decision making. The ethical concepts of paternalism, maternalism, and shared decision making (operationalized as command, consequence, and concordance, respectively) formed the conceptual framework for the analysis of the interactions. Videotaped interactions of 85 physicians and 42 nurse practitioners in either joint or solo practice were analyzed. Tests of a priori hypotheses using hierarchical log-linear modeling yielded the following significant results: Males and physicians in solo practice used more command statements and fewer consequence statements than females and nurse practitioners in solo practice, who used fewer command statements and more consequence statements. All groups used more command/consequence statements than concordance statements.     

Diagnostic styles of general practitioners confronted with ambiguous symptoms. An exploratory study

This study explores the diagnostic process of general practitioners confronted with ill-defined and ambiguous complaints, which eventually appeared to be caused by a malignancy. Three aspects were rated: (a) the adequacy of the initial problem definition; (b) the carefulness of further diagnostic methods; and (c) how the suspicion of malignancy originated. These three aspects, which were strongly connected, seem to be parts of a diagnostic approach with two polar extrems: a critical style and a biased style. Characteristic of a critical style is full awareness of detail, careful observations, consideration of ambiguous symptoms, and consciousness that the correct diagnosis is often other than the one initially judged most likely. The opposite, the biased style, is characterized by little alertness for detail, less careful observations, and overinterpretation of facts supporting the initial hypotheses.     

Practice methods among nurse practitioners treating depressed women

OBJECTIVE: To determine practice methods and beliefs about degree of competence in the assessment, diagnosis, and treatment of depressive symptoms in women by nurse practitioners (NPs). DATA SOURCES: A survey about the diagnosis and treatment of depressive symptoms in women was mailed to 3,000 NPs randomly selected from the membership of the American Academy of Nurse Practitioners. Family, adult, women's and gerontological NPs were included; 1,647 surveys were returned (55%). CONCLUSIONS: Assessment and treatment protocols used by NPs were consistent with the AHCPR guidelines and similar to the protocols used by psychiatrists and non-psychiatric physicians, yet only 65% believed their education had adequately prepared them to assess/diagnose depression and only 52% believed they had been adequately prepared to treat depression. IMPLICATIONS FOR PRACTICE: Findings suggest areas for improvement in the formal education and continuing education of NPs.     

独立上岗护士执业准入管理实践与体会

[目的]探讨独立上岗护士执业准入管理实施办法.[方法]制定独立上岗护士执业准入管理考核办法,对已取得国家执业资格的注册护士上岗前实行准入考核,成绩合格者颁发独立上岗执业资格证书.具备护士执业证、独立上岗执业资格证的护士方可独立上岗值班,享受独立上岗护士的有关待遇.[结果]实施独立上岗护士执业准入管理办法后,岗位职责履行达标率上升,各类人员对其工作满意度提高.[结论]实施独立上岗护士执业准入管理,可以提升其履行岗位职责的能力,提高护理工作满意度.     

The psychiatric educational experiences of advance beginner RNs

The nursing profession is in an extraordinary position to improve educational experiences of prospective nurses, particularly within psychiatric nursing. To acquire an enhanced understanding of the nurse's instructive learning process and skills regarding psychiatric nursing, this study described and explored the experiences of advance beginner nurses employed in mental health facilities. It also denoted the registered nurses' (RNs) educational preparedness to function in their new professional role. Reflection of the nurse's personal experiences was acquired by using a qualitative study with a phenomenological approach. Colaizzi's Frame work [Colaizzi, P., 1978. Psychological research as the phenomenologist views it. In: Valle, R., King, M. (Eds.), Existential Phenomenological Alternative for Psychology. Oxford University Press, NY, pp. 48-71] guided the mode of data analysis by enlisting 15 advance beginner nurses to participate in in-depth, audio-taped interviews. Results from this study indicated a need for educational improvements to accurately reflect trends of psychiatric patient care in order to emphasize interpersonal relationships as well as multi-diagnosis and co-morbidity. Additionally, increased contact with diverse patient populations and responsibilities congruent with other clinical placements in managing the patient's overall care were noted to be critical. This study suggests that some nursing educational programs can improve their curriculum, methods of teaching and approach used to introduce students to psychiatric mental health nursing.     

Practice patterns of underrepresented minority nurse practitioners in New York state, 2000

Using data collected from a sample of 1,319 nurse practitioners (NPs) in New York state in 2000, differences in practice patterns by race and ethnicity were identified. NPs from underrepresented minority (URM) groups were more likely than non-URM NPs to work in hospitals, community health centers, and schools but less likely to work in physician offices and NP practices. URM NPs were also more likely to report a specialty certification in women's health. Several different measures of primary care provision were examined, with URM NPs substantially more likely to meet all four measures of primary care practice than non-URM NPs. Finally, URM NPs were more likely than non-URM NPs to practice in federally designated health profession shortage areas.     

Practice environment,independence, and roles among DNP- and MSN-prepared primary care nurse practitioners

BackgroundMany nursing schools are adopting the Doctor of Nursing Practice (DNP) as the preferred model of nurse practitioner (NP) education and eliminating Master of Science in Nursing (MSN) programs. To date, no studies have explored the relationship between DNP preparation and NP practice environment, independence, and roles.PurposeThe purpos of this study is to compare practice environment, independence, and roles among DNP- and MSN-prepared primary care NPs.MethodsThis study used a cross-sectional design and observational regression analysis of survey data.FindingsDNP-prepared NPs reported: 1) more favorable NP-Physician Relationships, 2) fewer clinical hours, and 3) more practice leadership. These differences were, however, small and not significant at 0.05 level.DiscussionWe found no major differences in practice environment, independence, and roles among DNP- and MSN-prepared primary care NPs. As more nursing schools establish DNP programs and more DNP-prepared NPs enter the field, it is especially important to continue to study the impact of DNP preparation on the NP workforce.