Military nurses and combat-wounded patients: a qualitative analysis of psychosocial care

PURPOSE: The aims were to explore the lived experience of combat‐wounded patients and the military nurses who care for them. DESIGN AND METHODS: The study was a qualitative phenomenological design, and focus groups were conducted with 20 nurses and 8 combat‐wounded patients. FINDINGS: Themes common to nurses and patients were coping, shared experiences, finding meaning, psychosocial nursing care, families, and bureaucratic structure. Thematic differences were the patients' perspectives “changed self” while nurses described “professional boundaries.” PRACTICE IMPLICATIONS: The importance of finding meaning presents ideas that could help nurses and patients cope better with stressful situations regardless of the setting.     

Preventing nursing burnout: a challenge for liaison psychiatry

The authors conducted a study to assess and compare the level of job satisfaction among five groups of registered nurses working at UCLA Hospital. Fifty-seven female nurses completed the MMPI, Locus of Control Test, Work Environment Scale, and a questionnaire designed to assess job satisfaction. Results showed that there were no significant personality differences among the five groups of nurses. Significant differences between some of the groups were found in demographic variables and in work-related variables such as involvement, task orientation, work pressure, sense of authority on the job, and perceived communication with peers or other groups in the work environment. Nurses on the Medicine unit tended to have lower overall job satisfaction than those in the other units. The involvement of the Psychiatric Liaison Service on the five nursing units is described and discussed as a possible method for providing psychosocial support to the nurses and reducing high turnover rates.     

Psychiatric nursing roles in a community mental health center

We describe the addition of medication monitoring to the duties of nurses working as case managers in a day treatment program for the chronically mentally ill. The nurses used their medical and behavioral knowledge to form a more complete picture of the patient than either a visiting psychiatrist or a case-manager who was not a nurse could do. This improved the integration of medication and other patient management decisions. It also improved cooperation between psychiatrists and nurses, better using the time and skills of both.     

Critical incident stress debriefing: a health promotion model for workplace violence

PURPOSE: To view the global impact of violence as a critical incident. DATA SOURCES: Published literature, author's experience. CONCLUSIONS: Psychiatric nurses can use the critical incident stress debriefing protocol to minimize adverse outcomes after a traumatic event. Workplace violence threatens the safety and well-being of nurses. Psychiatric nurses are more likely to encounter workplace violence than nurses in other settings and must prepare themselves using proactive health-promoting activities, for example the critical incident stress debriefing (CISD) model. This health-promotion model provides immediate emotional support and education about normal stress reactions, and may reduce the risk of chronic and disabling emotional and physical consequences.     

Musculoskeletal complaints among a group of Turkish nurses

The aim of the present study was to describe the prevalence and distribution of symptoms of musculoskeletal complaints among Turkish nurses who are practicing general nursing. The study population consisted of 120 nursing staff from four large general hospitals in Erzurum, Turkey. In every hospital six departments (surgery, medical, obstetric and gynecology, psychiatry, pediatric, and neurology) were selected. A Nordic standardized questionnaire described by Kuorinka et al. (1987) about complaints of the musculoskeletal system and a self-administered questionnaire involved information on the respondent's job and employment history, individual characteristics, physical and psychosocial risk factors at work, and general health status, were used by the researchers. Test data were analyzed for the difference between two population proportion and percentage. In the total population, 90% of all nurses reported at least one musculoskeletal complaint, 60% reported at least two, and 36% reported spells of three complaints in the past 6 months. Low back complaints were the most prevalent of musculoskeletal complaints, reported by 69% of the nurses. Neck complaints were less prevalent than shoulder (46% and 54%, respectively). Nurses with back complaint more often reported neck (28%) and shoulder (34%) complaints. Chronic low back, neck, and shoulder complaints were experienced by 41%, 25%, and 33% nurses, respectively. On the other hand, chronic complaints showed a correlation with working departments. The nurses working in surgery and obstetric and gynecology departments have more chronic complaints than the nurses working in other department (p<.05). The article's findings do not differ from those of other countries. Despite its limitations, this study points to the importance of perceived worked-related physical demands in relation to reported neck, shoulder, and back musculoskeletal complaints in Turkish nurses. But, further inquiries are needed to identify other physical exposures that may be related to musculoskeletal complaints.     

Nurses' views of parasuicide in a developing country.

This study examines the knowledge, beliefs, attitudes, intentions and experiences of nurses at various stages of their careers with regard to patients who have made suicide attempts. It focuses particularly on the relationship of traditional Shona beliefs about suicide and considers how they interact with western medical beliefs. A detailed questionnaire covering these elements was administered to three groups of nurses. They were sampled at either the beginning or end of their training or after approximately ten years experience. Knowledge of suicide was found to be poor and attitudes towards parasuicide were negative. Traditional beliefs were held strongly by all groups of nurses; western beliefs were strongest amongst experienced nurses. Practical implications of these attitudes and beliefs for training are considered.     

Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan

To assess the rapidly changing psychological status of nurses during the acute phase of the 2003 SARS outbreak, we conducted a prospective and periodic evaluation of psychiatric morbidity and psychological adaptation among nurses in SARS units and non-SARS units. Nurse participants were from two SARS units (regular SARS [N=44] and SARS ICU [N=26]) and two non-SARS units (Neurology [N=15] and CCU [N=17]). Participants periodically self-evaluated their depression, anxiety, post-traumatic stress symptoms, sleep disturbance, attitude towards SARS and family support. Results showed that depression (38.5% vs. 3.1%) and insomnia (37% vs. 9.7%) were, respectively, greater in the SARS unit nurses than the non-SARS unit nurses. No difference between these two groups was found in the prevalence of post-traumatic stress symptoms (33% vs. 18.7%), yet, three unit subjects (SARS ICU, SARS regular and Neurology) had significantly higher rate than those in CCU (29.7% vs. 11.8%, respectively) (p<0.05). For the SARS unit nurses, significant reduction in mood ratings, insomnia rate and perceived negative feelings as well as increasing knowledge and understanding of SARS at the end of the study (all p<0.001) indicated that a gradual psychological adaptation had occurred. The adjustment of nurses in the more structured SARS ICU environment, where nurses care for even more severely ill patients, may have been as good or better than that of nurses in the regular SARS unit. Occurrence of psychiatric symptoms was linked to direct exposure to SARS patient care, previous mood disorder history, younger age and perceived negative feelings. Positive coping attitude and strong social and family support may have protected against acute stress. In conclusion, the psychological impact on the caring staffs facing future bio-disaster will be minimized with lowered risk factors and a safer and more structured work environment.     

Attitudes toward the mentally ill in a sample of professionals working in a psychiatric hospital in Beijing (China).

The attitudes of psychiatric doctors and nurses toward the mentally ill in a large urban psychiatric hospital in China were compared using the Community Attitudes toward the Mentally Ill (CAMI). Data indicated that the attitude of professionals differed on 11 of the 40 questions of this instrument. Those questions are divided along 4 dimensions: authoritarianism, benevolence, social restrictiveness and rehabilitation in the community. Results showed that psychiatric doctors have a more liberal and positive attitude toward the mentally ill than psychiatric nurses, especially about their rehabilitation in the community. Factor analysis also indicated that nurses were more likely than doctors to attribute negative characteristics to the mentally ill. Some explanations are proposed to explain these differences.     

Effectiveness of stress management training for nurses working in a burn treatment unit

All fourteen nurses working in a burn unit were given three hours of individual training in cognitive behavioral stress management skills. Anxiety measures were obtained before, during, and after training by weekly administration of the State-Trait Anxiety Inventory, and by daily administration of a nurses' stress scale constructed for this study. Nurses were randomly assigned to two groups which were treated using a successive-groups time-series design. Results suggested that stress management training was effective in reducing work-related anxiety among inexperienced nurses but not among experienced nurses. The gains made by the inexperienced nurses may have been more associated with increases in their understanding of stress and their feelings of control over stress than with changes in their actual stress management behavior.     

Expert nurses or specialised nurses, a choice for psychiatry

The question of creating a section of expert nurses or specialised nurses in psychiatry has arisen frequently since the advent of the multi-skilled nursing diploma in 1992. It is important to ask what challenges would be involved and to question the links between society and psychiatry.     

Musculoskeletal complaints among a group of Turkish nurses

The aim of the present study was to describe the prevalence and distribution of symptoms of musculoskeletal complaints among Turkish nurses who are practicing general nursing. The study population consisted of 120 nursing staff from four large general hospitals in Erzurum, Turkey. In every hospital six departments (surgery, medical, obstetric and gynecology, psychiatry, pediatric, and neurology) were selected. A Nordic standardized questionnaire described by Kuorinka et al. (1987) about complaints of the musculoskeletal system and a self-administered questionnaire involved information on the respondent's job and employment history, individual characteristics, physical and psychosocial risk factors at work, and general health status, were used by the researchers. Test data were analyzed for the difference between two population proportion and percentage. In the total population, 90% of all nurses reported at least one musculoskeletal complaint, 60% reported at least two, and 36% reported spells of three complaints in the past 6 months. Low back complaints were the most prevalent of musculoskeletal complaints, reported by 69% of the nurses. Neck complaints were less prevalent than shoulder (46% and 54%, respectively). Nurses with back complaint more often reported neck (28%) and shoulder (34%) complaints. Chronic low back, neck, and shoulder complaints were experienced by 41%, 25%, and 33% nurses, respectively. On the other hand, chronic complaints showed a correlation with working departments. The nurses working in surgery and obstetric and gynecology departments have more chronic complaints than the nurses working in other department (p <. 05). The article's findings do not differ from those of other countries. Despite its limitations, this study points to the importance of perceived worked-related physical demands in relation to reported neck, shoulder, and back musculoskeletal complaints in Turkish nurses. But, further inquiries are needed to identify other physical exposures that may be related to musculoskeletal complaints.     

Counselling services for nurses — a forgotten responsibility

In this article I suggest that there is now an overdue case for increasing the provision of counselling services to nurses employed in the National Health Service (NHS). This view is grounded in what nurses are saying and doing about counselling, and occupational stress research in nursing.     

The National Stroke Nursing Council: a nursing call for action

Nursing is fundamental to the care of stroke patients. From the acute setting all the way to rehabilitation and community reintegration, nursing is there. Having well-educated and highly skilled nurses to monitor and care for stroke patients is crucial. Equally important is the collaboration of colleagues at a national level to facilitate and disseminate research and best practice guidelines across Canada. The National Stroke Nursing Council aims to fill this role. Stroke nurses from across Canada were invited to a national forum in 2005, hosted by the Canadian Stroke Network. The focus of this forum was to elucidate issues of concern to nurses across the stroke care continuum in relation to a Canadian Stroke Strategy. Subsequent to this forum, a cadre of nurses, after undergoing a rigorous screening process, were selected to form the inaugural National Stroke Nursing Council (NSNC). With ongoing support from the Canadian Stroke Network, the mandate of the NSNC is to promote leadership, communication, advocacy, education and nursing research in the field of stroke.     

Factors Influencing Nurses’ Attitudes towards Patients in Jordanian Addiction Rehabilitation Centres: a Qualitative Study

Attitudes of health professionals towards patients with addiction continues to be negative, which is increasingly recognized as a major barrier to the receipt of optimal clinical care by those patients. This study aims to describe nurses’ attitudes and the underlying factors influencing nurses’ attitudes towards patients in two addiction rehabilitation centers in Jordan. Employing a case study design, using ethnographic fieldwork, we collected data from a purposive sample of twenty-one clinical nurses, using semi-structured interviews, which were analyzed for themes derived from the literature. Negative nurses’ attitudes towards “addicted” patients ranged from stigmatization, marginalization, avoidance of patients, to class discrimination. Major socio-cultural factors (honor-gender-shame triad, socialization process, mass media, perceiving addiction as a “hopeless” condition), and other contributory factors played a role in constructing nurses’ negative attitudes. We recommend a nursing curriculum that includes education regarding addiction behavioral patterns, and a continuing education regarding patients’ rights, legal and ethical aspects of nursing care.     

Collaboration or chaos: a consumer perspective

Consumer participation in all levels of mental health service provision is now government policy throughout Australia. However, effective participation by consumers requires collaboration between mental health nurses and consumers. Effective collaboration and the partnership between those who provide and receive services requires trust and respect on both sides. Accompanying consumers on their 'journey' of wellness and recovery is likely to also provide mental health nurses with opportunities for personal and professional growth.     

Behavioural psychotherapy training for nurses in Australia: a pilot program

This paper describes a pilot program that examined the feasibility of training for qualified mental health nurses in behavioural psychotherapy in response to the perceived need for improved client access to services. A 6-month course was conducted with four nurses from the in-patient mental health unit at Flinders Medical Centre, South Australia. They received a combination of workshop training and supervised practice by qualified and experienced nurse behavioural psychotherapists and were assessed throughout the period for clinical competency and level of knowledge in the subject. All four nurses completed the training satisfactorily. Each trainee treated four clients who presented with a range of anxiety disorders. The implications for further training of suitably qualified mental health professionals in the area are discussed.     

Role and contribution of nurses for learning disabilities: a local study in a county of the Oxford–Anglia region

Thirty‐two professionals (i.e. nurses, teachers and managers) working in the field of learning disabilities were interviewed regarding the current and future role of registered nurses for learning disabilities (RNLDs). The present exploratory study used semi‐structured interviews based on four main research questions examining the contribution of RNLDs in terms of knowledge, practical skills, future skills and the development of services. The results show that RNLDs are held in high regard, being characterized by a breadth of knowledge, qualities and skills. The findings also make clear that differences exist in the perceptions of the different professional groups, and that the way forward for RNLDs remains unclear in both the minds of nurses and colleagues. Suggestions are made to help clarify the future position of RNLDs.     

Present status and problems of schools for physically disabled children from the viewpoint of a school physician

We evaluated the problems of physically disabled children in schools, and clarified the roles of school physicians and the appropriate state of child neurologists. The range and severity of disabilities of disabled children in schools have gradually been increasing. Although nurses were assigned to provide medical care, the roles of school nurses differ among schools. In addition, about 50% of primary care physicians for these children are not Board-Certified Child Neurologists. Therefore, the instructions of medical care by primary care physicians to teachers and nurses are not well structured, and increase the physical and mental stress of teachers and school nurses. Thus the importance of the roles of school physicians has been increasing. As a school physician, I would request the followings to the Japanese Society of Child Neurology: (1) a proposal concerning support for commuting methods, (2) further improvement in postgraduate education in medical care and support for physically disabled children, (3) the standardization of written instructions for school, and (4) a proposal concerning the roles of nurses in school for disabled children.     

Nurses as psychiatric consultants in a general hospital emergency room

Psychiatric nurses' experience in milieu therapy, home treatment, community aftercare, and psychotherapy can be the basis for new roles in mental health. This study used psychiatric nurses as consultants to general physicians in a general hospital emergency room. Psychiatric nurses successfully managed 66% of the psychiatric referrals in the emergency room and required only telephone consultation in a majority of the remaining cases to develop and implement a satisfactory treatment plan. The resistance to using nurses in this new role seems a result of anxiety generated in the emergency room staff and physicians. Sensitivity to these discomforts reduces “undermining” behavior and provides the opportunity for new roles to develop, be defined, and be accepted.