Florence Nightingale, feminism and nursing

Three key aspects of Florence Nightingale's remarkable life are examined. First, the influences during her formative years: the education and guidance provided by her father, the resistance by her family when she decided to become a nurse; and the rejection by Nightingale of the societal expectations of a woman in the Victorian era. Secondly, her professional life is examined, in particular how she appears to have been viewed by certain members of society, and how in turn she viewed them. It is anticipated that her position as an early feminist will be postulated and illuminated. Thirdly, an analysis of her personal and professional life indicates a way forward for the nursing profession.     

Withdrawal of life-support treatment: the experience of critical care nurses

Technological advances in health care have made it possible to restore and prolong life for patients who would have died in the past. Unfortunately, one consequence of this is that some patients linger in intensive care units (ICUs), dependent on the technologies but with no hope of recovery. Therefore, decisions regarding withdrawal of life-support treatment are increasingly being faced by the health-care team.

This study aimed to explore the lived experience of critical care nurses who had cared for patients during withdrawal of life-support. The methodology employed was interpretive phenomenology. Interviews were conducted with seven critical care nurses, with the meanings of the experience of withdrawal of life-support treatment for these nurses extrapolated from the narratives and clustered into themes.

The study highlighted the importance of honest communication during the processes of decision-making and withdrawal of treatment. It was important for these nurses to be sure that family members were well-informed regarding the process of withdrawal of life-support treatment and that they could provide support and ensure that the patient's comfort and dignity were maintained during the process. The need to debrief after the event became evident but formal debriefing processes were rarely undertaken.     

Faculty/student perception of organizational climates in the schools of nursing, Oyo State, Nigeria

This study examined the influence of educational status and gender on the faculty and students' perceptions of their school climates. A self-designed questionnaire was used to elicit information from the 385 subjects (320 students and 65 tutors). Analysis using the t-test technique revealed that there were no significant differences at the 0.05 level of probability in the perceptions of: (a) faculty and students on climate variables “thrust” (t = 0.31) and “control” (t = 1.19); and (b) both sexes on climate variables “thrust” (t = 1.69), “control” (t = 1.13) and “disengagement” (t = −0.53). The conclusion therefore, is that educational status and gender have little or no influence on the peoples' perception of their school climates.     

Academic espionage: dysfunctional aspects of the publish or perish ethic

There are many dysfunctional manifestations relative to the tenure and promotion process. These are disruptive to academic life. Much of this is encouraged by the university because of their publish or perish ethic. Excellence in classroom teaching and success in the field of clinical and human endeavours are not highly valued in deliberations to grant tenure and advancement in academic rank. Research and publications are the major yardsticks upon which a faculty member is judged. This prevailing perspective poses a dilemma for many nursing faculty who have high clinical workloads and have not been socialized for academic survival. The pressures to publish and research can be achieved in a realistic and non-stressful way. Three aspects seem to be particularly relevant to facilitate this achievement; these are: anticipatory planning, balancing the workload, and understanding the interpersonal dimensions of collegeality.     

Peripheral intravenous catheters in situ for more than 96 h in adults: What factors affect removal?

Peripheral intravenous catheters (PIVC) are widely used in clinical nursing, but indwelling time remains a subject of debate. This study aimed to assess the risk factors for PIVC phlebitis in adults and provide a basis for indwelling time decisions. A total of 189 first‐time PIVC patients in the emergency ward were assessed between May and October 2015. Data were retrieved for patient characteristics and PIVC assessment records. This study showed that over two‐thirds (67.72%) of PIVCs were removed because of phlebitis, including oedema (37.57%), rubefaction (33.33%), pain (32.28%), slow infusion speed (13.23%) and accidental extrusion (2.12%). PIVC indwelling time in the planned removal group was higher than that obtained for the unplanned removal group: 152.42 (74.58) vs. 94.64 (50.15) h, P < 0.001. At indwelling times > 96 h, 28.57% (n = 54) of catheters caused phlebitis, although 23.28% (n = 44) showed no phlebitis. PIVC phlebitis was associated with treatment with compound amino acid infusion (OR: 2.624), site at the elbow joint (OR: 3.049), haemoglobin level (OR: 2.492), white cell count (OR: 2.196) and catheter size (OR: 1.837). Study findings suggest that PIVC might be used for longer durations based on nursing assessments and health education.     

Enhancing the management of deteriorating patients with Australian on line e‐simulation software: Acceptability,transferability, and impact in Hong Kong

International concerns relating to healthcare professionals’ failure to rescue deteriorating patients exist. Web‐based training programs have been developed and evaluated in Western settings but further testing is required before application in non‐Western countries, as traditional modalities of learning may differ between cultures. We trialed an Australian English language online simulation program for the management of deteriorating patients, Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST²ACTWeb), to test cultural acceptability, transferability, and educational impact. The study was designed as a quasi‐experimental evaluation of the FIRST²ACTWeb program with final year nursing students from a Bachelor of Nursing program at the University of Hong Kong. Participants completed pre‐course and post‐course tests, three interactive scenarios, and program evaluations. The program was positively evaluated, with significant improvements in knowledge, skills, self‐rating of performance, confidence, and competence. Outcomes were comparable to earlier evaluations with Australian students, demonstrating that an interactive simulation‐based program of patient deterioration management has cultural and language acceptability and transferability across communities with significant educational impact.     

Identification of malaria hot spots for focused intervention in tribal state of India: a GIS based approach

Background  

In India, presently malaria shows a declining trend whereas Plasmodium falciparum (Pf) cases show an up trend. In central India, specifically, Madhya Pradesh (M.P.) a forested and tribal area, control of malaria is logistically difficult and outbreaks are frequently recorded, reasons for this being inadequate surveillance, poor reporting, a time lag in reporting to decision makers and a lack of geo referenced information to pin point the trouble spots for a timely preventive action.