Some issues in the assessment of clinical practice: a review of the literature

? This paper focuses on some issues in the assessment of clinical practice of particular interest to the author. ? The assessment of students of nursing in clinical practice is acknowledged as a long-standing and difficult problem. ? There is little consensus as to what is meant by the term competence when applied to clinical nursing practice, making the assessment of clinical practice a mainly subjective process. ? The English National Board (1989) has distinguished the term mentor as meaning counsellor and guide, nevertheless the roles of mentor and assessor are frequently confused. ? It is suggested that nurses are equally accountable for the accurate assessment of student nurses' clinical skills as they are for their own practice. ? The validity and reliability of tools used to assess clinical practice are difficult to establish, making objective assessment complex at best, and impossible at worst. ? The assessment of the reflective process has been suggested as one way out of the dilemma, but the ability to think and to write does not necessarily translate into competent clinical practice.     

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest

Reclaiming 'Big Nurse': a feminist critique of Ken Kesey's portrayal of Nurse Ratched in One Flew Over the Cuckoo's Nest Nurse Ratched or 'Big Nurse' in Ken Kesey's counter-culture novel One Flew Over the Cuckoo's Nest is one of popular culture's most arresting and memorable images of the nurse. She is, however, deemed to be remarkable primarily for her malice and authoritarianism. This paper argues that such a purely realist reading fails to fully appreciate the significance of the character of Nurse Ratched. A feminist critique of the novel contends that die importance of 'Big Nurse' is less related to how realistic/unrealistic or good/bad she is as a nurse. Nurse Ratched is important because she exemplifies all diat traditional masculinity abhors in women, and particularly in strong women in positions of power and influence. This paper explores the stereotype of 'Big Nurse' and argues that Kesey's vision of her ultimate 'conquest' is not a progressive allegory of 'individual freedom', but a reactionary misogyny which would deny women any function other than that of sexual trophy.     

STRESS IN THE RURAL EMERGENCY ROOM

ABSTRACT: This study identifies stress-producing factors reported by registered nurses (RNs) attending serious incidents in an Australian rural hospital's emergency room. A Delphi approach was used to determine the six most significant stress-producing factors, and these factors were then ranked by two groups of nurses. The rankings were compared using the Spearman Rank Order Coefficient of Correlation and were found to be dependent on years of nursing experience of the RNs taking part in the study. The more experienced group nominated 'anxiety about nursing a family member or close friend' as the most significant stress-producing factor, while the less experienced group reported 'concerns about nursing a child' as the most important stress-producing factor. Possible reasons for the variation in rankings are discussed, and recommendations are made in the light of the study's findings.     

网约护士参与“互联网+护理服务”意愿及影响因素研究

目的 探讨网约护士参与“互联网+护理服务”意愿及影响因素,为提高网约护士参与“互联网+护理服务”的积极性提供参考。方法 2022年1—2月,采用便利抽样法选取广州市开展“互联网+护理服务”医院的279名网约护士为研究对象,采用一般资料调查表、“互联网+护理服务”意愿影响因素量表和组织支持量表进行调查。结果 网约护士参与“互联网+护理服务”意愿得分(12.39±1.61),控制一般资料(职务、获得从业资格时间、居家护理服务经历)的影响后,发现感知风险、感知价值、便利条件、工具支持是网约护士参与“互联网+护理服务”意愿的影响因素(R²=0.641),可解释参与意愿变异的64.1%。结论 网约护士参与“互联网+护理服务”意愿处于中等偏上水平,为患者提供“互联网+护理服务”的意愿受感知风险、感知价值、便利条件和工具支持的影响。     

The role of specialist nurses in delivering effective care in a tertiary sarcoma referral service

Musculoskeletal sarcomas are rare cancers with an incidence of less than 1% of all cancers. Management of these tumors requires multidisciplinary care comprising of numerous specialists. Critical decisions following collaborative discussion among treating specialists followed by timely communication and starting prompt treatment are vital in delivering care in such rare sarcomas. While musculoskeletal surgeons, radiologists, and clinical oncologists are well known, the role of specialist nurses has been less described. They form a vital pillar in any tertiary sarcoma service by assisting in collaborative care, having consultations in nurse-led clinics, offering psychological support, imparting details of treatment to patient and helping in palliative care. This narrative review focuses on the role of trained specialist nurses in a tertiary sarcoma service and gives insight into their vital role in delivering timely, coordinated, effective care.     

Stress among student nurses: is it practical or academic?

Summary

• ? Previous research into stress among student nurses has only concentrated on the practical aspects of nursing and has ignored stress caused by the academic side of training. In comparing Registered General Nurse (RGN) and Diploma of Higher Education in Nursing (Dip. HE Nursing) students using a modified nurses stress scale, the intensity of stress was investigated.
• ? It was hypothesized that there would be a difference in the total stress scores between the two pre-registration education courses as well as within the practical and academic elements.
• ? Dip. HE Nursing students were significantly more stressed than RGN students, but equally for practical and academic elements. RGN students were significantly more stressed on the practical elements. Factors analysis clearly identified two factors: (i) the practical elements, and (ii) the academic elements of nursing. A third factor was also identified and this was related to stress induced by issues concerning death and suffering in the patient.
• ? These results have implications for the development of the nurse education course (Dip. HE Nursing) which is still in its infancy.

     

Pilot study of a visitor volunteer programme for community elderly people receiving home health care

There is a need to evaluate community support programmes for elderly people. In this randomized control trial (RCT), we determined the effectiveness of 'friendly visitors' in a volunteer programme of a visiting nurses organization in Southern Ontario, Canada. The Volunteer Friendly Visitor Programme was developed to support elderly people receiving homemaking and nursing care in the community. Volunteers are screened, trained, interviewed and matched to homebound elderly clients for general interest, visit expectations and personality. Volunteers spend three to four hours on average per week with clients socializing in mutually agreed-upon ways. The nursing staff identified clients who were lonely for this additional support. These newly-referred clients were randomly allocated to receive a friendly visitor or not for six weeks. Those receiving the volunteer visitor improved in life satisfaction and two social support measures: worth and social integration. Thus, the addition of volunteer visitors to planned homemaking and nursing care made a difference for elderly in the community.     

The impact of nurses' encounters with cancer on their attitudes towards the disease

Summary

• ? A study to develop understanding of nurses' knowledge, confidence and educational needs in relation to cancer care was undertaken.
• ? Data from this study on nurses' attitudes and the effect of professional encounters with cancer on such attitudes are presented.
• ? A cancer attitude scale was completed by 127 nurses, and 68 of the sample were interviewed in depth.
• ? Data presented reveal a pervasive negative attitude towards cancer amongst these nurses, and the important negative impact that professional encounters with cancer have on nurses' feelings about the disease.
• ? Data presented are taken from a larger study, which is reported elsewhere (Corner, 1990; Corner & Wilson-Barnett, 1992).

     

儿科常见护患冲突的管理对策

目的:减少护理纠纷的发生.方法:通过对儿科常见护患冲突原因的分析,更新护理理念,增强法律意识,注重沟通技巧,重视护理工作环节衔接.结果:有效预防、化解科内护患冲突.2003～2005年我科未发生护患纠纷.结论:通过不断总结经验,持续护理质量改进,护患冲突、纠纷明显减少.     

性病诊治中护患关系的伦理学探讨

探讨影响性病诊治中护患关系的伦理学因素,并提出相应的护理对策,以期建立和谐的新型护患关系.护理道德义务、保护性病患者个人隐私、护士的职业进取心、性病患者的疾病知情权等因素是当前影响性病诊疗中护患关系的主要伦理学因素;因此,加强护士的职业道德教育、尊重患者的人格和隐私权、提高自身护理专业水平、普及健康教育等伦理学措施有助于改善护患关系,最终规范性病的诊疗.