实习本科护生专业承诺对工作价值观的影响

目的了解实习本科护生专业承诺对工作价值观的影响。方法便利抽样选取某高校实习本科护生202名为研究对象,采用一般资料、大学生专业承诺调查量表和工作价值观量表对其进行调查,并分析其相关性。结果实习本科护生专业承诺评分为(88.20±11.76)分,工作价值观评分为(121.73±19.15)分;实习本科护生的专业承诺各维度与总分均与工作价值观评分呈正相关(P0.05);专业承诺的规范承诺和理想承诺维度是工作价值观的主要影响因素(均P0.05)。结论实习本科护生专业承诺对其工作价值观起着正面积极的影响,护理教育者应当采取相应的措施提高护生专业承诺水平,帮助其树立积极的工作价值观。     

护理专业学生实习后期心理一致感现状及影响因素研究

目的:调查护理专业学生(护生)实习后期心理一致感现状,并分析其影响因素,以期为制定有针对性的相关措施提供参考。方法:采用便利抽样的方法选取河南省两所三级甲等医院147名实习护生作为研究对象,采用一般资料调查表、心理一致感量表(SOC-13)、大学生元认知能力量表对其进行问卷调查。结果:实习护生心理一致感总分为(53.23±9.05)分、元认知能力总分为(83.65±14.07)分,心理一致感总分与元认知能力总分及各维度得分呈正相关(P<0.05)。多重线性回归分析结果显示,性别、父母是否为医务人员、元认知能力是影响护生实习后期心理一致感的主要因素(P<0.05)。结论:性别、父母是否为医务人员、元认知能力影响护生实习后期心理一致感,护理管理者及临床带教老师应根据护生实习后期的心理一致感现状制订带教计划,提高其心理一致感。     

Clinical teachers as role models: perceptions of interns and residents in a Lebanese medical school

OBJECTIVE: To identify the characteristics and learning impact of role models as perceived by interns and residents in an Arabic Middle Eastern country, Lebanon. METHODS: A structured and self-administered questionnaire was sent to the cohort of interns (n = 34) and residents (n = 66) training in a Lebanese university hospital. The questionnaire contained pre-specified items related to professional and personal characteristics of positive and negative role models, as well as to the impact of these models on professional learning and career choices. Responders were asked to recognise and to rank-order the items associated to their identified models. RESULTS: A total of 88 responders (97%) had positive role models and 87 responders (96%) had negative role models in their current training programme. Characteristics identified most frequently and ranked most highly by the trainees were related to clinical skills in positive role models and to inadequate humanistic and collaborative attitudes in negative models. Role modelling had a positive impact on the achievement of clinical skills for 55% of the responders, and on the acquisition of humanistic and collaborative attitudes for 30% of them. Thirty-eight per cent of the trainees were influenced by their role models in the choice of their specialities. Responses were generally comparable between levels of training and between medical and surgical specialities. CONCLUSION: Clinical teachers, practising in a non-occidental cultural and medical learning environment, are considered very frequently as role models by their interns and residents and have a positive impact on their professional learning and career choices. Strategies to reinforce role modelling are needed in Lebanon, in order to pass a broad spectrum of professional values to our students.     

The implementation of the UHC/AACN new graduate nurse residency program in a community hospital

Transition into the workforce for the new graduate nurse is affected by many factors. New graduate nurses can benefit from support provided through participation in the UHC/AACN Residency Program. The retention of even one graduate nurse saves the employing institution up to an estimated $80,000 annually. St Joseph's Hospital has improved the retention of new graduate nurses from approximately 40% to 100% with the addition of the UHC/AACN Residency Program alongside other system changes. Data are being monitored at St Joseph's and on a national level through this multisite collaborative aimed at improving patient care and increasing nurse retention.     

Residents who stay late at hospital and how they perform the following day

CONTEXT: The limits imposed on the official working hours of paediatric residents do not necessarily reduce the amount of time they spend at work. Fatigue and stress can result from staying late voluntarily, and this in turn can alter clinical performance, much as long obligatory hours did in the past. METHODS: A cross-sectional analysis was made of a systematic sample of 243 primary care visits conducted in 1990 by 52 paediatric residents at a teaching hospital. The paediatric residents reported on their work responsibilities the night before each primary care visit and their communication style during the visit was analysed from recordings made on audiotapes using the Roter Interactional Analysis System (RIAS). RESULTS: Paediatric residents who care for critically ill children were more likely to stay late even if they were not on call. During primary care visits the next day, those paediatric residents who stayed late were more verbally dominant--their verbal input, as a proportion of the total, was: 0.67 (stayed late) versus 0.62 (on call), P = 0.007; 0.67 (stayed late) versus 0.64 (left on time), P = 0.02. Paediatric residents who stayed late displayed less patient-centredness: patient-centred talk as a proportion of total 0.31 (stayed late) versus 0.36 (on call), P = 0.02; 0.31(stayed late) versus 0.34 (left on time), P = 0.03. Compared with paediatric residents who left on time, those who stayed late reported feeling less fulfilled; if their clinic was in the afternoon, they also reported more fatigue. CONCLUSIONS: The care of critically ill children may make paediatric residents more liable to remain at work after the end of their shift. The clinical interactions of such residents were more dominant and less patient-centred. Helping paediatric residents to learn to manage their work while under clinical stress could promote better adherence to guidelines on working hours and have a positive impact on patient care.