Clinical Nursing Experience Research Articles

The Experience of Clinical Nurses after Korea's Enactment of Workplace Anti-Bullying Legislation: A Phenomenological Study.

Workplace bullying is a global issue that has emerged over the past decades and is widespread all around the world. In Korea, there is a high prevalence of bullying in nursing. In 2019, Korea enacted its workplace anti-bullying legislation. This study explores the changes experienced by nurses after the enactment of the legislation and identifies problems and improvements. Qualitative research was conducted using the phenomenological analysis method proposed by Van Kaam. Twelve nurses with experience in working before and after the enactment of the legislation were selected as study participants. They worked in various departments in five general hospitals across Korea. Purposive sampling was used to recruit participants. Data were collected using one-on-one interviews. These data were analyzed by extracting significant statements and classifying them into categories, themes, and subthemes. The analysis yielded 14 subthemes, five themes, and three categories. The three categories were “positive effect of the law”, “need for awareness of the law reform”, and “impracticalities of the law that caused chaos”. There is a difference between the theory of the law and how things happen in practice in actual nursing situations. Nurses have been educated about the new law, but better education with input from nurses themselves is needed. This study lays the groundwork for a quantitative study of the issue.

A grounded theory of clinical nurses' process of coping during COVID-19.

Aims and ObjectivesTo explore clinical nurses’ process of coping during COVID‐19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster.BackgroundThe COVID‐19 pandemic has provoked widespread disruption to clinical nurses’ work. It is important to understand clinical nurses’ processes of coping during disasters to support the nursing workforce during events such as global pandemics.DesignWe employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ).MethodsData collection entailed semi‐structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses’ coping processes inductively building concepts around these points.ResultsThe predictor of nurses’ outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID—a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses’ confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing.ConclusionsUnderstanding clinical nurses’ experience of coping during COVID‐19 is essential to maintain the nursing workforce during similar disasters.Relevance to clinical practiceNurse leaders can target areas that support nurses’ confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.

The Traumatic Experience of Clinical Nurses During the COVID-19 Pandemic: Which Factors are Related to Post-Traumatic Growth?

ObjectivePost-traumatic growth (PTG) is a positive result of fighting against traumatic events. This study aimed to investigate the current status of PTG of clinical nurses and analyze its influencing factors.MethodsA total of 1790 nurses participated in the study and completed the questionnaire. Demographic data and related scales of PTG, post-traumatic stress disorder, coping style, social support, and self-efficacy were collected online. Through univariate analysis and multiple linear regression analysis, the related influencing factors were studied.ResultsThe total score of PTG of 1790 nurses was 67.17 ± 14.79. The analysis revealed that good social support and self-efficacy were important factors to improve the level of PTG of clinical nurses, while bad psychological state and working for many years were the negative factors of PTG.ConclusionGood social support and self-efficacy can help clinical nurses cope with the novel coronavirus disease 2019 pandemic and accept the disease’s challenges. If these factors can be considered in clinical practice, this will help promote clinical nurses’ mental health.

An Exploratory Study to Develop a Virtual Reality Based Simulation Training Program for Hypovolemic Shock Nursing Care: A Qualitative Study Using Focus Group Interview.

Although patients with hypovolemic shock are common in clinical practice, nursing students have little chance of coming across them during their practicum. The main focus of this qualitative study was to explore the elements essential for a virtual reality (VR) based simulation program for hypovolemic shock nursing care. To this end, we conducted focus group interviews with three expert groups of 15 (five from each group) experienced clinical nurses (≥10 years) with experience in hypovolemic shock nursing care. Data were collected in June and July 2020, and after transcribing the interviews, the data analysis involved theme development as part of qualitative content analysis. The exploratory research results were classified into five themes: experience of hypovolemic shock nursing care, determinants of patient prognosis, essential nursing competence, scenario construction, and direction for VR simulation program development. Based on their experience of hypovolemic shock nursing care, the participants suggested concrete development directions for scenarios and VR-based simulation training programs. This article proposes the development of a VR-based simulation program that reflects the exploratory research results of this study in order for nursing students to take an interest in hypovolemic shock nursing care and efficiently improve related skills.

Nurses’ perceptions of preparedness for acting as Nurse Unit Managers: A cross-sectional study.

BackgroundThe Nurse Unit Manager role is vital to achieving outcomes in health care. Although research shows that Nurse Unit Managers feel underprepared for the role, little is known about the experiences of senior clinical nurses as they move into the role. The perspectives of these nurses are important because their perceptions of preparedness will likely affect their experiences, impacting patient and organisational outcomes. AimThe aim of this study was to explore the development opportunities available to potential nurse unit managers in an Australian health service, the effectiveness of these and nurses’ perceptions of preparedness for acting in the role. MethodsA largely quantitative approach was used to collect cross-sectional data via a survey-based study design. The study examined the experiences of senior nurses who had acted in the Nurse Unit Manager role, across four domains aligned with the role's position description. FindingsOverall, participants reported feeling unprepared for the Nurse Unit Manager role, which negatively affected their experiences. Participants reported a deficit in support and structured development opportunities provided to potential Nurse Unit Managers. Where education was received, participants reported feeling more confident and prepared. DiscussionThe findings suggest that education, mentorship and experience in acting in the role contributed to nurses feeling prepared and confident about transitioning into the Nurse Unit Manager role. Further research should be directed to the development, implementation and evaluation of structured development programs that encompass these aspects. ConclusionThis study indicates that strategies should be implemented to improve the preparation of potential Nurse Unit Managers.

Development and Pilot Analysis of the Bruise Visibility Scale

IntroductionThe accuracy of assessing and documenting injuries is crucial to facilitate ongoing clinical care and forensic referrals for victims of violence. The purpose of this cross-sectional, pilot study was to evaluate the inter-rater reliability and criterion validity of a newly developed Bruise Visibility Scale (BVS). Methods: The instrument was administered to a diverse sample (n = 30) with existing bruises. Bruises were assessed under fluorescent lighting typical of an examination room by three raters who were randomly selected from a pool of eight experienced clinical nurses. Colorimetry values of the bruise and surrounding tissue were obtained using a spectrophotometer. Results: The BVS demonstrated good single (ICC = 0.71, 95% CI = 0.54 – 0.84) and average agreement (ICC = 0.88, 95% CI = 0.78 – 0.94) between raters. A significant, positive moderate correlation was found between mean BVS scores and overall color difference between the bruise and surrounding skin (Pearson’s r = 0.614, p < 0.001). Conclusion: With further research, the BVS has the potential to be a reliable and valid tool for documenting the degree of clarity in bruise appearance.

Perception of Nursing Students on Recovery of Persons with Mental Illness

The concept of recovery assumes various meanings, depending on the context in which it is raised. The present study aimed at exploring the perceptions of the nursing students about recovery of persons with mental illness (PwMI). Based on convenience sampling and their willingness, 460 undergraduate (UG) and postgraduate nursing students from 85 colleges of nursing in India who came for Psychiatric Nursing clinical experience at the study institute, which is a tertiary care psychiatric institute in South India between May 2017 and December 2018, took part in the study. A semi-structured, self-administered questionnaire was distributed to the students. The data were analysed using statistical software (SPSS 22 version) and P &lt; 0.05 was considered as the level of significance. Majority (86.5%) of the students were females and UGs (77.6%). Among them, 4% had a family history of mental illness. More than half (54.1%) of the students had experience of taking care of PwMI. Results revealed that more than three-fourth (76.1%) of the students had used the term 'recovery' in the psychiatric setting. Majority of them agreed that early detection of mental illness helps in recovery (90.4%), and patient's self-confidence can be increased by keeping him/her busy and engaging in meaningful activities (91.1%). However, nearly 70% agreed that isolating patients with mental illness from family/friends/support groups can be a barrier to recovery. The study provides the preliminary findings of the perception of nursing students on recovery from mental illness. The study has implications on improving the perception on the recovery of PwMI and the need for educating the public on mental illness.

Polypharmacy in the Older Adult: Medication Review in the Community

Polypharmacy remains a significant healthcare issue in the United States, resulting in drug interactions, adverse drug reactions, and potentially dangerous complications. Polypharmacy, often defined as the simultaneous use of five or more medications, may lead to adherence problems and an increased risk of hospitalizations and death, particularly in the older population. Medication management was incorporated into undergraduate nursing clinical experience in an affordable housing urban community as part of the New Jersey Geriatric Workforce Enhancement Program (NJGWEP), a 5-year grant supported by DHHS-HRSA. This paper will describe the first phase of this project, which involved the determination of the prevalence of polypharmacy and high-risk medications in this setting. The charts of sixty residents were reviewed and along with demographic information, the following data was collected: total number of medications (prescription, non-prescription and herbal supplements), high-risk medications using Beers criteria and identification of common themes or issues. The average age of the residents was 72 years, with cardiovascular diseases and diabetes mellitus being the most common comorbidities. Fifty-two of the sixty residents (86%) received five or more medications daily, meeting the definition of polypharmacy. The average number of medications taken on a daily basis was 8.9. Among the residents, centrally-active agents such as gabapentin, tramadol and lorazepam were the most commonly prescribed medications. The second phase of this project will include implementation of a medication reconciliation process to identify potential issues using the Beers criteria and implement appropriate interventions to ensure safe medication practices in this high-risk population.

Liderazgo &amp; clima organizacional de un hospital pediátrico cubano. Visión de enfermeras jefas y asistenciales

Objective: Describe experiences of nurses heads and clinical nurses on the causes that may affect the organizational climate of pediatric services in a Cuban hospital. Method: Qualitative and exploratory study done in the months of April - December, 2018 with 14 heads nurses and 11 healthcare nurses, belonging to the Pediatric University Hospital "Paquito Gonzales Cueto", Province of Cienfuegos, Cuba. The data were collected with the focus group technique; the narratives were processed through content analysis based on the theoretical framework of organizational climate with the central category of leadership. The research was evaluated by the Ethical-Scientific Committee of the reference hospital. Results: Four subcategories of content analysis emerged based on the theoretical framework. The most important was “ideology of a manager “followed by "continuous improvement" "listening for relational harmony" and "sense of belonging". Conclusions: the main causes as affecting organizational climate are related to the characteristics of the leader and the possibilities of overcoming them and the rest of the staff.

임상 간호사의 환자 및 보호자로부터의 폭력 경험 실태와 폭력 경험별 대처 방법

Purpose: This research was done to investigate the violence experience and violence coping method of clinical nurses in a general hospital, and to help nurses to work in safe working places. Methods: Data were collected from January to March in 2017 for 73 nurses working in wards, intensive care unit and emergency room at one general hospital. Descriptive statistics, X²-test with the SPSS 25.0 program were used for data analysis. Results: 77.2% of participants experienced verbal abuse from patients, 35.2% experienced physical threat from patients and 86.3% of participants experienced violence whom 86.2% experienced verbal abuse and 20.7% experienced physical violence from patients. Over 50.0% of participants had coping methods(direct response, seeking for help, no action) of violence experience. Most frequent violence coping methods were ‘try to calm down by conversation (63.0%)’ followed by ‘report verbally to supervisor (52.1%)’, ‘Call for help with colleagues (52.1%)’. Conclusion: It is needed the support of the institutional communication system to prevent violence as well as tailored to clinical workplace to the clinical nurses cope more against violence.

Experiences of clinical first-line nurses treating patients with COVID-19: A qualitative study.

AimTo explore the work experience of clinical first‐line nurses treating patients with coronavirus disease 2019 (COVID‐19).BackgroundCOVID‐19 has been listed as an international public health emergency. Clinical first‐line nurses are at a high risk of infection, and they face a lack of experience and inadequate preparation for COVID‐19, leading to physical and psychological disorders.MethodsA qualitative study was conducted from January to February 2020 at a COVID‐19‐designated hospital in Wuhan, China. Thirty nurses were selected for the study using a purposive sampling method. Data were collected by semi‐structured interviews and analysed using content analysis.ResultsTwo main categories were defined in the study from the perspective of nurses: negative experiences during clinical first‐line work and positive impacts of clinical first‐line work. Under the first category, two subcategories were included: psychological experiences of clinical first‐line work and difficulties faced during clinical first‐line work. The analysis further yielded two subcategories for the second category: the needs of clinical first‐line work and the impact of clinical first‐line work on professional attitudes.ConclusionsThe results demonstrate that success depends upon strengthening emergency training and knowledge of infectious diseases for nurses, providing adequate protective equipment and improving the emergency response plans of hospitals for public health emergencies.Implications for Nursing ManagementIt is believed that our findings will guide hospital managers to make improvements in personal, administrative and institutional areas and that they will provide a reference and inspiration for nurses with regard to public health emergencies in the future.

Assessing the Impact of a Preclinical Immersion on Nurse Practitioner Student Confidence for the Initial Clinical Experience.

It is important for faculty to prepare nurse practitioner students for their first clinical experiences to ensure student success. The purpose of this project was to implement a preclinical immersion and determine student perceptions about this experience. A half-day preclinical immersion was instituted at the beginning of the family nurse practitioner students' first clinical course. Demographic information and survey data were obtained before the preclinical immersion experience, after completion of the immersion experience, and during the last 2 weeks of the first clinical course. Students' ratings of their clinical skills and knowledge improved during the duration of the semester for 5 of the 7 items. Directed content analysis revealed 3 themes: understanding of clinical expectations, face-to-face interactions with faculty, and cognitive/emotional clinical perceptions. The use of preclinical immersion experiences may both practically and emotionally prepare students for graduate nursing clinical experiences.

A unique program for nursing students to enhance their mentalization capabilities in relation to clinical thinking.

While nurses strive to provide optimal patient-centered care, this is not always straightforward, as some cases are more emotionally charged than others - depending on the patient's mental, emotional, and physical state, and on the nurses themselves. Therefore, in order to provide accurate therapeutic responses while maintaining their own personal well-being, nurses must develop strong mentalization capabilities. We present a unique program for nursing students, specifically targeted at enhancing their mentalization abilities as part of their communication skills for dealing with emotionally charged situations. In the program, he students first learn to identify what leads them to experience increased emotional loads and how this affects their mentalization processes. Next, they learn alternative coping patterns for their benefit, enabling their own emotional regulation while providing optimal care for their patients. Conducted in small groups, this holistic four-year program is led by experienced clinical nurses and psychologists; the learning is based on actual experiences encountered by the students during their clinical experience.

Clinical research nursing and factors influencing success: a qualitative study describing the interplay between individual and organisational leadership influences and their impact on the delivery of clinical research in healthcare.

Clinical research delivery is a term increasingly used to describe the work undertaken to implement studies which explore and test prevention, diagnosis and treatment in healthcare. Such studies range from multi-site clinical trials to single site observational projects. Whilst widely acknowledged as fundamental to effective healthcare, clinical research is complex to deliver and is met with challenges in the busy clinical environment. The perceptions and experiences of Clinical Research Nurses, whose work is central to this agenda, have emerged as important, yet frequently overlooked insights in relation to the potential success of research delivery. Increased understanding of these insights is essential to address the barriers and maximise facilitators to success in clinical research. To better understand how the perceptions and experiences of Clinical Research Nurses relate to potential for success in research delivery. Seven focus groups and two one-to-one interviews (27 participants) were conducted in a large tertiary North East England National Health Service Foundation Trust between March and June 2017. Clinical Research Nurses' described perceptions and experiences of working to co-ordinate and deliver a range of research as individuals, within their teams, throughout the wider organisation, and beyond. Two key elements situated within an overarching theme of leadership emerged as likely to impact on how successfully they were able to practise:• the individual (self-leadership).• the organisation (leadership culture). The framework emerging from this study illustrates a complex interplay between personal attributes and organisational culture, mediated by national strategies and targets associated with the clinical research agenda. When situated within the concept of leadership, it broadens the potential for understanding the underlying issues and increases the range of possible support mechanisms to improve experiences for Clinical Research Nurses. Framing the challenges in this way contributes new knowledge to the dialogue surrounding clinical research delivery.

Clinical nurses' encounters of feeling disrespected: A phenomenological study.

The purpose of this inquiry was to explore the lived experience of clinical nurses' encounters with feeling disrespected. This phenomenological study used a hermeneutic approach to interview seven registered professional nurses who self-identified as feeling disrespected. All participants have worked in the clinical areas for at least 2 years. A phenomenological approach utilizing Giorgi's method was used to analyze the data, interpret and reflect on the findings for this study. The Parse method was used as a guiding paradigm. New knowledge about feeling disrespected contributes to nursing science and may help nurses and organizations that employ them, provide a healthy work environment that supports and retains them. The experience of feeling disrespected was illuminated by the following themes: "powerless, feeling like a nobody, treated like you are "stupid", "utter discouragement", and "broken connections". The ethical dilemmas experienced by these nurses resulted from negative behavioral and communication patterns, from those whom they didn't expect. It was not the patients who disrespected these nurses, it was nurses with whom they worked.

Qualitative study on psychological experience of front-line nurses combating new coronavirus pneumonia

Objective To explore the psychological experience of front-line nurses combating the novel coronavirus pneumonia (NCP) epidemic and provide suggestions and evidence for clinical interventions. Methods From January 25th to 27th, 2020, a semi-structured interview was conducted using phenomenological research methods on 10 front-line nurses combating NCP from a Class III Grade A hospital, and Giorgi phenomenological analysis was used to analyze the data. Results The psychological experience of clinical front-line nurses in this study could boil down to three themes: negative psychological experience (fear, worry, and fatigue), insufficient ability to cope with public health emergencies (insufficient awareness of disease, and insufficient emergency rescue nursing skills), and rational understanding of the fight against the epidemic (a sense of mission and confidence). Conclusions Clinical front-line nurses have different levels of negative psychological experience and lack the ability to respond to public health emergencies. Hospitals should strengthen psychological assistance and humane care for clinical front-line nurses, promote training for emergency disaster rescue nursing, improve hospital emergency management capabilities, and ensure efficient rescue work. Key words: Nurses; Pneumonia; Novel coronavirus pneumonia; Psychological experience; Qualitative study

Efficacy of “Acceptance and Commitment Therapy” Psychological Nursing in a Stroke Patient

Objective: To summarize 1 case of ACT (Acceptance and Commitment Therapy, as “ACT”) psychological nursing clinical experience. Method: ACT Application for psychological nursing, provides detailed program guidance for psychological care. Results: Sleep quality, psychological flexibility and self-management ability of the patient have been improved. Conclusion: It’s the first time to apply ACT to the psychological nursing for a stroke patient, which has achieved good results; it provides a detailed clinical experience as guidance for the development of psychological nursing; it also provides a clinical basis for the follow-up exploration of psychological nursing technology model.

More than a cultural experience: Assessing the impact of a medical-surgical international clinical on nursing students' academic performance

A review of the extant literature suggests that there remains a dearth of evidence regarding the evaluation of well-defined outcomes related to international nursing clinical experiences. The purpose of this study was to explore the relationship between students' clinical experience (traditional versus international) and a number of academic outcomes including final medical-surgical course grades, performance on relevant Assessment Technologies Institute (ATI) proctored exams, and National Council Licensure Examination (NCLEX) pass rates. A non-experimental design was implemented using retrospective data obtained from a small university in the Midwest. Students complete a medical-surgical clinical in India during the interim of their third semester in the nursing program. Results of the t-tests show a statistically significant difference in final grades for Adult Health II theory when comparing students who completed a traditional clinical (M = 83.1, SD = 3.8) with those who completed an international clinical (M = 81.6, SD = 5.2); t(100) = 2.0, p = .043. The difference in mean scores for traditional clinical students (M = 70.3, SD = 6.6) versus international clinical students (M = 66.2, SD = 7.2) for the Adult Medical-Surgical proctored exam reached statistical significance, t(119) = 4.5, p ≤ .001. In contrast, there was no significant difference in means scores between the two groups with regard to scores on the Comprehensive Predictor proctored exam (traditional clinical, M = 76.1, SD = 5.9; international clinical, M = 75.2, SD = 6.4); t(121) = 1.0, p = .316. Finally, a chi square test of independence found that the relationship between clinical status and performance on NCLEX was not statistically significant, χ2 (1, N = 197) = 0.132, p = .716. Further research is needed to examine the impact of international clinicals on a broader range of outcomes including academic, cultural competency, and clinical performance measures.

Nurse Practitioner Job Satisfaction and the Healthy Work Environment.

Nurse Practitioner Job Satisfaction and the Healthy Work Environment.

“There was Only One Nurse for Everyone”: Student Reflections of a School Nursing Clinical Experience

PurposeUndergraduate nursing faculty face challenges when teaching pediatric clinicals. Changes to pediatric care and hospital admissions have contributed to a shortage of clinical sites where students can learn to care for children with varied nursing needs. The purpose of this study was to describe benefits and barriers of pediatric clinical placements with a school health component. Design and methodsA qualitative analysis of 38 student reflective journals was conducted to identify experiences following student participation in school nursing clinicals. ResultsThree themes and three sub-themes were identified. Major themes included: benefits of the clinical experience, suggestions for improvement, and an appreciation for the school nurse role with subthemes of greater responsibility than anticipated, resource constraints, and lack of support. ConclusionsSchool nursing clinical experiences allow nursing students to interact with children with broad range of ages, abilities, and health statuses, and preview a professional pathway they may otherwise never be exposed to. School nursing experiences also help nurse educators address the shortage of inpatient pediatric clinical site placements while facilitating student exposure to the impact of social justice and social determinants on child health. Practice implicationsNurse educators are encouraged to incorporate school nursing clinical experiences in pediatric curricula. Partnering with school districts in which student enrollment reflects diversity in culture, socio-economic status, and access to healthcare should be a priority so students may see first-hand the impact of social determinants on the health of clients and populations.