Narratives Of Nurses Research Articles

Visualizing Nursing Narratives: An Evaluation of Latent Dirichlet Allocation Topic Modeling for Care Reports.

The increasing volume of unstructured textual data in healthcare, particularly in nursing care reports, presents both challenges and opportunities for enhancing patient care and operational efficiency. This study explores the application of Latent Dirichlet Allocation (LDA) topic modeling to analyze free-text nursing narratives from inpatient stays in three different clinics, aiming to uncover the latent thematic structures within. Utilizing the R programming environment and the visualization tool LDAvis, we identified three main themes: "Patient Well-being," "Patient Mobility and Care Activities," and "Treatment and Pain Management," the latter combining two closely related but initially distinct topics due to their overlapping content. Our findings demonstrate the potential of LDA topic modeling in extracting meaningful insights from nursing narratives, which could inform patient care strategies and healthcare practices. However, the study also highlights significant challenges associated with the method, including the sensitivity to parameter settings, the lack of updates for key software packages, and concerns about reproducibility. These issues highlight the need for meticulous parameter validation and the exploration of alternative text analysis methodologies for future research. By addressing these methodological challenges and emphasizing the importance of comparative method analysis, this study contributes to the advancement of text analytics in healthcare. It opens avenues for further research aimed at developing more robust, efficient, and accessible tools for analyzing free-text data, thereby enhancing the ability of healthcare professionals to use unstructured data to improve decision making and patient outcomes.

Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards.

To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Qualitative action research was used working with nurses as co-researchers. Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. This paper has adhered to the COREQ guidelines. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.

Exploring Nursing Care for Patients With COVID-19 Using International Classification for Nursing Practice-Based Nursing Records.

This study explored nursing care topics for patients with the coronavirus disease 2019 admitted to the wards and intensive care units using International Classification for Nursing Practice-based nursing narratives. A total of 256630 nursing statements from 555 adult patients admitted from December 2019 to June 2022 were extracted from the clinical data warehouse. The International Classification for Nursing Practice concepts mapped to 301 unique nursing statements that accounted for the top 90% of all cumulative nursing narratives were used for analysis. The standardized number of nursing statements for each concept was calculated according to the types of nursing care and compared between the two groups. The most documented topics were related to infection; physical symptoms such as sputum, cough, dyspnea, and shivering; and vital signs including blood oxygen saturation and body temperature. Nurses in the intensive care units frequently documented concepts related to the directly monitored and assessed physical signs such as consciousness, pupil reflex, and skin integrity, whereas nurses in wards documented more concepts related to symptoms patients complained. This study showed that the International Classification for Nursing Practice-based nursing records can be used as source of information to identify nursing care for patients with coronavirus disease 19.

Predicting Postoperative Hospital Stays Using Nursing Narratives and the Reverse Time Attention (RETAIN) Model: Retrospective Cohort Study.

Nursing narratives are an intriguing feature in the prediction of short-term clinical outcomes. However, it is unclear which nursing narratives significantly impact the prediction of postoperative length of stay (LOS) in deep learning models. Therefore, we applied the Reverse Time Attention (RETAIN) model to predict LOS, entering nursing narratives as the main input. A total of 354 patients who underwent ovarian cancer surgery at the Seoul National University Bundang Hospital from 2014 to 2020 were retrospectively enrolled. Nursing narratives collected within 3 postoperative days were used to predict prolonged LOS (≥10 days). The physician's assessment was conducted based on a retrospective review of the physician's note within the same period of the data model used. The model performed better than the physician's assessment (area under the receiver operating curve of 0.81 vs 0.58; P=.02). Nursing narratives entered on the first day were the most influential predictors in prolonged LOS. The likelihood of prolonged LOS increased if the physician had to check the patient often and if the patient received intravenous fluids or intravenous patient-controlled analgesia late. The use of the RETAIN model on nursing narratives predicted postoperative LOS effectively for patients who underwent ovarian cancer surgery. These findings suggest that accurate and interpretable deep learning information obtained shortly after surgery may accurately predict prolonged LOS.

A deductive thematic analysis of nurses with job-related problems who completed suicide during the early COVID-19 pandemic: A preliminary report.

Prior to the novel coronavirus (COVID-19) pandemic, nurses died by suicide more frequently than the general population. Antecedents prior to death include known job problems, such as disciplinary action; diversion of medications; inability to work due to chronic pain; and physical and mental illness. The aim of this study was to explore the suicide experience of nurses who died with known job-related problems during the early phase of the COVID-19 pandemic compared to what has been previously described. Deductive reflexive thematic analysis was used to analyze narratives of nurses with known job problems who died by suicide from the Centers for Disease Control and Prevention's National Violent Death Reporting System. Forty-three nurses with known job-related problems completed suicide between March and December 2020. Factors associated with death were similar to previous findings with notable exceptions, increased prevalence of suicidal ideation and post-traumatic stress prior to the event. Pandemic-specific issues were noted including reduction in hours, fear of disease transmission, civil unrest, and grief-related trauma. Suicide prevention programs need to address both institutional and individual factors associated with nurse suicide. As previously recommended, transitions into retirement and job loss are vulnerable times warranting psychological support. Further, strategies to reduce the impact of stressors and increase support for nurses are needed at the organizational level. A systems level approach to hardwire coping strategies is indicated pre-licensure and throughout nurses' careers. A new focus on how to process personal and professional grief is warranted. Resources are needed for nurses traumatized by life (rape, childhood trauma) or work-related experiences.

Reflections on Black Nurses' Invisibility: Exploring the Contribution of Black Nurses to British Columbia (Canada), 1845-1910.

Black nurses are at the margins of the annals of history and there is a dearth of historical accounts of their work. Drawing on our historical research about Black nurses in British Columbia (Canada) between 1845 and 1910, we point to the complexity of Black women's lives and argue that Black nurses disrupted the conceptualization of Blackness and Black womanhood of the time. We demonstrate the vital contributions of Black nurses to the health of communities and add to existing scholarship that redefines the nursing narrative: one in which white nurses are not the start and end point of history.

La Narrativa de Enfermería Una perspectiva desde de la lengua indígena Autores/as

Introduction: People indigenous In Mexico generally have their own uses and customs that make them different, they have particular ways of understanding the world and interacting with it. When there are specific health problems in this population, it is important that the nursing professional who treats them knows and understands the importance of performing care interventions based on their culture and language, in order to improve their quality of care. Objective: To analyze significant experience from the indigenous language with narrative nursing through patterns Carper knowledge and philosophical visions of Newman and Fawcett. Development: The nursing narrative focused on a Nahuatl speaking person treated in a public hospital by a nursing student, during a surgical intervention. A greater emphasis on the ethical and limited empirical pattern was identified. With respect to the nursing vision, it was located in a vision of Reciprocity (Newman) / Interactive Integrative (Fawcett) since the student acted based on values, beliefs, interests and experiences of the person to guide and to take care of it from the Nahuatl. Conclusion: It is concluded that the nursing narrative and the proposal of analysis works as a tool of reflection to improve the care given to the person in hospital environments and highlights the need for nursing to understand the culture and traditions of vulnerable groups through the indigenous language in their healt interventions.

The COVID-19 pandemic: Narratives of front-line nurses from Wuhan, China.

This study aimed to explore the experiences of nurses in Wuhan Hospital as front‐line workers during the COVID‐19 pandemic. A descriptive qualitative study of such nurses was conducted from a tertiary hospital in Wuhan. Semi‐structured individual interviews were undertaken with 8 registered nurses who were front‐line health workers in one of the COVID‐19 wards and 3 nursing managers from the response team. Five discrete themes were identified from the narratives of nurses' experiences during the COVID‐19 outbreak in Wuhan: “content of fundamental care,” “teamwork,” “reciprocity,” “nurses’ own worries,” and “lifelong learning and insights.” Nurses in the front line of care during the COVID‐19 pandemic can contribute important information from their hands‐on experience for providing a holistic response to an infectious outbreak like COVID‐19. The concerns nurses raised at both personal and professional levels have implications for nursing education and clinical practice settings, particularly in the time of a pandemic when nurses' well‐being requires attention, and at the same time for considering organizational factors that enable nurses to provide care to patients with confidence. Hospital policies and nursing management need to be ready and adhere to flexible work planning systems and approaches during a pandemic.

Radiological nursing narrative: Rigorous evidence of practice

Radiological nursing narrative: Rigorous evidence of practice

Nurses' response to spiritual needs of cancer patients.

In this qualitative study, nurses from the United States of America (USA) and Switzerland were asked to recount their spiritual care experiences with cancer patients and their own responses to their patients' spiritual needs. Recent advances in cancer care have highlighted the importance of spirituality and spiritual care as part of quality palliative care from the time of a patient's diagnosis through end of life. Nurses who play an important role in supporting patients, describe their own discomfort when confronting their patients' spiritual needs. A qualitative survey was used to collect narratives of nurses' experiences in responding to spiritual care needs (n=62). The accounts were analyzed using thematic analysis. Nurses identified patients as having spiritual needs and their own experiences in addressing spirituality or religion. Patients sought meaning in their illness, which, they believed, led to disease acceptance. Nurses reported their patients' struggles with challenging disease situations and their own challenges in addressing patients' spirituality/religion. With experience, nurses developed ways of talking with patients about spirituality/religion, which profoundly impacted their own lives and resulted in personal growth. Patients' spirituality was identified by nurses who tried to address patients' spiritual needs drawing on existing resources. For nurses, supporting patients in their spirituality and finding meaning in the disease situation eventually led to disease acceptance.

Empowerment issues in Japan’s care industry: Narratives of Filipino nurses and care workers under the Economic Partnership Agreement (EPA) labour scheme

Empowerment issues in Japan’s care industry: Narratives of Filipino nurses and care workers under the Economic Partnership Agreement (EPA) labour scheme

Empowerment issues in Japan’s care industry: Narratives of Filipino nurses and care workers under the Economic Partnership Agreement (EPA) labour scheme

Empowerment issues in Japan’s care industry: Narratives of Filipino nurses and care workers under the Economic Partnership Agreement (EPA) labour scheme

Personal narratives of nurses who care for patients at the end of life.

Little attention has been paid to the ways in which nurses personally experience, understand and assign meaning to providing palliative care. A qualitative study of four nurses working with patients in the terminal phase in a hospital in Mexico was conducted to understand their lived professional experiences and relationships with death. Four interviews were analysed using the Greimasian actantial-semiotic model. Actants were categorised by narrative role and their actions were analysed. The grammatical features of the narration were also examined. Nurses sought a good death for the patient, which they typically achieved, and spiritual peace for themselves, which they often did not. Nurses placed a high value on personal, social and professional recognition for their work. The philosophical themes affecting nursing as a vocation that emerged included life and death, truth and honesty and the role of God and the family. These professional values were often contradictory, and these dilemmas should be addressed in professional training and support.

English

This study extends on the phenomena of control environment of Intensive Care Unit (ICU) in Brazil through narratives of physicians, nurses and auditors and also analyzes the results with interpretative discourse analysis.  The structuration theory based on Giddens and discourse analysis toeing Laclau and Laclau and Mouffe  were also used to reflexively discuss the data constructed.  Based on one–on–one discussion held with the interviewee we infer that unawareness of control consciousness of the public servants in the healthcare units reflects on the behaviour that emanates unintended consequences of flaws in internal control procedures.  The identity in the social structures makes them believe in what they do, which keeps them abreast of the awareness of the societal responsibility and this seems to drive the control environment.  Finally, it is understandable that effective control environment cultivates certain dynamics in order to curb fraud.  They are transparency on outreach and employee welfare, non-dogmatic management style upon succession, non-idolatry of corporate governance, and sense of continuous control awareness.  Others are consistent process of active AIS, clear perception of risk of non-compliance, reward for dedication, holding to strategic alliances and positing sustainability.     Key words: Internal control, control environment, fraud, structuration theory, interpretative discourse analysis, ICU, healthcare, Brazil.  &nbsp

Prediction of Postoperative Length of Hospital Stay Based on Differences in Nursing Narratives in Elderly Patients with Epithelial Ovarian Cancer.

The current study sought to evaluate whether nursing narratives can be used to predict postoperative length of hospital stay (LOS) following curative surgery for ovarian cancer. A total of 33 patients, aged over 65 years, underwent curative surgery for newly diagnosed ovarian cancer between 2008 and 2012. Based on the median postoperative LOS, patients were divided into two groups: long-stay (>12 days; n = 13) and short-stay (≤12 days; n = 20). Patterns in nursing narratives were examined and compared through a quantitative analysis. Specifically, the total number (TN) of narratives pertaining to care and the standardized number (SN), which was calculated by dividing the TN by the LOS, were compared. Experts evaluated the relevance of the phrases extracted. LOS was then predicted using machine learning techniques. The median postoperative LOS was 18 days (interquartile range [IQR]: 16-24 days) in the long-stay group and 9.5 days (IQR: 8-11.25 days) in the short-stay group. In the long-stay group, surgery duration was longer. Overall, patients in the long-stay group showed a higher volume of nursing narratives compared with patients in the short-stay group (SN: 68 vs. 46, p = 0.021). Thirty-two of the most frequently used nursing narratives were selected from 998 uniquely defined nursing narratives. Multiple t-tests were used to compare the TN and real standardized number (RSN; minimum p < 0.1). Mean and standard deviation of classification results of long-short term memory recurrent neural networks for long and short stays were 0.7774 (0.105), 0.745 (0.098), 0.739 (0.107), and 0.765 (0.115) for F1-measure, precision, recall, and area under the receiver operating characteristic, respectively. Agreement between the differential narratives as assessed by statistical methods and the expert response was low (52.6% agreement; McNemar's test p = 0.012). Statistical tests showed that nursing narratives that utilized the words "urination," "food supply," "bowel mobility," or "pain" were related to hospital stay in elderly females with ovarian cancer. Additionally, machine learning effectively predicted LOS. The current study sought to determine whether elements of nursing narratives could be used to predict postoperative LOS among elderly ovarian cancer patients. Results indicated that nursing narratives that used the words "urination," "food supply," "bowel mobility," and "pain" significantly predicted postoperative LOS in the study population. Additionally, it was found that machine learning could effectively predict LOS based on quantitative characteristics of nursing narratives.

Everything changes to stay the same: persistent global health inequalities amidst new therapeutic opportunities and mobilities for Filipino nurses

ABSTRACTThe global migration of Filipino nurses has received significant attention, yet little is known of these healthcare workers’ experiences and mobilities within the Philippines. I explore the experiences and narratives of Filipino nurses living in Manila, some of whom have no desires to migrate. I uncover the often novel forms of therapeutic mobilities undertaken by these nurses, focusing on call centre nursing and entrepreneurship as key alternative career pathways within the realms of ‘therapeutics’. Through interrogating the various mobilities undertaken by nurses – physical mobilities and migration, socioeconomic mobilities and occupational mobilities in the form of a career change – it becomes clear that international physical mobility is no longer key. Nevertheless, Filipino nurses continue to provide care in global contexts in novel ‘therapeutic’ industries and doing so allows them to increase their socioeconomic mobility.

Good Relations between Nurses and Patients: Spreading the Wings of Imagination, Protecting Patients’ Souls

Objective: To ascertain a method for building good nurse-patient relations from the narratives of veteran nurses who have accumulated profound nursing experience, and to show these phenomena in model form. Methods: Semi-structured interviews were conducted, verbatim records of the contents of the interviews produced, and qualitative analysis undertaken. Results of analysis and concepts considered important were shown in model form. Results: Veteran nurses, utilizing their nursing specialization, showed “Concern as humans,” transcending their professional specialty. This was expressed as “spreading the wings of imagination” in order to know what is important to patients, and “protecting souls” in order to defend, together with patients, what is most important to the latter. “Spreading the wings of imagination to protect patients’ souls” became the key to build good nurse-patient relations. Conclusion: Nurses with deep experience expressed building good nurse-patient relations as “spreading the wings of imagination and protecting patients’ souls.” We were able to ascertain that in nursing practice, using the sensitivity of veteran nurses, is one way of manifesting nursing conduct.

Taboo in the Workplace: A Qualitative Study of Taiwanese Nurses' "Not-Eating Pineapple" in Clinical Practice.

There has been an increased emphasis on nurses' mental health and well-being in the workplace. Psychologists have established a correlative link between individual's beliefs on luck and mental health. The pineapple taboo has been observed among Taiwanese hospital nurses as a prevalent superstitious belief for bringing luck or warding off increased clinical workloads, but how and why the ritual persists in the hospital workplace remains unknown. This article aims to explore the latent meaning of observance of the taboo and how it is related to nurses' clinical practice and possibly affects their mental health at work. A qualitative research was designed in line with the hermeneutic phenomenological method. Through purposive sampling, 18 nurse participants were recruited for in-depth semistructured interviews. Resulting from the ensuing analysis, 3 modalities were identified as constituting the spectrum of observance of the taboo: (a) "strictly not eating pineapple"; (b) "not eating pineapple at work"; and (c) "eating pineapple without admitting to doing so." Each reflects the position of nurses revealed in relation to the pineapple taboo in clinical settings. Based on the subjective narratives of nurses, it may be understood as an active moral attempt at "being right" rather than a passive avoidance of bad luck in the taboo observation. The findings facilitate an appropriate understanding of the embedded meaning of nurses' workplace-related belief and its seminal function of empowerment for nurses in holistic nursing practice.

The Great War through Women's Eyes

ABSTRACT How did women serving in World War I frame their encounters with mortality? While the sacrificial mother and the homefront sweetheart are familiar figures from the Great War, tens of thousands of American women who served overseas are left out of gendered depictions of sacrifice and loss. Although these valiant women willingly faced the dangers war brought, how they understood these experiences after the fact is less clear. An underutilized source, their wartime scrapbooks, provides insight into their responses. This article, the results of an honors undergraduate student project at Rosemont College, focuses on visual narratives of wartime nurses, two with Pennsylvania connections and one from New York, as examples of women's efforts to record histories of a war from which they are too often excluded.

Nursing lives in the blogosphere: A thematic analysis of anonymous online nursing narratives.

The aim of this study was to explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. The research design was qualitative description. Between May-August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses' interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Three major themes arose in these nurses' online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Anonymous nursing blogs offer valuable, longitudinal insights into nurses' perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses' experiences of nursing work, as well as nurses' recommendations for addressing issues causing them to feel frustrated in their work environments.