Nursing Care Skills Research Articles

Development and application of the mobile-based virtual nursing simulation training content: A mixed methods study

Purpose: Nursing clinical practice education is transforming with the advent of mobile education and the unique experiences it offers in caring for virtual patients. For this innovative approach, this study aims to evaluate the efficacy of mobile-based virtual women’s breast cancer nursing simulation training content on nursing students’ confidence, satisfaction, and learning flow. It also examines the nursing students’ virtual patient care experiences.Methods: A mixed methods approach using a convergent design was employed to examine students’ cancer care confidence and satisfaction, learning flow, and learning experiences. Quantitative data through online questionnaires and qualitative data through focus group interviews were collected, merged, and analyzed.Results: This study developed a virtual nursing training module aimed at caring for women with breast cancer, a novel approach to facilitate mobile-based simulation training for nursing students. Data were analyzed using descriptive analysis, a chi-squared test, Fisher’s exact test, t-test for participant homogeneity (experimental: 20, control: 20), independent t-test, and paired t-test. Satisfaction (t=3.53, <i>p</i>=.001) and confidence (t=4.07, <i>p</i>=.001), as well as flow (t=3.78, <i>p</i>=.001), significantly improved in the experimental group compared to the control group. Two core themes and five sub-themes were derived from the experimental group’s experiences acquired by caring for women with breast cancer virtually, including that the students “Virtually cared for breast cancer patients, learning as if real.”Conclusion: The mobile-based virtual nursing simulation training content allowed nursing students to upgrade their comprehensive nursing care skills by experiencing a fun and practical environment made possible by a new learning method.

Evaluation of the effect of stoma care training using the pechakucha method on stoma care skills and anxiety in nursing students: A single-blind randomized controlled trial

AimThis study aimed to evaluate the effects of stoma care training delivered using PechaKucha (PK) on the stoma care skills and anxiety of nursing students. BackgroundInnovative learning methods are needed to make the educational content of nursing courses more interesting and comprehensible. The PK presentation technique is used in various business sectors and can be considered as a novel teaching strategy for the development of stoma care skills in nursing education. The PK method is a visual and narrative slide-based presentation technique involving 20 slides (usually containing images only) that are shown for 20 s each, for a total presentation length of 6 min and 40 s. DesignA single-blind randomized controlled study was conducted according to the CONSORT guideline. MethodsThe study sample comprised 96 first-year nursing students (47 in the intervention group and 49 controls). Data were collected during the 2024 spring semester using a student information form, the Stoma Care Skill Rubric and the State-Trait Anxiety Inventory. Stoma care training was delivered using the PK method for the intervention group and a classic lecture presentation for the control group. SPSS version 25.0 was used for statistical analysis. Independent-samples t-test was used to evaluate differences in mean stoma care skill and anxiety scores between the intervention and control groups. ResultsThe mean stoma care skills score two days after training was significantly higher in the intervention group (mean 42.59, SD 4.44) than in the control group (mean 33.87, SD 7.52) (p<0.05). Mean state anxiety scores after training did not differ significantly between the intervention group (mean 41.74, SD 6.51) and the control group (mean 43.08, SD 6.62) (p>0.05; Table 3). ConclusionThe PK method can be used as an alternative to classic slide-based presentations in nursing education. This study offers the first literature data regarding the efficacy of PK-based education for nursing care skills. Concise and image-based PK presentations may make the skill steps easier to understand and remember.

APN nurses' core competencies for general clinical health assessment in primary health care. A scoping review.

The field of Advanced Practice Nursing (APN) has developed over the past six decades. However, the definition of roles and responsibilities of APN nurses seem to be contested due to both a lack of a clear definition of the concept and to institutional and cultural barriers that restrict the nurses' opportunities to practise to the full extent of their competencies. The objective of this scoping review was to identify, examine and conceptually map the available literature on APN nurses' core competencies for general health assessment in primary health care. We performed a scoping review, following the methodological guidance for reporting as it is described by the Joanna Briggs Institute (JBI). Furthermore, the PRISMA-ScR statement and checklist for reporting scoping reviews were followed. Guiding the initial process for the search, we used the Population, Concept and Context mnemonic (PCC) to clarify the focus and context of the review. We found three areas of core competencies on which APN nurse draw in performing general health assessments in primary health care: (1) 'Collaborative, leadership and management skills' (2) 'Person-centred nursing care skills' and (3) 'Academic and educational skills'. Furthermore, we found that the three areas are interrelated, because it is crucial that APN nurses draw on collaborative competencies related to leadership and management to meet the service users' needs and deliver high-quality and person-centred care. There is a need for a more specific investigation into how APN nurses' core competencies play a role during general health assessments of patients in primary care. We suggest an evaluation of what works for whom in what circumstances looking into the interrelation between competencies, skills and knowledge when an APN nurse performs a general health assessment in a primary healthcare setting.

Nursing students’ perceptions of older adults, confidence, and anxiety level changes with their first clinical rotation: A descriptive pilot study

Nursing students often hesitate to work with older adults due to a lack of knowledge and preconceived notions. Students also experience increased anxiety and lack confidence in assessment and communication skills. This study is a descriptive pilot study to examine nursing students' perceptions towards older adult care, anxiety levels, and confidence in nursing care skills before and after their initial clinical rotation in a long-term care facility to develop future supportive educational programs and studies. 70 first-semester baccalaureate nursing students from a single nursing college answered five Likert scale questions through an online survey link. Results showed a significant increase in students' confidence in assessment and communication skills, and a decrease in anxiety after the clinical. However, students' willingness to work with older adults did not significantly change and was even lower than before the clinical. The positive sentiment of caring for older adults increased by 5.6%, negative sentiment decreased by 0.9%, and neutral sentiment decreased by 4.7%. Clinical education should prioritize strategies to reduce pre-clinical anxiety, emphasize the significance of working with older adults, and address barriers to enhance students' perceptions and attitudes toward this population.

Self-Reported Clinical Practice Skill Readiness of Final Year Nursing Students Studying in Bengaluru, Karnataka: An Institutional-Based Cross-Sectional Study

Abstract Introduction In recent few years, the production of nurses in both the public and private sectors has been growing rapidly to fill up the gap of health care staff. As there is a lack of data available on clinical practice readiness among final year nursing students in India, the question remains of how nursing students see themselves and what qualities and areas interest them are of great importance. Objectives This study was conducted to determine the clinical practice skill readiness among final year nursing students and also to explore the factors that show the significant difference with clinical practice skill readiness level. Methodology A nonexperimental institutional-based cross-sectional online survey was conducted from October 15 to November 15, 2020 using a simple random sampling technique. A total of 200 final year nursing students have participated in the study through the self-structured and prevalidated comprehensive nursing competencies questionnaire (CNCQ). Data was collected through Google Form and exported to SPSS version 20.0 for further analysis. To compare the nursing competencies score with selected demographic characteristics, a one-way analysis of variance and an unpaired t-test were applied at a 95% confidence interval (CI). The post hoc test was used to check for multiple comparisons. Results Results of the study revealed that the overall CNCQ mean score of basic nursing skills were reasonably high (39.08 ± 13.27) compared with advanced nursing care skills (13.03 ± 5.28). A significant difference (p &lt; 0.05) was observed in overall clinical posting duration in both basic (p &lt; 0.004) and advanced (p &lt; 0.001) nursing skills with selected demographic variables. There is also a significant difference found in the overall level of qualification (p &lt; 0.004) in basic nursing skills. It was observed that in basic nursing care skills half of the year clinical posting (minimum 6 months) duration had a significant difference with the improved performance skills (p &lt; 0.005) (0.57; 95% CI 0.14–1.00). Whereas the results also show that, the advanced nursing skills will be greatly improved if the nursing students get an opportunity to practice in different specialty areas for at least 2 months (p &lt; 0.013) (0.62; 95% CI 0.11–1.14) or half of the year (p &lt; 0.001) (0.95; 95% CI 0.34–1.56). This result shows a clear indication of how important clinical posting for nursing students is. Conclusion Our data suggested that the final year nursing students are losing ground in clinical practice readiness and competency. The result also shows that the clinical competency score will greatly improve in both basic and advanced nursing skills if the students are exposed to the clinical areas at least for a few months. Our findings will support the stakeholders, authorities of nursing colleges, and policymakers to make a significant decision to enhance the clinical practice among final year nursing students.

Community nurses’ knowledge and nursing care skills on enteral nutrition: A knowledge transfer programme

The researcher aims to evaluate the effect of the knowledge transfer programme on community nurses' knowledge and nursing care skills on enteral nutrition in the care of critically ill survivors. In this study, the researcher used an interventional study; a pre-test and post-test for community nurses' knowledge of enteral nutrition and a post-test for nursing care skills on enteral nutrition. This programme involved community nurses currently working at community clinics under the Ministry of Health Malaysia. Pre- and post-test community nurses' knowledge of the knowledge transfer programme shows an improvement result. There was no association between the knowledge of community nurses and nursing care skills on enteral nutrition. Knowledge transfer programme enhanced community nurses' knowledge and nursing care skills on enteral nutrition care for critically ill survivors in community settings.

Determinant Factors of Supervisor Model 4S (Structure, Skill, Support, Sustainability) Against the Implementation of Islamic Spiritual Care

Introduction: The supervision model commonly applied in nursing is the 4S model, namely the Structure, Skill, Support and Sustainability (4S) stages. This supervision model can be applied by the head of the room and the head of the shift as a supervisor in overseeing the implementation of Islamic spiritual nursing care in adult inpatient rooms. Purpose: to analyze the relationship between the role of the 4S supervisor model and the implementation of Islamic spiritual nursing care in adult inpatient rooms. Methods: the study used a cross sectional method. The sampling technique with a proportionate stratified random sampling was 62 nurses. Data analysis used univariate, bivariate analysis with Spearman test, and multivariate with logistic regression. Results: showed the role of the 4S supervisor model was good (88.7%), the implementation of Islamic nursing care was good category (52%), there was a relationship between the role of model supervision 4S with the implementation of Islamic spiritual care, with a significance value of &lt;0.0001 and the strongest relationship between the 4S model and the implementation of Islamic spiritual care is the variable skill and sustainability, seen from the significance value for skills of 0.05 (Pvalue ≤0.05), and sustainability of 0.01 (Pvalue ≤0.05). The strength of the relationship is seen based on the OR [EXP {B}] value, respectively, skill (0.194) and sustainability (0.109). Discussion: The probability of nurses implementing Islamic nursing care well is 90% if they provide Islamic spiritual nursing care skills and continuous supervision by the hospital supervisor.

Chemotherapy Induced Nausea and Vomiting in Patient Suffering from Sigmoid Colon Cancer (Case Report)

The patients suffering from cancers receive different types of treatments like chemotherapy, radiotherapy and surgery. Those patients who receive chemotherapy exhibit different side effects due to it. The most common side effects are nausea and vomiting. In this paper it is explored that, what is sigmoid colon cancer, what are its causes and symptoms. In addition, the nursing physical assessment and nursing care plane is explored in a logical way. Moreover, in the last of the paper some recommendations are given to improve the nursing care skills of nurses.

Book Reviews

Kersey-Matusiak G. Springer Publishing; 2019. Paperback; 347 pages.Equity, diversity, and inclusion are coming to the forefront of nursing care skills, knowledge, and abilities. Social determinants for a population are not the only contributors to health. We are also learning that providing the same care and applying the same research evidence to all patients do not work.Delivering Culturally Competent Nursing Care is a textbook; it is not light reading. However, we should all include this content in our library to inform our care.The book is divided into 2 sections. The first part focuses on building cultural competency skills by defining the concept, explaining the use of models and guidelines, and discussing how to work with culturally diverse colleagues. The second part is built around the needs of various populations, such as those who speak a different language, practice a different religion, or are morbidly obese.Kersey-Matusiak uses the concept of culture broadly as including “an individual’s cultural background, but also the various cultural groups to which individuals belong that may influence their health and well-being.” This definition avoids classifying individuals on the basis of the first or most easily defining characteristics and creating stereotypes.Our experience with the coronavirus disease 2019 (COVID-19) pandemic emphasizes the need for this content. We have learned about how comorbidities, ethnicity, and age are affecting outcomes for patients with COVID-19. Researchers are working hard to ensure diverse populations of patients are included in the COVID-19 vaccine trials. We have also learned about the inequities of the care delivery system, the importance of following science, and the effect of long-term outcomes on returning to normal life.Delivering Culturally Competent Nursing Care is a worthwhile investment and an excellent reference for all levels of nurses, including educators, managers, and advanced practice nurses. As you are able to identify your own cultural background and biases, you will learn how to view the patients and colleagues around you in a more culturally competent way. The book is part of the Springer CONNECT platform that allows access to additional online materials through an access code when you purchase the book.Gladwell M. Little Brown; 2019. Hardback; 400 pages.We all talk to strangers; health care workers perhaps more than some other professionals. Gladwell posits that we tend to assume people are telling the truth, unless they behave weirdly or inappropriately. In this book, he discusses the flaws in this assumption. The goal is to understand our thought processes and to learn to avoid misunderstandings and subsequent poor decisions. This book is a quick read, and Gladwell uses historical situations to support his thoughts about talking to strangers.Brown B. Hazelden Publishing; 2010. Paperback; 160 pages.It is the 10-year anniversary of the original publication of this book and Brown’s highly viewed TED Talks. The Gifts of Imperfection is a description of conclusions drawn from Brown’s research on the topic of shame. Or, in her words, her inability to “unsee” the patterns from the research. This is a great quote to start you off: “Owning our story and loving ourselves through that process is the bravest thing we will ever do.”Maxwell JC. Harper-Collins Leadership; 2008. Hardback; 128 pages.Mentoring is not only necessary but is an art to be learned. It is a way to bring along the generations that will be our colleagues as well as to plan for succession. Maxwell is a well-known author in the world of leadership development; he approaches this topic in 3 steps: Getting Ready, Engaging in the Mentoring Process, and Taking People Higher. Mentoring 101 is a short book and helps you focus your thinking on how you can mentor others.

ASSESSMENT OF PATIENT’S SATISFACTION OF NURSING CARE PROVIDED BY CLINICAL DEPARTMENTS IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL IN 2019

Background: The quality of nursing care plays an important role in overall quality of medical care. Nurses and midwives perform care well, contributing to making patients feel secure, confident, cooperative, and increasing treatment efficiency and patient satisfaction. Objective: To assess the patient’s satisfaction with nursing care provided by clinical departments in Hue University of Medicine and Pharmacy Hospital in 2019. Subject and method: A cross-sectional study on 600 inpatients at Hue University of Medicine and Pharmacy Hospital. Results: The general proportion of patient statisfaction was 71.4%%. Patients were satisfied more with mental health services (77.8%), nursing care skills (75.5%) and the relationship with nurses (70.2%), consulting health education services (73.6%). Patient were less satisfied with hospital hygiene (61.5%). Conclusion: overall, more patient show enthusiasm with the medical care provided by nurse (71.4%). However, the patient’s satisfaction with hospital hygiene stood at only 61.5%. Keywords: Quality of nursingcare, nurse, midwife

Assessment of Nursing Care Skills in Neonatal Unit: A Cross Sectional Observational Study

Objective: Increased hospital treatment is required to reduce neonatal mortality in low/middle-income (LMIC) countries. Nurses are vital for providing safe and efficient treatment, but a shortage of nurses and high patient workloads can lead to missed treatment. We aimed to evaluate thecare provided to newborns and finding missing care using direct observation methods.&#x0D; Material and Methods: Cross sectional observational study. The sample size was 133 which were calculated through Slovin’s formula. An adopted research tool was used which contain two sections. Section I included demographic data of nurses and neonates admitted in the ward. Section IIwas an Observational checklist on neonate’s care with “Yes” “NO” which include 5 main themes that had sub points.&#x0D; Result: Handing over the baby was less fifty five percent. Member not assesses the patient at the end of shift 54.1% nurses done this and 45.1% missed this task. Intravenous drug administration with a septic technique was 42 percent. Counselling of kangaroo mother care was 45.9 percent done and 54 percent missed.&#x0D; Conclusion: Research addresses a significant gap in global literature regarding quantification of nurse’s treatment using direct observational methods. We found considerable variability in the implementation of the task with potentially significant consequences for well-being and health of patients. The concentration of nursing tasks in babies was less than 60% on average. Tertiary care setting environment lacks a large proportion of nursing care with potentially serious effects on patient health and outcomes.

EFFECTIVENESS OF SIMULATION TEACHING AMONG UNDERGRADUATE NURSING STUDENTS IN CHILD CARE

Aim: Simulation preparing is created as of late and is presently generally utilized in medication and nursing training. The reason for the present research is to assess nursing understudies' information abilities and self-announced certainty, capability, fulfillment levels identified with the utilization of simulation in child care. Materials and Methods: This randomized controlled investigation was led with a comfort test of 50 nursing understudies from B.Sc Nursing course understudies was chosen in the year 2019-2020. Students were assigned to experimental and control groups.. To collect the study data educational practices questionnaire consists of nursing care knowledge assessment form and nursing care skill assessment form for children were used. A pre-test post-test design was used to evaluate the effectiveness of simulation teaching in child assessment. The students in the experimental group had simulation training about assessment and care of children; the understudies in the benchmark group were prepared with conventional training strategies. The students from both groups were observed in the hospital environment. Results: Clinical skills and information scores of the understudies in the experimental group were higher than the control group. Simulation preparing added to the advancement of their fearlessness emphatically. Conclusion: In this paper, the simulation teaching on Megacore kid simulator was beneficial and student’s clinical application skill achievements improved.

The Storyboard Development of Virtual Reality Simulation (VRS) of Nursing Care in Respiratory System Disorders Course

Introduction :Practicingclinical nursing skills requires high fidelity learning methods but are often constrained by financial factors. Virtual Reality Simulation (VRS) is a practical learning method that is able to project visually the experience of practicing nursing care in a virtually real situation. VRS is financially affordable and portable, allowing students to learn whenever and wherever. This study focused on developing the storyboard of a VRS as a method of practicing nursing care skills in the case of acute respiratory system infection at Faculty of Nursing, Universitas Padjadjaran. Methods: This study utilized qualitative descriptive design.An expert group consists of a paediatric nurse, a senior paediatric nursing lecturer, an e-learning expert and two VR experts was working serially to develop the case and storyboard. The case development stage was conducted using a Focus Group Discussion (FGD) and the storyboard development stage used two workshop sessions. The NLN/Jeffries Simulation was used as a framework to develop the storyboard. Results: The learning objectives, scenes, actions, challenges and redirect elements were identified. The learning objectives is the most essential foundation in building a storyboard. Conclusion: The storyboard template allows subject matter experts to develop VRS that capable to train nursing care skills in a safe and immersive environment.

Discourses on discharge care for children with special healthcare needs.

analyze the discourse of healthcare professionals and families on the continuous and complex care for children with special healthcare needs; understand hospital discharge as a process centered on children demands and family learning. qualitative research conducted between 2013 and 2015 through semi-structured interviews, document analysis and the sensitive creative method; the participants were ten children with special healthcare needs, six professionals and eleven family members from a public pediatric teaching hospital in Rio de Janeiro. The data underwent critical discourse analysis. at discharge, family caregivers should learn innovative care to guarantee the maintenance of their children's lives at home, but preparation is limited. the clinicians and the families pointed out Nurse as the most qualified professional for this preparation, since caring for these children requires nursing care skills.

A project to reduce the incidence of intubation care errors among foreign health aides

Foreign health aides are the main providers of care for the elderly and the physically disabled in Taiwan. Correct care skills improve patient safety. In 2010, the incidence of mistakes among foreign health aides in our hospital unit was 58% for nasogastric tube care and 57% for tracheostomy tube care. A survey of foreign health aides and nurses in the unit identified the main causes of these mistakes as: communication difficulties, inaccurate instructions given to patients, and a lack of standard operating procedures given to the foreign health aides. This project was designed to reduce the rates of improper nasogastric tube care and improper tracheostomy tube care to 20%, respectively. This project implemented several appropriate measures. We produced patient instruction hand-outs in Bahasa Indonesia, established a dedicated file holder for Bahasa Indonesian tube care reference information, produced Bahasa Indonesian tube-care-related posters, produced a short film about tube care in Bahasa Indonesian, and established a standardized operating procedure for tube care in our unit. Between December 15th and 31st, 2011, we audited the performance of a total of 32 foreign health aides for proper execution of nasogastric tube care (21 aides) and of proper execution of tracheostomy tube care (11 aides). Patients with concurrent nasogastric and tracheostomy tubes were inspected separately for each care group. The incidence of improper care decreased from 58% to 18% nasogastric intubation and 57% to 18% for tracheostomy intubation. This project decreased significantly the incidence of improper tube care by the foreign health aides in our unit. Furthermore, the foreign health aides improved their tube nursing care skills. Therefore, this project improved the quality of patient care.

Developing Practical Knowledge Content of Emergency Nursing Professionals

There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

E-Learning Education Program for Registered Nurses

The aim of this study was to describe registered nurses' experiences with an e-learning education program (ELEP) conducted at a 776-bed teaching medical center in Taipei. The study was completed in three stages: planning, implementation, and evaluation. Nurses who were registered were randomly assigned either to the ELEP or traditional in-classroom program (TICP). Data were analyzed using descriptive and inferential statistics. Forty-two nurses participated (22 in the ELEP and 20 in the TICP). Scores for participants were all > 70 points (out of 100) for both programs. Of the five courses, only teaching and learning and communication showed significant statistical difference between the two groups (p = .001). Nearly all participants (97.6%) felt satisfied with their program (both ELEP and TICP). All nurses passed the nursing care skill tests. Findings should help guide efforts to popularize e-learning education in Taiwan and help create alternative learning methods for future continuing nursing education programs.

Developing an e-learning education programme for staff nurses: Processes and outcomes

To describe the Instructional System Design Processes (analysis, design, development, implementation, and evaluation) used to develop an e-learning education programme for staff nurses at a 700-bed teaching medical center in Taiwan. Evidence has shown that education via e-learning improves knowledge and skills; however, with cost constraints and limited resources, finding effective alternatives is critical for health professionals. Five courses required for N2 to N3 level nurses were designed for both e-learning and traditional in-classroom programmes. Multiple-choice written test questions and a satisfaction questionnaire were used to compare outcomes between programmes. Nursing care skills were rated as pass or fail. Both programmes were begun at the same time and completed within a 3-month period. Forty-two staff nurses participated in this study. All nurses' knowledge scores were >70 points (out of 100) and all passed nursing care skills. In five courses, only teaching and learning and communication were statistically significantly different (p=0.001). Nearly all nurses (97.6%) felt satisfied or very satisfied with the programmes. Instructional System Design Processes provide an alternative delivery system for in-service nursing education which allows for individualized leaning.

Occupational changes in nursing: the situation of enrolled nurses.

The move to one level of qualified nurse in the United Kingdom (UK) is, in part, a consequence of professionalizing strategies. Registered nurses now undertake technical work previously performed by doctors. The role of enrolled nurses, and their career intentions, have not been considered in light of these changes, despite the fact that many still work in the National Health Service. This paper considers the pursuit of professionalization by nurses, illustrating the argument with findings from an empirical study of conversion to registered nurse by enrolled nurses. The paper is based on a secondary analysis of a large data set, originally used to explore ethnic inequalities in nursing. Data from 2968 respondents were analysed to answer a number of research questions relating to the characteristics of different groups of enrolled nurses and predictors of conversion to registered nurse. These included demographic characteristics, markers of career orientation, career progression and job satisfaction. This study used secondary analysis of data and, therefore, exploration of issues was limited, not least because the data were 10 years old. Also, the design was cross-sectional and respondents' experiences related to different stages of the phenomenon under study and the same group was not studied over time. Enrolled nurses who had converted to registered nurse were more likely than those who had no intention of converting to: be male, be younger, have been nursing longer, not be working on elderly care wards, have a high career orientation, not have taken a career break, and work full-time. Most of these factors predicted likelihood to convert. Although nurses who converted to registered nurse were more likely to anticipate career progression, they were less likely to be satisfied with their work. In attempts to define rewarding nursing work, the importance of ensuring that qualified nurses continue to retain basic nursing care skills should be acknowledged. This may offer an uncomfortable view to those seeking to further the professional status of nursing.

Teaching Rwandan families to care for people with AIDS at home.

AIDS causes disabling symptoms during its chronic and terminal phases. Families throughout the world, whether related to the patient by blood or affection, provide most of the personal care for him or her at home during these phases. Whether the family has access to advanced medical care or not, they can be taught simple comfort measures and nursing care skills that will improve the well-being of the patient. In Rwanda, a small country in east-central Africa, Red Cross volunteers were trained to teach these skills. The volunteers then returned to their villages to help local families. Six months later, 24 of these families were interviewed about the impact of the volunteers' visits. Families indicated they had benefited from being taught the caregiving skills. They also appreciated the emotional support attendant to the volunteers' visits. In summary, the training course enabled volunteers both to enhance family nursing care skills and to provide emotional support to families caring for people with AIDS at home. This training can also be used by volunteers to assist families caring for members ill with other endemic chronic infectious diseases.