Pathways to nursing: A qualitative exploration of the education and training decision-making of nursing students.

Objective: This study aimed to assess the quality of the nursing care plan developed using ChatGPT-3.5 and Gemini-2.0 Flash for a breast cancer patient. Material and Methods: The research was both descriptive and comparative. The patient's anamnesis in the breast cancer care plan example from Birol's Nursing Process, a significant resource on the nursing process in Turkey, was presented to the artificial intelligence models ChatGPT-3.5 and Gemini-2.0 Flash. The care plan formed by these models was assessed in relation to the breast cancer care plan example presented in Birol's book, Nursing Process, and the nursing diagnoses established by the International North American Nursing Diagnoses Association (NANDA). Results: Upon evaluating the replies of artificial intelligence models about the nursing care process, it was observed that both models encompassed the phases of nursing diagnosis, goal setting, intervention planning, and assessment; however, only ChatGPT-3.5 incorporated the stages of data collecting and execution. In the sample care plan, 7 nursing diagnoses were generated by ChatGPT-3.5, whereas 6 were produced by Gemini-2.0 Flash in a comparable manner. Furthermore, both models handled supplementary diagnoses that were excluded from the example care plan. The diagnoses generated by ChatGPT-3.5 were akin to those found in NANDA, but the diagnoses produced by Gemini-2.0 Flash encompassed distinct diagnoses absent from NANDA. In the context of nursing interventions, ChatGPT-3.5 concentrated on assessing the efficacy of care post-intervention, whereas Gemini-2.0 Flash prioritized patient education and informational processes during all interventions. Conclusion: ChatGPT-3.5 demonstrated superior efficacy compared to Gemini-2.0 Flash in the nursing process. Furthermore, it was established that both AI models are applicable in nursing diagnosis and the formulation of interventions under the supervision of nurses. It is advisable to incorporate AI systems into the nursing education process under the oversight of nursing educators.

The postpartum period is a phase of maternal adaptation following childbirth. During this stage, mothers commonly experience various discomforts, including pain, fatigue, and mood disturbances. Lavender aromatherapy is one of the non-pharmacological interventions used to reduce pain and enhance emotional well-being by promoting comfort, openness, and a sense of reassurance. This study employed a case study design with a descriptive approach, implemented through the stages of the nursing care process using lavender aromatherapy as the primary intervention. The instruments used were the Visual Analog Scale (VAS) to assess pain and fatigue, and the Positive Affect Negative Affect Schedule (PANAS) to evaluate mood. Assessment and data analysis revealed that the primary nursing problems identified in both patients were acute pain and risk of infection, with an improvement in parental role readiness observed in the main case. Following the administration of lavender aromatherapy, both patients demonstrated reductions in pain and fatigue scores, as well as improvements in mood. Initially, pain and fatigue were categorized as moderate, but decreased to mild levels after the intervention, accompanied by an increase in positive affect. These findings indicate that lavender aromatherapy effectively reduces pain intensity, alleviates fatigue, and enhances mood among postpartum mothers.

HighlightsThis study examines the clinical reasoning process of nurses working in emergency departments. The resulting Nursing Clinical Reasoning Model highlights the dynamic, contextual, and relational nature of decision making in emergency care.What are the main findings?The Nursing Clinical Reasoning Model conceptualizes clinical reasoning as a dynamic and iterative process.Clinical reasoning is embedded in the nurse–patient–family relationship and is shaped by contextual factors that influence how nurses assess, intervene, and respond to patient needs.What is the implication of the main finding?Applying this model in emergency settings may lead to an earlier recognition of patient severity, faster and more consistent interventions, and improved patient safety. It also implies benefits for training and protocol development by clarifying the subprocesses that underpin nurses’ decision making.Background: Nurses’ clinical reasoning is increasingly being recognized as a core competence that enhances the quality and safety of care across diverse healthcare settings. Nurses with refined clinical reasoning skills contribute significantly to improved health outcomes and broader health gains. In emergency departments, this competence is essential to rapidly assessing complex problems, anticipating complications, and preventing the deterioration of patients’ clinical conditions. Such expertise enables nurses to discern the severity of clinical situations quickly and intervene effectively. Objectives: The aims of this study were to analyze the clinical reasoning process of nurses and develop a theory that explains this process in emergency care settings. Methodology: This qualitative study explored the following research question: “How do nurses enact the clinical reasoning process in emergency departments?” The Grounded Theory methodology was used, with a theoretical sample of 20 nurses. Data collection methods included in-depth interviews, participant observation, and field notes. Results: The theoretical analysis identified clinical reasoning as a substantive theory composed of two subprocesses: Diagnostic Nursing Assessment and Therapeutic Nursing Intervention. Nurses’ clinical reasoning determines two levels of patient severity—Level I, life-threatening situations (immediate risk), and Level II, non-life-threatening situations (expressed problems)—according to which nursing interventions are adjusted. Conclusions: The Nursing Clinical Reasoning Model is a dynamic and continuous process that involves both Diagnostic Nursing Assessment and Nursing Therapeutic Intervention. It is deeply rooted in the nurse–patient–family relationship and is shaped by the specific care context, which influences nurses’ assessments and interventions and patients’ responses and behaviors.

Hypertension, known as the silent killer, is a global health problem with a high prevalence rate. Hypertension needs to be treated seriously to prevent complications. The purpose of this study was to apply nursing care and finger grip and deep breathing relaxation techniques to hypertensive patients using a comprehensive nursing process approach. This study used a descriptive method with a case study approach accompanied by the application of evidence-based practices. Nursing care was provided to a 57-year-old female patient with a medical diagnosis of hypertension. The assessment revealed four nursing problems, namely risk of decreased cardiac output, acute pain, risk of nutritional deficiency, and activity intolerance. The implementation carried out for the nursing problem of risk of decreased cardiac output included performing finger grip relaxation and deep breathing techniques. The evaluation results showed a decrease in blood pressure from 211/100 mmHg on the first day to 152/76 mmHg on the third day. Nurses can teach finger grip relaxation and deep breathing techniques to patients and families to lower blood pressure.

Gout arthritis is a degenerative joint disease commonly found in older adults, characterized by the accumulation of uric acid crystals that cause acute pain and inflammation in the joints. This case study aimed to describe the nursing care process for an elderly patient with acute pain due to gout arthritis using non-pharmacological therapy of warm ginger compresses at the Dewanata Elderly Social Service Center in Cilacap. The method used was a nursing care approach including assessment, diagnosis, intervention, implementation, and evaluation. The main nursing diagnoses identified were acute pain, impaired physical mobility, and disturbed sleep pattern. The interventions focused on pain management through ginger warm compresses, relaxation techniques, and activity modification. On the first day, the patient reported severe stabbing pain in the right knee with a pain scale of 6 and limited movement. After two days of nursing intervention, the pain intensity decreased to a scale of 5, serum uric acid levels dropped from 12 g/dl to 9.4 g/dl, and the patient reported improved sleep quality and mobility. The results indicate that non-pharmacological interventions, especially warm ginger compress therapy, effectively reduce joint pain, improve comfort, and enhance physical function in elderly patients with gout arthritis. In conclusion, comprehensive gerontological nursing care with a combination of pharmacological collaboration and non-pharmacological approaches can improve the quality of life and functional independence of elderly gout arthritis patients.

Ovarian neoplasms are one of the gynecological disorders that are often diagnosed at an advanced stage because the symptoms are not specific. This condition causes various nursing problems ranging from pain, risk of infection, risk of bleeding, to nutritional disorders. This study aims to describe the nursing care process for a post-operative patient diagnosed with cystic ovarian neoplasm. The design used was a case study with a nursing process approach. The research subject was a 44-year-old woman who was treated in the gynecological surgery ward and complained of abdominal enlargement, nausea and vomiting, pain scale 5, leukocytosis, anemia, and poor nutritional status. Data collection was carried out through interviews, observations, physical examinations, and medical record reviews. Four main nursing diagnoses were established, namely acute pain, risk of bleeding, risk of infection, and risk of nutritional deficiency. Interventions included pain management, bleeding prevention, infection prevention, and nutritional management, supported by the collaboration of analgesic and antibiotic administration, as well as nutritional consultation. The results showed a decrease in pain from a scale of 5 to 4, a decrease in drainage from 600 cc to 300 cc, a decrease in leukocytes from 25,660/mm³ to 17,700/mm³, and an increase in food intake, which resulted in an increase in body mass index from 15 to 16.9 kg/m². These findings indicate that nursing interventions can improve patient conditions, although pain management still requires additional interventions to achieve optimal results. The results of this study reinforce the importance of a holistic approach in the care of ovarian cancer patients, especially in the postoperative phase.

This study evaluated the effectiveness of virtual reality simulation in enhancing nursing students' competency in the nursing process. A multicenter randomized controlled trial was conducted at 3 nursing schools with 62 students randomly assigned to either an experimental group or a control group. The experimental group used the Oculus Quest 2 to engage in a 360-degree video-based simulation of a patient with pulmonary thromboembolism, while the control group reviewed the same scenario using text-based materials. Both groups collected objective and subjective patient data and completed nursing process documentation. Confidence in the nursing process and preparedness for practice were assessed through pretests and posttests. Learning satisfaction and engagement were measured postintervention. The quality of nursing process documentation was evaluated by an independent rater blinded to group assignment. The experimental group showed significantly higher scores in documentation quality and reported greater learning satisfaction than the control group. However, no significant differences were observed in engagement, confidence, or preparedness between the groups. These findings suggest that 360-degree video-based virtual reality simulations can effectively support nursing students' learning of the nursing process. To maximize learning outcomes, future research should incorporate more active learner participation, including verbal and physical task performance, along with structured debriefing and feedback.

Hypertensive emergency is a critical condition that requires prompt, accurate, and professionally documented nursing care through standardized nursing processes. One of the challenges in the Emergency Department of Ar Rasyid Hospital Palembang is the suboptimal implementation of 3S-based nursing documentation (SDKI, SLKI, and SIKI) for patients with hypertensive emergencies. This community service activity aimed to enhance nurses’ professionalism through the implementation of socialization on 3S nursing documentation in emergency nursing care. The methods included an initial survey, interviews, observations, and the administration of pre-test and post-test, followed by socialization sessions and simulation of 3S documentation. The participants consisted of head nurses, team leaders, and staff nurses in the emergency department. The evaluation results demonstrated a significant improvement in nurses’ knowledge and understanding after the intervention, as reflected by higher post-test scores compared to pre-test scores. Furthermore, the implementation of 3S documentation became more consistent in emergency nursing records, both manually and through electronic medical records. This activity confirms that socialization and simulation of 3S documentation are effective strategies to improve the quality and professionalism of emergency nursing care for hypertensive emergency patients in hospital emergency departments.

Background:Medical infrastructures, application of control strategies, and proper implementation of logistic policies are vital for successful management of an epidemic in a country, but all of them are under the influence of the health and management policies of countries. Thus, this study aimed to compare the strategies used by Iranian and Chinese nurses for management of patients with COVID-19.Materials and Methods:This study was conducted based on the conventional content analysis method of Graneheim and Lundman approach. Participants were recruited by purposeful sampling among the nurses working in the COVID-19 wards of Shariati Hospital in Tehran, Iran, and Haikou Hospital in Hainan, China. Data were collected by conducting semistructured interviews from August 2020 to February 2021. Then, the differences in used strategies by the nurses in the two countries were investigated using the data were analyzed using MAXQDA-10, qualitative data analysis software, and descriptive analysis technique.Results:In-depth interviews were carried out with nine Chinese and ten Iranian nurses. With “Managers as the key element to overcome the crisis” as the main category, six categories and 22 subcategories were excluded from the Iranian interviews. With “Action to control crisis” as the main category, eight categories and 19 subcategories were excluded from the Chinese interviews.Conclusions:Nursing managers in China focused on the process of training nurses to take care of patients with COVID-19 and reducing the transmission of infection among health care workers. However, nursing managers in Iran focused on compensating the shortage of nurses, shortening the duration of patients’ hospitalization, daily monitoring of nurses’ performance, and ventilator settings of patients.

Application of Abdellah’s Nursing Process in Patient Care with ECMO: A Case Report

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Background: Women with high-risk pregnancies following infertility are vulnerable to anxiety, which may contribute to adverse pregnancy outcomes and impaired prenatal attachment. While previous studies have examined anxiety in infertility or high-risk pregnancy separately, limited evidence exists on theory-based nursing interventions that integrate both conditions to support maternal role attainment. This study addresses this gap by applying an integrated nursing model based on King’s Goal Attainment Theory and Mercer’s Becoming a Mother Theory.Purpose: To describe how King’s Goal Attainment Theory and Mercer’s Becoming a Mother Theory are operationalized within the nursing care process to support maternal role attainment in women with high-risk pregnancies following infertility.Methods: This case series applied Goal Attainment Theory and Becoming a Mother Theory in the nursing care of five women. A seven-day intervention was provided to support encoding into long-term memory. Participants were pregnant women with a history of infertility who achieved natural conception and presented with high-risk conditions. Goal Attainment Theory facilitated interactive communication to achieve mutual goals, while Becoming a Mother Theory guided support for maternal role attainment.Results: Participants demonstrated adequate knowledge and strong commitment to pregnancy care but experienced psychosocial challenges, suboptimal prenatal attachment, and limited preparation for childbearing. Theory-based nursing care grounded in King’s Goal Attainment Theory and Mercer’s Becoming a Mother framework actively engaged clients in problem identification, goal setting, and collaborative care planning, thereby enhancing understanding of health conditions, reducing anxiety, strengthening commitment to prenatal care, and improving prenatal attachment across cases.Conclusion: Clients’ participation supports maternal adaptation and role attainment during pregnancy. Integrating Goal Attainment and Becoming a Mother Theory offers a practical and person-centered framework for women with high-risk pregnancies following infertility. The findings emphasize the importance of shared goal-setting and interactive communication. Further research with a larger sample is needed to confirm broader applicability.

Abstract: Objective: To explore the evidence-based nursing optimization strategy for catheter tip positioning during peripherally inserted central catheter (PICC) insertion in patients with persistent left superior vena cava (PLSVC). Methods: For one ovarian cancer patient with PICC malposition in the coronary sinus (CS) due to PLSVC, multi-modal imaging techniques were integrated to accurately locate the catheter tip. The catheter position was adjusted based on evidence (withdrawing 5 cm), and a standardized nursing process was established, including personalized health education, catheter fixation and displacement monitoring, complication monitoring, establishment of a specialized disease information archive system, and formulation of a follow-up plan. Results: The catheter tip was successfully withdrawn from the coronary sinus (at the T8 level) to the middle and lower part of the PLSVC (at the T6 vertebral level), and the catheter functioned normally after adjustment. No complications such as arrhythmia or thrombosis occurred during the 332-day chemotherapy period. Conclusion: The PICC tip in PLSVC patients should be positioned in the middle and lower part of the PLSVC (at the T5–T7 vertebral level). This new standard can effectively avoid CS-related complications. The integration of multi-modal imaging techniques and evidence-based nursing management are key to ensuring safe infusion.

Introduction: The nursing process (NP) serves as a methodological framework for designing nursing interventions, promoting quality of care, and ensuring continuity and traceability of care. Although it is integrated into initial training in Senegal, the use of this approach in clinical practice remains limited. Objectives: The study aimed to examine the perceptions of healthcare supervisors regarding knowledge, attitudes, and practices related to the nursing care process. Materials and Methods: A qualitative study was conducted to explore the perceptions of healthcare supervisors regarding knowledge, attitudes, and practices related to nursing process. Care service supervisors from eight (08) regional hospitals in Senegal were interviewed using semi-structured interviews based on reasoned sampling. A thematic content analysis was performed on the data collected using the complete transcripts. Results: The added value of the NP in the organization of nursing work and in improving the quality of care is understood by the participants. However, they stated that implementing EHRs is difficult and that the implementation of NP is fraught with obstacles, including a lack of continuing education, excessive workloads, a lack of supervision, and the absence of institutional guidelines. Although there is a willingness to use NP, their use remains limited and confined to the early stages of NP implementation, particularly data collection and planning. Conclusion: The efficient and effective use of NP requires institutional support, educational reinforcement, and the recognition of supervisors as agents of change within the healthcare organization.

Objective: The present case study aims to identify effective nursing interventions in a patient diagnosed with Markis type II coronary ectasia and multiple comorbidities through the implementation of the Nursing Process (NP). Methodology: A qualitative, descriptive, and analytical approach was employed, based on Marjory Gordon’s Functional Health Patterns. For the formulation of nursing diagnoses, outcomes, and interventions, the NANDA, NOC, and NIC taxonomies were used. Priority was given to complications such as decreased cardiac output, ineffective breathing pattern, risk of aspiration, and electrolyte imbalance. The implemented interventions reflected clinically relevant improvements in the patient’s condition. Conclusion: It is concluded that the use of the Nursing Process facilitated organized, patient-centered care focused on the individual’s specific needs, promoting a progressive and personalized recovery. This case highlights the fundamental role of nursing in the follow-up, care, and comprehensive support of individuals with rare cardiovascular conditions and underscores the importance of developing care protocols adapted to local realities.

The process of nurses’ confrontation with ethical conflicts in home care: a grounded theory study

Introduction: Care management during the process of platelet donation by apheresis should include actions that promote constant evaluation of the processes, aiming to promote continuous improvements based on scientific practices. Objective: To map potential evidence in the literature for care management in platelet donation by apheresis. Method: A scoping review was carried out, following the recommendations of the Joana Briggs Institute using the Prisma ScR checklist. To answer the research question: What are the practices in care management during the process of platelet donation by apheresis?, it was used the acronym PCC, where the problem (P) of the research is care management; the concept (C) are the practices, and the context (C) is the process of donating platelets by apheresis. The stages of identification, selection, eligibility, and inclusion of the listed articles were carried out by two reviewers individually and are represented through the Prisma ScR flowchart. Results: Of the 419 studies found, 29 articles addressing the study topic were included. The following were highlighted from the extraction of evidence: hematocrit/hemoglobin assessment at each apheresis platelet donation. Conclusion: The compilation of this evidence can serve as a basis for care management in clinical practice and the quality of care for donors. It contributes to the strengthening of work processes of nurses specializing in hemotherapy.

BackgroundProfessional practice and care process of nurses are affected by many factors such as nurses' lifelong learning tendencies, career barriers, and job satisfaction.ObjectiveThis study aimed to evaluate the relationship between nurses' effective lifelong learning tendencies, career barriers, and job satisfaction.MethodsThis study was conducted with 1665 nurses working at a university and a city hospital in Ankara. The study data were collected using the "Personal Data Form", "Effective Lifelong Learning Scale", "Career Barriers in Nursing Scale", and "Minnesota Job Satisfaction Scale".ResultsWe found that nurses had high mean scores of effective lifelong learning and moderate mean scores of career barriers and job satisfaction. Effective Lifelong Learning Scale and Career Barriers in Nursing Scale total scores were not significantly correlated; Effective Lifelong Learning Scale correlated positively with Minnesota Job Satisfaction Scale; Career Barriers in Nursing Scale correlated negatively with Minnesota Job Satisfaction Scale.ConclusionSupporting the advancement of nurses and the nursing profession, which will strengthen the future and sustainability of health institutions, will also increase the quality of nursing care and improve patient outcomes. For this reason, we think that increasing nurses' lifelong learning skills and removing career barriers will have a positive effect on not only their job satisfaction but also patient outcomes.

This study explores the application effect of the nursing model based on the concept of enhanced recovery after surgery (ERAS) in the perioperative period of gastric cancer patients, aiming to optimize the nursing process, accelerate postoperative recovery, and improve the quality of nursing care. A retrospective analysis was conducted on 120 patients who underwent radical gastrectomy for gastric cancer in our hospital from January 2022 to December 2024. The patients were divided into an observation group and a control group, with 60 cases in each group. The control group received the traditional perioperative nursing model, while the observation group received the nursing model based on the ERAS concept. The 2 groups were compared in terms of postoperative hospital stay, incidence of complications, time to first flatus, time to first out-of-bed activity, patient satisfaction, pain score, and psychological score. The observation group had a significantly shorter postoperative hospital stay than the control group (7.2 ± 1.5 days vs 10.5 ± 2.1 days, P < .001). The total incidence of complications was significantly lower in the observation group than in the control group (10.0% vs 26.7%, P = .013). The time to first flatus (24.5 ± 5.2 hours vs 36.8 ± 6.5 hours, P < .001) and the time to first out-of-bed activity (20.3 ± 4.1 hours vs 30.5 ± 5.3 hours, P < .001) were both significantly shorter in the observation group than in the control group. The patient satisfaction score was significantly higher in the observation group than in the control group (92.5 ± 5.6 points vs 80.2 ± 6.8 points, P < .001). The postoperative pain score was significantly lower in the observation group than in the control group, and the psychological score was significantly better in the observation group than in the control group. The nursing model based on the ERAS concept can significantly shorten the postoperative hospital stay of gastric cancer patients, reduce the incidence of postoperative complications, promote the recovery of postoperative gastrointestinal function and the improvement of early mobilization ability, and at the same time, improve patient satisfaction, reduce postoperative pain, and improve psychological status. It has important clinical application value and is worthy of promotion and application in clinical practice.