Role Of Nursing Professionals Research Articles

Attracting and maintaining the Y Generation in nursing: a literature review

This paper explores the literature related to attracting the Y Generation (Y Gen: people born between 1980 and 2000) to the nursing profession and retaining them in our current workforce. A comprehensive review of the literature supported the need for further research. Three searches were conducted and all relevant literature was reviewed by each researcher. Literature included in the review was chosen based on specific search-term inclusion. Structured searches were conducted with no limitations on publication type, date or language. Search engines used included: Australian Family and Society, CINAHL, Expanded Academic, Google Scholar, Medline, ProQuest and PubMed. A critical review of the literature, particularly empirical work on the subject has informed decision making regarding the research questions that remain to be explored. The literature revealed that the Y Gen is currently contributing to the nursing workforce demographics. Much discussion exists surrounding the integration of the Y Gen into the workplace along with the other three generations of nurses. There is also an abundance of descriptions of the Y Gen characteristics and values. There is, however, limited reference relating to what attracted this generation to nursing or what might retain them in the nursing workforce. The Y Gen is the largest generation to enter our workforce since the Baby Boomers. Health services need to recognize the needs of the Y Gen nurses and develop strategies to move the profession forward by preparing the current workforce and environment for a generation that is already here. The focus should be on their strengths with development made to structure a workforce that will support the Y Gen in their professional nursing role. Understanding what attracts the Y Gen to nursing, what managers can do to retain the Y Gen in nursing and how the nursing profession can support the Y Gen to assume a role in nursing and nursing governance will ensure that the retiring generation has left the nursing profession in capable hands.

Sudden informal caregivers: the lived experience of informal caregivers after an unexpected event

The purpose of this qualitative study was to understand the lived experience of individuals taking on the role of informal adult caregivers after an unexpected event involving a relative. The literature on the development of the role of informal caregivers widely recognises that protecting and promoting the quality of life of caregivers should be a priority for health professionals. However, knowledge about how individuals develop as sudden caregivers is scarce, with existing knowledge centring mainly on the physical aspects of caregiving. What it means to become a caregiver or to experience role redefinition remains largely unclear. Hermeneutic phenomenology provided the framework that guided this study. Unstructured interviews were used for collecting data. We used Van Manen's approach to analyse data and to reveal themes. Reflexivity and collaborative analysis were used to address rigour. From caregivers' interviews (n = 14), four main themes were identified: losing control over time, feeling alone, failing expectations and taking over someone else's life. The caregiving experience is characterised as a transition process or a period of ongoing focussing and de-focussing. The extent to which caregivers feel connected with others, redefine their personal use of time and feel comfortable with their new responsibilities indicates how they are managing this transition and how well they are achieving balance in their new role, i.e. from feeling 'exclusively' a caregiver to being 'also' a caregiver. Facilitating successful transitions is within the scope of the role of professional nurses. Information about the meaning that caregivers attribute to their experience - relationships, options and strategies - is crucial, as it will help nurses to plan, assess and design adequate nursing interventions to support informal caregivers, especially in unexpected situations.

UNDERGRADUATE NURSING STUDENTS' Perceptions of Service-LearningThrough a School-Based Community Project

Service-learning (SL) is an experiential teaching method that combines instruction with community service, with the aim of enriching students' academic learning, interpersonal skills and sense of responsibility while making meaningful contributions to the community. However, measuring outcomes of service-learning projects is difficult. This article reports on the perceptions of 18 third-year undergraduate nursing students who took part in a pilot service-learning project targeting tobacco use in a local elementary school. Faculty members evaluated the program's outcomes by engaging students in structured reflection on the program about its relevance to their future careers as practicing professionals, especially in community-based settings. The students' perceptions were elicited through three sets of reflective assignments following the project. Findings from the reflective assignments suggest that the pilot program was successful in enhancing the students' academic, social, and personal development while building a partnership between the school of nursing and key players in the community, including school-based nurses, teachers, administrators, families, and community leaders. The author suggests that service-learning projects can help nursing students accomplish key developmental tasks of the college years (such as building their competence, autonomy, and integrity), while helping impart the skills and values they will need as they graduate and seek professional nursing roles.

Left alone - Swedish nurses’ and mental health workers’ experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study

The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general.

The New Fundamentals in Nursing: Introducing Beginning Quality and Safety Education for Nurses' Competencies

This article describes the redesign of the fundamentals of nursing course using an organizing framework and teaching strategies identified in the Quality and Safety Education for Nurses (QSEN) initiative. Six QSEN competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) are essential for nursing practice. Beginning knowledge, skills, and attitudes (KSAs) associated with each competency were identified in a preliminary Delphi survey as important to incorporate early in prelicensure nursing curricula. Redesign requires a shift in focus from task-training and psychomotor skills development to incorporation of a systems context, reflecting redefined values and interventions associated with safety, quality, and professional nursing roles. A course revision, based on the QSEN competencies definitions, selected beginning KSAs, exemplar resources, and teaching strategies, is described. The reframing of fundamentals of nursing is essential to prepare new graduates for contemporary practice.

The mediating role of psychological empowerment on job satisfaction and organizational commitment for school health nurses: A cross-sectional questionnaire survey

Background The importance of the professional role of school health nurses in promoting children's health in their school environment is widely recognized. However, studies of their working experience have revealed feelings of disempowerment that appear to be related to insufficient support from school managers. In these unsupportive working environments, it seems possible that psychological empowerment may play a mediating role to strengthen employees’ satisfaction and commitment to their employing organization. Objectives The aim of this study is to test an exploratory model of empowerment in a Taiwanese sample of school health nurses by examining the mediating role of psychological empowerment in the relationship between external factors and work-related attitudes, specifically job satisfaction and organizational commitment. Design A cross-sectional survey with self-reported questionnaires. Participants and methods Probability proportional sampling was used to generate a randomly selected sample of 500 school health nurses in elementary and junior high schools in Taiwan. A total of 330 valid questionnaires were returned, yielding a response rate of 66%. Results The exploratory model including all hypothesized variables provided an adequate fit ( χ 2 = 29.24; df = 17; p = .052; adjusted goodness-of-fit index [AGFI] = .96; goodness-of-fit index [GFI] = .98; root-mean-square error of approximation [RMSEA] = .05) for the data and indicated that psychological empowerment did not fully mediate the relationship between organizational empowerment and job satisfaction because of the strong direct effects of organizational empowerment on job satisfaction. The influence of empowerment on organizational commitment was mediated through job satisfaction. Conclusions Psychological empowerment did not mediate the relationship between external factors and work attitudes, and job satisfaction emerged as an important factor. If school leaders can improve the job satisfaction of school health nurses, this will help them achieve greater commitment and loyalty of school health nurses to their employing schools.

A preliminary analysis of narratives on the impact of training in solution-focused therapy expressed by students having completed a 6-month training course

Solution-focused brief therapy (SFBT) is a therapeutic approach utilized in a wide variety of settings. Its roots are in systemic and family therapy, and the emphasis in practice is on helping clients identify what their life will be like when they no longer have their problem, and how close they are to experiencing that situation now. The literature suggests that SFBT is at least as effective as other forms of psychotherapy. This pilot-study explored the impact of a training course in SFBT on the nurses who took part. Interviews were carried out with participants (n= 8) and narrative accounts were analysed and grouped according to emerging themes. Three major themes were perceived; Trust in clients, Positivity and Confidence, and these were supported by interconnected minor themes relating to the eclectic use of the approach, the use of language within the approach, and the application of SFBT in wider life. It is argued that training in SFBT may have a positive impact on the therapeutic and professional role of nurses, and that further studies are required to explore the impact of SFBT training on the professional and cultural identity of nurses.

Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence

The experience of living with cancer is associated with a variety of consequences in several central aspects of a patient's quality of life, including intimacy, body image, human relationships, sexuality, and fertility. Despite their importance, incidence, and impact on psychosocial well-being, sexual health care (SHC) is a matter not frequently dealt with by nurses in daily practice. The purpose of this study was to gather evidence regarding knowledge, attitudes, and behaviors of oncology nurses toward sexual health issues and to identify salient and latent key factors which influence provision of SHC in the context of cancer. A critical review of the literature was conducted over a period of three decades and 18 original research articles were retrieved and analyzed. A comprehensive data analysis revealed that, although oncology nurses hold relatively liberal attitudes and recognize provision of sexual health care as an important nursing role, they possess limited sexual knowledge and communication skills, while often avoid or fail to effectively respond to patients' sexual concerns. Nine possible influential key factors have been studied: incorrect assumptions toward sexual issues, comfort, sexual knowledge, professional nursing role, patient- and nurse-related issues, work environment-related issues, continuing education activities, and society-related factors. Conflicting findings are reported. The findings of the present study propose that there is an evident need of dispelling the myths about sexual health in cancer care. Besides, continuing education activities and availability of education materials could assist nurses to adequately address sexual concerns while caring for patients with cancer.

Nurses Conceptions of the Professional Role of Operation Theatre and Psychiatric Nurses

The shortage of specialist trained nurses in the operating theatre and psychiatric care is a problem in Swedish health care. There is a great need for recruitment since in both areas nurses have a high average age and few students register in these specialties at university. The reason for the low interest for these specialties is not clear. The purpose of the study was to investigate nurses' and nurse students' conceptions of the professional role of operating theatre and psychiatric care nurses. A qualitative approach with phenomenographic method was used. Twelve nurses and four nurse students were interviewed. Three categories of conceptions within each specialty emerged. Operating theatre nurses'professional role was perceived as: Dependent assistant, Responsible monitor and Fragmented nurse. Psychiatric nurses' professional role was perceived as: Empathetic agent, Conscious diplomat and Fragmented nurse. The informants had difficulties in understanding the professional role in both fields. One conclusion is that the theoretical and clinical training in basic nurse education play an important role for choosing specialist training as operating theatre nurse or psychiatric nurse.

Shifting moral values to enhance access to health care: Harm reduction as a context for ethical nursing practice

Background People who are street involved including those experiencing homelessness and substance use are at increased risk of morbidity and mortality. Such inequities are exacerbated when those facing the greatest inequities in health have the least access to health care. These concerns have rarely been addressed in bioethics and there has been a lack of explicit attention to the dominant societal and organizational values that structure such injustices. The purpose of this paper is to describe the underlying value tensions that impact ethical nursing practice and affect equity in access to health care for those who are street involved. Methods In this paper, findings from a larger qualitative ethnographic study of ethical practice in nursing in the context of homelessness and substance use are reported. The original research was undertaken in two ‘inner city’ health care centres and one emergency department (ED) to gain a better understanding of ethical nursing practice within health care interactions. Data were collected over a period of 10 months through face-to-face interviews and participant observation. Results In order to facilitate access to health care for those who are street-involved nurses had to navigate a series of value tensions. These value tensions included shifting from an ideology of fixing to reducing harm; stigma to moral worth; and personal responsibility to enhancing decision-making capacity. A context of harm reduction provided a basis for the development of relationships and shifted the moral orientation to reducing harm as a primary moral principle in which the worth of individuals and the development of their capacity for decision-making was fostered. Conclusions Implementation of a harm reduction philosophy in acute care settings has the potential to enhance access to health care for people who are street involved. However, explicit attention to defining the harms and values associated with harm reduction is needed. While nurses adopted values consistent with harm reduction and recognized constraints on personal responsibility, there was little attention to action on the social determinants of health such as housing. The individual and collective role of professional nurses in addressing the harms associated with drug use and homelessness requires additional examination.

U.S. Genetics Nurses in Advanced Practice

To describe characteristics and professional roles of genetics nurses in advanced practice. A cross-sectional descriptive survey administered in 2004 as one component of a comprehensive study of genetic services and the health workforce. The sample was 211 U.S. members of the International Society of Nurses in Genetics. The survey included demographic characteristics, education, credentials, professional roles, and attitudes about genetic healthcare issues. The majority of respondents had master's degrees and many had earned doctorates in nursing (20%) or other fields (12%). Thirty-one percent were certified as nurse practitioners; 57% provided direct patient care, with the largest percentage working in genetics (26%) or oncology (22%) settings. Over one-third were educators and 19% conducted genome-related research. Genetics nurses in advanced practice in the US focus on both genomic discoveries and clinical health care through the application of genomic knowledge into health care, research, and nursing education.

The training and development needs of nurses in Indonesia: paper 3 of 3

BackgroundIndonesia's recent economic and political history has left a legacy of widespread poverty and serious health problems, and has contributed to marked inequalities in health care. One means of responding to these challenges has been through a reconsideration of the professional roles of nurses, to enable them to deal with the range and complexity of health problems. However, there are currently a number of obstacles to achieving these aims: there is a serious shortfall in trained nurses; the majority of nurses have only limited education and preparation for the role; and there is no central registration of nurses, which means that it is impossible to regulate either the profession or the standards of care. This study aimed to establish the occupational profiles of each grade of nurse, identify their training and development needs and ascertain whether any differences existed between nurses working in different regions or within hospital or community settings.MethodsAn established and psychometrically valid questionnaire was administered to 524 nurses, covering three grades and coming from five provinces.ResultsSignificant differences in job profile were found in nurses from different provinces, suggesting that the nature of the role is determined to some degree by the geographical location of practice. The roles of hospital and community nurses, and the different grades of nurse, were fairly similar. All nurses reported significant training needs for all 40 tasks, although these did not vary greatly between grade of nurse. The training needs of nurses from each of the provinces were quite distinct, while those of hospital nurses were greater than those of community nurses.ConclusionThe results suggest that the role of the nurse is not as diverse as might be expected, given the different levels of preparation and training and the diversity of their work environments. This may reflect the lack of a central registration system and quality framework, which would normally regulate clinical activities according to qualifications. The differences in training needs between subsections of the sample highlight the importance of identifying skills deficits and using this information to develop customized post-registration education programmes. Together, these results provide a rigorous and reliable approach to defining the occupational roles and continuing education needs of Indonesian nurses.

Enhancing nursing leadership: Through policy, politics, and strategic alliances

There are a number of key professional nursing roles within New Zealand in which the incumbents are in a position to influence policy, either as individuals or by being in strategic alliances with others. Strategic alliances between key professional leaders in different nursing roles can help the profession by directly influencing policy development and implementation. This form of policy entrepreneurship is an important component of professional leadership.

Action Methods in the Classroom: Creative Strategies for Nursing Education

Nursing education recognizes the need for a framework of experiential learning that supports the development of professional roles. Action methods, originated by Jacob L. Moreno (1953), can be readily adapted to any nursing classroom to create the conditions under which students learn and practice professional nursing roles. While nurse faculty can learn to use action methods, they may not fully comprehend their theoretical underpinnings or may believe they are only used in therapy. This article explores Moreno's ideas related to psychodrama and sociodrama applied in classroom settings, and presents many examples and tips for classroom teachers who wish to incorporate action methods into their classes.

Parent or nurse? The experience of being the parent of a technology‐dependent child

This paper reports a study exploring parents' experiences of caring for a child who is dependent on medical technology, and in particular of performing clinical procedures on their own children. A group of children with a continuing need for the support of medical technology have emerged in community settings as a result of medical advances and government policies. Caring for these children has a significant social and emotional impact on parents, because of their specialized and intensive care needs. Obtaining appropriate and coordinated home support services is problematic. Grounded theory techniques were used, and in-depth interviews were conducted with the parents of 24 children. Parents' accounts revealed that their constructions of parenting were shaped by the nature of their role in caring for their child and by the transformation of their homes by medical equipment and personnel. They described themselves as having a role that had both parenting and nursing dimensions. Parents managed this tension and defined their role and relationship to their child to be primarily one of parenting by differentiating parental care-giving and its underpinning knowledge from that of professionals, particularly nurses. Parenting a technology-dependent child alters the meaning of parenting. Professionals need to recognize that providing care has a substantial emotional dimension for parents, and that they need opportunities to discuss their feelings about caregiving and what it means for their parenting identity and their relationship with their child. A key professional nursing role will be giving emotional support and supporting parents' coping strategies. Parents' perceptions of nurses raise questions about whether nurses' caregiving is individualized to the needs of the child and family, and whether parental expertise is recognized.

The Educational Needs and Professional Roles of Canadian Physicians and Nurses regarding Genetic Testing and Adult Onset Hereditary Disease

Objective: To investigate the knowledge, professional involvement and confidence of Canadian nurses and physicians in providing genetic services for adult onset hereditary disease. Methods: 1,425 physicians and 1,425 nurses received a mailed questionnaire with reminders. The response rates were 50% (n = 543) and 79% (n = 975), respectively. Results: Forty-eight percent of physicians and 31% of nurses lacked formal education in genetics. Respondents reported being involved in caring for people at risk for adult onset hereditary disease. Their levels of confidence that they could perform tasks, such as counselling about predictive genetic tests, however, were lower than their levels of expectation that it would be important for them to provide these services. Conclusions: The expected roles and educational needs of Canadian nurses and physicians have broad areas of overlap suggesting the possibility of combined professional education programs and multiple ways of organizing teams to provide genetic services to people at risk for adult onset hereditary disease.

Student Perspectives on the George Mason University 12th Annual Washington Health Policy Summer Institute

As an elective course for their PhD in nursing program, four doctoral students participated in the June 2004 12th annual George Mason University (GMU) Washington Health Policy Institute. This unique educational offering included presentations and interaction with nursing and health policy leaders and discussion of health policy issues with legislators. Participants were able to incorporate newly acquired health policy skills into their current professional nursing roles and stay connected with other like-minded colleagues who attended the Summer Health Policy Institute. They left believing that they can positively affect current health policy issues by taking an informed, proactive stance and supporting political action committees. Their nursing expertise and knowledge of patients makes them important players in the health policy-making arena. The GMU Washington Health Policy Institute proved to be a premier policy learning experience. It provided these nurses with the opportunity to learn from and network with leading health policy experts.

Changing focus of practice for community health nurses: Advancing the practice role

Many parents lack support in their parenting role that was once provided through extended families and community structures. Thus, some new parents experience high levels of stress and low self-esteem associated with the challenges of parenting. The lack of support also results in family discord and breakdown with the family environment having the potential to adversely impact children’s mental and physical wellbeing and development.The Community Mothers Program (CMP) was initially developed in England and offers support to families during the first year of parenting. The program aims to provide parents with the support once experienced from within the extended family. It also aims to enrich community development by building the capacity of community members living in local communities to support parents.This paper describes the impact of the CMP when implemented into Western Australian as well as the changes to the professional practice role of community child health nurses involved in the program. The Community Mothers Program has proved to be very successful. The success is attributed to the partnership model established between community members, parents, and child health nurses.

The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses’ unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses’ innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.

Developing the academic nursing practice in the midst of new realities in higher education.

The academic nursing practice has a role in replenishing the diminished resources that confront higher education and, if well conceived and managed, is a viable option to support existing academic program stability and growth. An alternative model for defining the academic practice--beyond traditional nurse-managed centers--is presented in this article. The cohesive interconnection of the education, research, and practice missions is addressed with examples of how each contributes to a variety of communities of interest and expands professional nursing roles through innovative care model testing and development. With effective business planning and infrastructure support, faculty practice plans can evolve to a second generation, with heightened societal accountability for service, academic, and collaborative research outcomes.