Role In Healthcare Settings Research Articles

The association of empathy and the work-family conflict in doctors of dental medicine.

Work-family conflict is a growing problem worldwide, because of changing work-family demographic trends and the spread of technology. Empathy, as the ability to understand and share the feelings of other people, is the essential component of emotional intelligence that plays a crucial role in healthcare settings. This study aimed to assess the level of emotional empathy and investigate its relationship with work-family role conflicts among dental medicine doctors. Materials and methods: In this study participated 589 doctors of dental medicine from Croatia, Serbia, Bosnia and Herzegovina. The questionnaire included general and demographic data, the Emotional Empathy Scale questionnaire and the Work and Family Role Conflict Assessment Scale questionnaire. Results: The research results indicate no significant association between empathy and conflict between work and family roles (R = 0.032, p = 0.435). Women have achieved significantly higher scores in Emotional Empathy Scale (p ≤ 0.001), while there was no difference in Work and Family Role Conflict Assessment Scale according to gender (p = 0.194). A difference in emotional empathy was observed depending on where the respondents were employed (p = 0.045) and depending on the specialisation of the dental medicine (p = 0.021). Conclusion: Female doctors of dental medicine demonstrated higher emotional empathy while the work-family role conflict is experienced equally by both genders.

Leading from the bottom: The clinical leaders roles in an HIV primary care facility in Eldoret, Kenya.

Clinical leaders in health systems play critical roles in making decisions that impact patient care and health system performance. Current literature has focused on the importance of clinical leaders' roles in healthcare settings and has not addressed the leadership aspect that clinical leaders engage in day-to-day decision-making in HIV facilities while providing HIV patient care. Therefore, identifying the leadership roles that wclinical leaders perform at HIV primary facilities is of critical importance. The study explored the views of healthcare providers working in AMPATH-MTRH HIV facility on what they perceived as the roles of clinical leaders at the HIV primary care facility. We conducted a qualitative exploratory study between December 2019 to May 2020, involving in-depth interviews with (n = 22) healthcare providers working in AMPATH-MTRH HIV facility, who were purposively and conveniently sampled to participate in in-depth interviews to explore perceptions regarding the leadership roles of clinical leaders. The collected data were analyzed thematically and Nvivo vs.12 software was used for data management. The following themes were identified from the analysis regarding perceived clinical leaders' roles in an HIV primary care facility: 1) Strategic roles: providing direction and guidance, ensuring goals and objectives of the department are achieved within the set timelines, planning, and budgeting for adequate resources to support patient HIV care 2) Interconnecting health systems levels and supervisory oversight roles: a link between management, staff, and patients, solving problems, organizing and attending departmental meetings, facilitate staff training, accountable, collaborating with other departments and leaders, defines and assigns responsibilities, ensure quality patient service, coordination, and management of daily activities 3) Research roles: data collation, analysis, generation, review and reporting to the management. Clinical leaders in the HIV care system perform leadership roles that are characterized by strategic, middle-level, supervisorial and research which reflects the model of the leadership and management style of the HIV care system. The understanding of these roles contributes valuable insights to HIV leaders and managers to recognize the important contribution of clinical leaders and consider reviewing Standard Operating Procedures to include these leadership roles and strengthen their capacity to maximize clinicians' contribution to improve HIV care and enhance responsive health systems.

Relationship between transformational leadership, adverse patient events, and nurse-assessed quality of care in emergency units: The mediating role of work satisfaction

BackgroundEffective leadership plays a pivotal role in healthcare settings, particularly in the fast-paced and high-pressure environment of the emergency room, as it is closely linked to patient safety and the overall quality of care. This study assessed the mediating role of work satisfaction in the relationship between nurses' perceptions of their nurse managers' transformational leadership, reported adverse patient events, and the nurse-assessed quality of care in the emergency units. MethodsA cross-sectional survey design was carried out involving 283 emergency room nurses from the Philippines, utilizing standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4). ResultsEmergency room nurses perceived their nurse managers as highly transformational. Nurses' perceptions of transformational leadership in their nurse managers were associated with a reduction in reported adverse patient events and an increase in nurse-assessed nursing care quality. Work satisfaction partially mediated the relationship between transformational leadership and nurse-assessed nursing care quality, but it did not serve as a mediator between transformational leadership and reported adverse patient events. ConclusionThe results suggested that enhancing transformational leadership behaviors among nurse leaders can foster work satisfaction in ER nurses, which, in effect, contributes to enhanced nursing quality of care provision in emergency settings.

Program Report: Improving Patient Experience at an Outpatient Clinic Using Continuous Improvement Tools.

Patient satisfaction with prompt and high-quality healthcare services plays a pivotal role in healthcare settings. The delivery of high-quality services within the healthcare sector is closely associated with continuous quality improvement (CQI), which is an incremental and progressive process that prioritizes the safety of all participants, favorable outcomes, systematic processes, and a regulated and improved working environment, particularly in later stages. Surprisingly, these aspects are less frequently explored in Middle Eastern countries. Thus, this research paper aims to assess the impact of quality services on patient satisfaction in tertiary care clinics located in the Middle East. To improve the quality of services in our clinic, we employed patient feedback as a valuable resource. We proactively reached out to all patients who had visited our hospital via mobile phone messages and requested their feedback on the services they received. Approximately 5% of all visitors responded and completed a comprehensive questionnaire. The majority of respondents expressed satisfaction with the services provided across various departments. However, they also offered valuable suggestions that helped us identify further areas for improvement and enhance the overall patient experience within our clinic. Drawing upon the feedback received, we meticulously considered the identified issues, redesigned our policies, and implemented strategic changes. Following the implementation of these new approaches, we once again sought patients' feedback on the quality of our services. Patient feedback highlighted the significant impact of optimized service delivery methods, resulting in a substantial increase in patient satisfaction. Overall, this study sheds light on the vital factors that can enhance patients' experience in outpatient clinics, emphasizing the importance of integrating patient feedback into continuous quality improvement initiatives. By utilizing this approach, healthcare providers, administrators, and researchers can effectively improve service quality and patient satisfaction. Consequently, this research paper serves as a valuable reference for public health stakeholders, administrators, and researchers in their pursuit of delivering exceptional healthcare experiences.

Allied health assistants' perspectives of their role in healthcare settings: A qualitative study.

Allied health assistants (AHAs) are important members of the health workforce and key to meeting population health needs. Previous studies exploring the role and utility of AHAs from multiple stakeholder perspectives suggest AHAs remain poorly utilised in many healthcare settings. This qualitative study explores the experiences and perspectives of AHAs working in healthcare settings to determine the contextual factors influencing their role, and mechanisms to maximise their utility. We conducted semi-structured interviews using purposive sampling with 21 AHAs, from one regional and three metropolitan health services in Australia, between February and July 2021. We used a team-based framework approach to analyse the data. Four major themes were identified: 1) AHAs' interpersonal relationships, 2), clarity and recognition of AHA roles and role boundaries, 3) AHAs accessing education and professional development, and 4) the professional identity of the AHA workforce. Underpinning each of these themes were relationships between AHAs and other healthcare professionals, their patients, health services, and the wider AHA workforce. This study may inform initiatives to optimise the utility of AHAs and increase their role in, and impact on, patient care. Such initiatives include the development and implementation of guidelines and competencies to enhance the clarity of AHAs' scope of practice, the establishment of standardised educational pathways for AHAs, and increased engagement with the AHA workforce to make decisions about their scope of practice. These initiatives may precede strategies to advance the AHA career structure.

Evaluation Of Anti-Biofilm Activity Of Bacterial Amylase Against Human Pathogens

Global healthcare crisis has a significant impact on human health and economy because of antimicrobial resistance. Emergence of antibiotic resistance due to excessive antibiotic use results in resistant microbes. Biofilm shows integral resistance to antimicrobial agents and the host defense system. Microbes that exist in the biofilms, shows 10-1000 times resistance to antibiotics as compared to the free life style. The biofilms of bacteria serve as a great issue in not only environmental and industrial line but also play an important role in healthcare setting. The biofilm producing bacteria such as Vibrio cholerae and antibiotic resistant bacteria like methicillin resistant Staphylococcus aureus (MRSA) cause deadly infections. In present study, efficacy of bacterial amylase was tested against biofilm formation of pathogenic microbes. For this, Amylase producing bacterial isolates (isolated from a variety of sources, such as waste, rhizosphere of vegetable soil, rice field, potato, and sugarcane field soils sources (ArPs, ArDs, ArSs, ArVs and ArRs) were utilized to reduce the microbial biofilm development against pathogenic isolates of Staphylococcus aureus and Pseudomonas aeruginosa. Six bacterial isolates (SB, SW, SU, PB, PW, and PU) obtained from cancer patients of tertiary care hospitals. Amylase enzyme extracted from ArPs showed maximum growth inhibitory effect on SW pathogen, while ArRs showed minimum growth effect upon SB pathogens. However, amylase showed highest anti-biofilm activity against SW pathogen. In general, the highest biofilm inhibition was recorded at pH7 at 37°C as compared to rest of pHs and temperatures. The efficacy of bacterial amylase in biofilm inhibition of human pathogens, seem promising and having significant potential in health care systems.

The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: a critical interpretive synthesis

BackgroundMiddle Managers (MMs) are thought to play a pivotal role as knowledge brokers (KBs) in healthcare organizations. However, the role of MMs who function as KBs (MM KBs) in health care is under-studied. Research is needed that contributes to our understanding of how MMs broker knowledge in health care and what factors influence their KB efforts.MethodsWe used a critical interpretive synthesis (CIS) approach to review both qualitative and quantitative studies to develop an organizing framework of how MMs enact the KB role in health care. We used compass questions to create a search strategy and electronic searches were conducted in MEDLINE, CINAHL, Social Sciences s, ABI/INFORM, EMBASE, PubMed, PsycINFO, ERIC and the Cochrane Library. Searching, sampling, and data analysis was an iterative process, using constant comparison, to synthesize the results.ResultsWe included 41 articles (38 empirical studies and 3 conceptual papers) that met the eligibility criteria. No existing review was found on this topic. A synthesis of the studies revealed 12 MM KB roles and 63 associated activities beyond existing roles hypothesized by extant theory, and we elaborate on two MM KB roles: 1) convincing others of the need for, and benefit of an innovation or evidence-based practice; and 2) functioning as a strategic influencer. We identified organizational and individual factors that may influence the efforts of MM KBs in healthcare organizations. Additionally, we found that the MM KB role was associated with enhanced provider knowledge, and skills, as well as improved organizational outcomes.ConclusionOur findings suggest that MMs do enact KB roles in healthcare settings to implement innovations and practice change. Our organizing framework offers a novel conceptualization of MM KBs that advances understanding of the emerging KB role that MMs play in healthcare organizations. In addition to roles, this study contributes to the extant literature by revealing factors that may influence the efforts and impacts of MM KBs in healthcare organizations. Future studies are required to refine and strengthen this framework.Trial registrationA protocol for this review was not registered.

Methicillin resistant Staphylococcus aureus - importance of appropriate empirical therapy in serious infections

India has been titled the capital of antimicrobial resistance in the world with the centre for disease dynamics, economics and policy (CDDEP) predicting two million deaths in India by 2050. As per the World Health Organisation’s global priority pathogen list of 2017, methicillin resistant Staphylococcus aureus (MRSA) has been classified as a ‘high priority’ pathogen due to its association with increased mortality rate, rising prevalence of resistance and increased burden on healthcare settings. A recent report by Indian Council of Medical Research signifies the exponential rise in the prevalence of MRSA in India, from 29% in 2009 to 39% in 2018. Serious MRSA infections are commonly associated with poor clinical outcomes coupled with increased hospitalisation stay and cost. Therefore, early identification and appropriate empiric treatment of MRSA plays a crucial role in healthcare settings. However, the constant rise in multi-drug resistance to the currently available anti-MRSA agents as well as their compromised safety profile limits its clinical use to manage severe MRSA infections. This review article explores the implications of severe MRSA infections and inappropriate empirical therapy on the clinical as well as economic outcomes. In addition, it also highlights limitations of the currently available anti-MRSA agents and the need for newer agents to manage multi drug resistant (MDR) gram positive infections.

Knowledge, Attitude, Practice, Perception, and Psychological Response of Nurses Regarding Covid-19; Literature Review

COVID-19 is a disease caused by a new corona virus resembling pneumonia and first appeared in China's Wuhan Province in November 2019. Nurses play an important role in health care settings, including prevention, infection control, isolation, continuous patient monitoring, and have occupational risk as well as high risk of exposure in providing care during the COVID-19 outbreak. The purpose of this literature review is to identify nurses' knowledge, attitudes, practices, perceptions, and psychological responses to COVID-19. This research method is a literature review. Search for articles using six databases namely PubMed, Ebscohost, Chocrane Library, ClinicalKey for Nursing, Science Direct, and Gray Literature using keywords based on PICO. There are 1,149 articles identified from 2019-2021, was found 21 relevant articles that were discussed and analyzed. Results: The majority of nurses had a good level of knowledge, had positive attitudes, good practices, and positive perceptions of COVID-19. Nurses are experiencing stress and psychological responses during the COVID-19 pandemic. Conclusion: The majority of nurses have a good level of knowledge, but there are still nurses who have less knowledge about diagnosis, prevention, treatment and control of COVID-19 infection, besides that nurses also experience psychological responses such as anxiety and depression related to COVID-19.

Increasing Nursing Retention to Reduce Financial Costs

Nurses play a major role in health care setting, providing the daily care to patients. Being a new graduate nurse is not easy especially when there is a great difference between the education environment and the real world of hospitals.

Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries.

BackgroundThe pharmacy profession has an important role in the frontline healthcare response to COVID-19 across all settings.ObjectiveThis study sought to explore the views and experiences of clinical pharmacists in relation to the provision of clinical pharmacy services during COVID-19.MethodsSemi-structured qualitative interviews were conducted with pharmacists working in clinical roles in healthcare settings across Europe. Participants were recruited through professional organisations of clinical and hospitals pharmacists combined with a snowballing technique. The Pharmacy Emergency Preparedness and Response Framework and Disaster Preparedness Framework for pharmacy services were used to generate data which were analysed using the thematic framework method.ResultsTwenty-two participants from 16 European countries described a range of measures to protect patients, public and healthcare staff against virus transmission including developing and disseminating educational materials. Most described their involvement in aspects of evidence provision such as facilitating clinical trials, gathering and appraising evidence and disseminating clinical information. Many hospital-based pharmacists were reassigned to new roles such as intensive care. Routine clinical services were extensively interrupted and remote forms of communication were used. Most were motivated by a strong sense of professionalism to continue delivering services. A number of facilitators and barriers to prevention, preparedness and response actions were identified which related to uptake of new roles, recognition of pharmacists roles in the healthcare team, information gathering, communication with patients and healthcare professionals, and provision of routine clinical services.ConclusionsParticipants in this multinational qualitative study described a range of service adaptations and adoption of novel roles to prevent and mitigate the public health impact of the pandemic. The study findings may help to inform governments, public health agencies and healthcare systems in harnessing ongoing service provision and adapt to any future interruptions.

A systematic review of reflective practice questionnaires and scales for healthcare professionals: a narrative synthesis

ABSTRACT Reflective Practice (RP) is considered a crucial component of personal and professional learning. RP is regarded as a way that professionals learn from experience to understand and enhance their practice by responding appropriately to self-reflection. Despite playing a crucial role in healthcare settings, there is little agreement on how to assess RP. This study aims to systematically review self-rating instruments that assess RP in healthcare professionals. Peer review articles assessing RP in healthcare professionals using a self-rating instrument, published in English between 1998 and 2018 from PubMed, CINAHL, and PsychInfo databases, were considered for inclusion. Eighteen papers were appraised, the strengths and weaknesses of the measures were discussed in accordance with an adapted critical appraisal checklist. In general, all self-report instruments included in this review were potentially generalisable to healthcare professionals or health science programmes with some adaptation. Given the limited evidence for other measurement scales, the Reflective Questionnaire and Self-Reflection and Insight Scale are recommended for measuring RP within healthcare settings. Future research developing a standardised tool for the review of mixed-method, heterogeneous, questionnaire studies is strongly recommended.

An exploration of role expectations of the clinical prosthetist.

The role of the clinical prosthetist in healthcare has evolved substantially, and it is likely that expectations of the role have changed in recent times. Organisational Role Theory provides a framework for considering the expectations and behaviours of health professionals regarding their functions and roles. The main objective of this study is to explore stakeholder consensus in role expectations of the clinical prosthetist in an Australian healthcare setting. Cross-sectional survey. The Prosthetist Role Expectations Scale was used to measure expectations and views of the roles of clinical prosthetists. The Prosthetist Role Expectations Scale has 72 items that form 11 subscales that describe prosthetist behaviour. It was distributed to six key stakeholder groups which included: prosthetists, prosthetic technicians, physiotherapists, medical rehabilitation specialists, orthotists and clients with limb loss. Of the 1064 surveys distributed, 275 were returned. An additional 35 electronic responses were received, resulting in 299 complete data sets. A high level of consensus across the different stakeholder groups was found for 10 of the 11 subscales. In contrast, there were significant differences between groups for the 'Independent Prescription' subscale (p ⩽ .05). Differences in expectations, as noted by individual Prosthetist Role Expectations Scale subscale items (7 of 72) may indicate that stakeholders perceive a prosthetist's role differently in select areas. There was broad agreement in expectations from stakeholders regarding the role of prosthetists in interdisciplinary functioning, research and communication related to prosthetic device provision and function. There were more varied expectations regarding prescription decisions, referral practices and clinician-client communication regarding emotional issues. It is important to understand the expectations that stakeholder groups have regarding the clinical prosthetist role in healthcare settings. Such information can guide health professional education and interprofessional practice and may reduce interpersonal and interprofessional conflict.

Detection of medical text semantic similarity based on convolutional neural network

BackgroundImaging examinations, such as ultrasonography, magnetic resonance imaging and computed tomography scans, play key roles in healthcare settings. To assess and improve the quality of imaging diagnosis, we need to manually find and compare the pre-existing reports of imaging and pathology examinations which contain overlapping exam body sites from electrical medical records (EMRs). The process of retrieving those reports is time-consuming. In this paper, we propose a convolutional neural network (CNN) based method which can better utilize semantic information contained in report texts to accelerate the retrieving process.MethodsWe included 16,354 imaging and pathology report-pairs from 1926 patients who admitted to Shanghai Tongren Hospital and had ultrasonic examinations between 1st May 2017 and 31st July 2017. We adapted the CNN model to calculate the similarities among the report-pairs to identify target report-pairs with overlapping body sites, and compared the performance with other six conventional models, including keyword mapping, latent semantic analysis (LSA), latent Dirichlet allocation (LDA), Doc2Vec, Siamese long short term memory (LSTM) and a model based on named entity recognition (NER). We also utilized graph embedding method to enhance the word representation by capturing the semantic relations information from medical ontologies. Additionally, we used LIME algorithm to identify which features (or words) are decisive for the prediction results and improved the model interpretability.ResultsExperiment results showed that our CNN model gained significant improvement compared to all other conventional models on area under the receiver operating characteristic (AUROC), precision, recall and F1-score in our test dataset. The AUROC of our CNN models gained approximately 3–7% improvement. The AUROC of CNN model with graph-embedding and ontology based medical concept vectors was 0.8% higher than the model with randomly initialized vectors and 1.5% higher than the one with pre-trained word vectors.ConclusionOur study demonstrates that CNN model with pre-trained medical concept vectors could accurately identify target report-pairs with overlapping body sites and potentially accelerate the retrieving process for imaging diagnosis quality measurement.

Using sedative substances until death: A mortality follow-back study on the role of healthcare settings

Background: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated. Aim: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control. Design: National mortality follow-back study in Switzerland between 2013 and 2014. Questionnaires on medical end-of-life decisions were sent to attending physicians of a continuous random sample of all registered deaths aged 1 year or older. Setting/participants: Of all sampled deaths, 3678 individuals who died non-suddenly and not through an external cause were included. Results: Across settings, continuous deep sedation appeared more likely in patients aged younger than 65 years (odds ratio range: 1.53–2.34) and as part of or after intensified alleviation of pain and symptoms (odds ratio range: 1.90–10.27). In hospitals, sedation was less likely for cancer patients (odds ratio: 0.7, 95% confidence interval: 0.5–1.0, p = 0.022). In nursing homes, sedation was more likely for people who were married (odds ratio: 1.8, 95% confidence interval 1.3–2.5, p = 0.001). Conclusion: In all settings, sedated patients have significantly more pain problems compared to patients not receiving sedation. Large differences between settings seem to indicate different patient populations, different levels of professionals’ palliative care experience and different availability of treatment options. Our study suggests that certain patient groups who may be as vulnerable to refractory pain and symptoms as others are less likely to receive continuous deep sedation until death when warranted.

Living With Moral Distress: The Perspectives and Experiences of Iranian Nurse Preceptors.

Background and Purpose: Preceptors play a key role in the transition experience of new nurses. Preceptorship is a stressful role and is influenced by contextual factors. There is a lack of sufficient understandings of the perspectives and lived experiences of Iranian nurse preceptors of preceptorship. The aim of this study was to explore the perspective and lived experiences of Iranian nurse preceptors of preceptorship. Methods: A qualitative design using a hermeneutic phenomenological approach was used. Six Iranian nurse preceptors were chosen using a purposeful sampling method from a large paediatric teaching hospital in an urban area of Iran. Data was collected using in-depth semi-structured interviews and was analysed using the Diekelmann et al.'s method of hermeneutic phenomenological analysis. Results: The data analysis resulted in the development of a constitutive pattern of 'living with moral distress', which was constituted of two major themes: 'asking for and being unable' and 'the experience of conflict'. Implications for Practice: The findings of this study can improve nurses' understandings of the preceptor's role and associated factors influencing the implementation of the preceptorship programme. 'Moral distress' caused by the preceptor role can influence nurse preceptors' mental health and also the patient care outcomes. More studies are required to explore this phenomenon in different contexts and cultures and design strategies for reducing the burden of taking this role on nurse preceptors. Also, policies are needed for developing a formal preceptor support system to help preceptors take this stressful and demanding role in healthcare settings.

Forming a joint dialogue among faith healers, traditional healers and formal health workers in mental health in a Kenyan setting: towards common grounds.

BackgroundQualitative evidence on dialogue formation and collaboration is very scanty in Kenya. This study thus aimed at the formation of dialogue and establishment of collaboration among the informal (faith and traditional healers) and formal health workers (clinicians) in enhancing community–based mental health in rural Kenya.MethodsQualitative approach was used to identify barriers and solutions for dialogue formation by conducting nine Focus Group Discussions each consisting of 8–10 participants. Information on age, gender and role in health care setting as well as practitioners’ (henceforth used to mean informal (faith and traditional healers) and formal health workers) perceptions on dialogue was collected to evaluate dialogue formation. Qualitative and quantitative data analysis was performed using thematic content analysis and Statistical Package Social Sciences (SPSS) software respectively.ResultsWe identified four dominant themes such as; (i) basic understanding about mental illnesses, (ii) interaction and treatment skills of the respondents to mentally ill persons, (iii) referral gaps and mistrust among the practitioners and (iv) dialogue formation among the practitioners. Although participants were conversant with the definition of mental illness and had interacted with a mentally ill person in their routine practice, they had basic information on the causes and types of mental illness. Traditional and faith healers felt demeaned by the clinicians who disregarded their mode of treatment stereotyping them as “dirty”. After various discussions, majority of practitioners showed interest in collaborating with each other and stated that they had joined the dialogue in order interact with people committed to improving the lives of patients.ConclusionDialogue formation between the formal and the informal health workers is crucial in establishing trust and respect between both practitioners and in improving mental health care in Kenya. This approach could be scaled up among all the registered traditional and faith healers in Kenya.

Graduate Clinical Nurse Preceptors: Implications for Improved Intra-Professional Collaboration

Advanced practice nurses have increased in number and public acceptance. Students preparing for these roles require quality clinical education so they are prepared to assume collaborative roles in healthcare settings. Although graduate clinical preceptors have a vitally important role in the clinical education and professional socialization of advanced practice students, there is a paucity of evidence about factors that influence their role commitment. In this article, the authors review the literature related to graduate-level, clinical-preceptor experiences; describe their study of 91 graduate clinical preceptors that identified factors influencing graduate clinical preceptors’ role commitment; report and discuss their findings; as well as the limitations of this study. They conclude that the graduate clinical preceptor role needs to be more visible and better integrated into schools of nursing and healthcare organizational structures, and identify the need for intra-professional collaboration among nursing faculty, administrators, and clinicians to facilitate the recruitment, cultivation, and retention of graduate clinical preceptors

Take me to a clinical reflexologist: An exploratory survey

This paper reports the results of a questionnaire exploring the role, training and experience of a 'clinical reflexologist'. The sample (n=105) was delegates at a clinical reflexology conference held at a major cancer treatment centre in the North West of England. The majority of participants had completed diploma level training (n=73) and were female (n=99). 62% (n=65) of the delegates had been practising for 6+ years and were practising in private practice, hospices and NHS settings amongst others. 40% (n=42) of participants actually worked across more than one of these settings. Respondents also reported working with a variety of healthcare concerns, including recovery from surgery, fertility, pain, smoking cessation and maternity and cancer care. Additional information was gathered related to training, referral rates from health professionals and access to professional and peer support. The questionnaire did not seek to explore what constitutes adequate training for clinical reflexology practice or respondents' view on whether being a registered nurse or allied health professional is a prerequisite for practising within a clinical environment. Additionally, caution must be taken with the reported findings as the respondents chose to attend the conference. This survey has provided, for the first time, some interesting information/views on what constitutes 'clinical reflexology' and how some practitioners are developing their roles in healthcare settings. Further research work is warranted.

Communicating bad news to patients: a reflective approach

Part of nurses' unique and challenging role in healthcare settings is engaging in difficult conversations with patients. Effective communication is essential to establish a successful nurse-patient relationship, put the patient at ease and promote better interactions. A reflective approach to care can help nurses to learn from experience and use this knowledge to communicate bad news to patients in a sensitive and timely manner.