Ward-based Nurses Research Articles

You don’t have to take a career break too literally

I identified with Chris Buswell's article about his career break (Options June 14). Like many ward-based clinical nurses, my hours had grown out of all proportion to my basic contract due partly to staff shortages, my inability to say 'no' to the desperate requests of over-stressed managers, and my own feelings of being indispensable.

Developing a new wound care formulary and guidelines.

Following an audit of the existing wound care formulary and guidelines, an updated version was developed, containing additional products and information. This was revised following advice from a range of professionals, then pilot tested on ward-based nurses. The nurses found the updated formulary useful, and made recommendations for changes to the wound care ordering system in the trust. Future guidelines will be regularly updated as developments in wound care occur.

Infection control training: evaluation of a computer-assisted learning package

An evaluation of the training module of an interactive infection control computer-assisted learning (CAL) software program was carried out with ward-based nurses, third-year medical students and infection control personnel. All nursing staff, 87% of the medical students and all infection control staff found the programme easy and enjoyable to use. The module was accessed 3101 times on the hospital network in 18 months with usage settling to between 100–150 times per month. There was a higher level of use by night-duty and weekend staff. Medical students gained as much infection control knowledge from using the CAL package (increase in correct responses from 63·5% to 83·4%;P<0·0001) as they did from a formal lecture (increase in correct responses from 62·1% to 79·5%;P<0·0001). We conclude the training module which is accessible on the hospital wards and across the academic network, is a convenient and effective way for staff and students to gain a basic understanding in evidence-based infection control practices, at locations and times suitable for them.

Burnout in mental health nurses: much ado about nothing?

The syndrome of burnout has been the focus of much research in the caring professions. Maslach and Jackson operationally defined the syndrome as comprising high levels of emotional exhaustion, high depersonalization and a reduced sense of personal accomplishment. They argued that the syndrome could be reliably measured using the 22-item Maslach Burnout Inventory. The present authors gave this scale to 648 ward-based mental health nurses along with a range of other standardized scales. The total sample was then divided into a high burnout group (high scores on all three subscales, N=37 or 5.7 percent) and a low burnout group (low scores on all subscales, N=66 or 10.2 percent). The findings show that burnout is a much less significant problem for mental health nurses than other researchers have indicated. There was, however, clear evidence for the construct validity of the burnout concept. Future directions for burnout research with mental health nurses are outlined. Copyright © 1999 John Wiley & Sons, Ltd.

Psychosocial care in oncology nursing: a study of social knowledge.

A combination of focus group and individual interviews aimed to examine psychosocial aspects of nursing within a social context and social knowledge held by two teams of ward-based oncology nurses. Five core categories of knowledge emerged: knowledge of how to care, knowledge of the patient, knowledge of the ward, knowledge of nurses coping, and knowledge of involvement. Involvement or emotional closeness was seen as a necessary, inevitable and potentially stressful feature of psychosocial care. The authors conclude that interpersonal and professional aspects of nursing must be balanced in order to provide effective psychosocial care.

Occupational stress and community mental health nursing: what CPNs really said.

The Claybury Nursing Stress Study assessed the levels of occupational stress experienced by both ward-based and community nurses. This paper presents the results obtained from a qualitative analysis of statements made by community psychiatric nurses during a questionnaire based interview. Key areas identified by CPNs as relevant to stress and coping are reported and suggestions for further, qualitative research in this area are made.

Stress and fitness in ward-based mental health nurses

Stress and fitness in ward-based mental health nurses

The Claybury Community Psychiatric Nurse Stress Study: is it more stressful to work in hospital or the community?

The Claybury community psychiatric nurse (CPN) stress study collected data on stress levels in 250 CPNs and 323 ward-based psychiatric nurses (WBPN) in the North East Thames region. Four out of 10 CPNs were found to be experiencing high levels of psychological distress on GHQ scores. Whilst both CPNs and WBPNs scored highly on scores of occupational burnout, especially on emotional exhaustion scores, WBPNs scored worse on emotional detachment from their patients and were achieving less personal fulfilment from their work. Both groups of nurses were more satisfied with direct patient clinical work than with their employment conditions, particularly their working environments and, for CPNs, their relationships with their managers. The different patterns of coping skills are explored and discussed for both groups of nurses, especially the use of social support, time management and organization of tasks. The study concludes that whilst major changes are occurring in the psychiatric arena for both groups of nurses, stress is reaping its toll on mental health nurses, in terms of higher absence rates, lower self-esteem and personal unfulfilment. This could not only affect the quality of patient care but also future career prospects for nurses. The study invites serious consideration of introducing stress-reducing measures in the work-place as well as further research into specific stressors for different groups of nurses.

The management of professionals: the preferences of hospital sisters and charge nurses.

This analysis of the preferences of how sisters and charge nurses are managed is the result of a two centre descriptive study using theoretical models of professionalism, developing preferences and exercising situational leadership. It was conducted to determine if the management structure preferred by sisters and charge nurses, in a general acute hospital setting, supported the professionalism of nursing. The outcomes were intended to help develop a strategic plan for the future of nursing and the management of nurses. The research instruments were a self-completed questionnaire (19 were returned, a response rate of 31.1%) and four semi-structured interviews. The findings disclosed some dissatisfaction with the present management arrangements. The sisters and charge nurses felt that their priorities for practice and professional issues were better supported by clinically involved, ward-based senior nurses than by unit-based senior nurses with a general management function. However, sisters' and charge nurses' discussions with ward-based senior nurses were apparently less effective than discussions in peer groups which led to influential collegial autonomy. This preferred management style can be supported by the use of situational leadership theory which would enhance collegial autonomy and professional satisfaction. Recognition of the sisters and charge nurses preferences and adjustment of their management would therefore enable them to participate effectively in organizational decision-making.

Quality circles: one organization's experience.

Decentralization of quality assurance activity or total quality management (TQM) is a goal set by many health services. Effective and efficient use of available resources is usually the goal. This article describes the efforts of one organization to decentralize its nursing quality assurance program. Quality circles provided forums for an increasing acceptance by ward-based nurses of their role in establishing quality as central to nursing practice. This emphasis on local group processes has helped staff to work with each other to solve problems related to the work of nursing.