Associateship in 1980. Part II: Selecting and maintaining a good relationship.
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PURPOSE/OBJECTIVES: To understand the experiences of oncology nurses who use the Internet in their practice when their patients use the Internet for cancer care. RESEARCH APPROACH: Heideggerian hermeneutics branch of phenomenology. SETTING: Oncology nurses were interviewed at their practice settings (n = 13), the researcher's office (n = 5), or their homes (n = 2). PARTICIPANTS: 20 nurses recruited from local and national Oncology Nursing Society meetings. Their practice sites were cancer centers, hospitals, clinics, veterans centers, communities, and Internet companies. METHODOLOGIC APPROACH: Data were collected by informal interviews that provided the narrative stories for hermeneutic analysis. MAIN RESEARCH VARIABLES: Internet use for cancer care, nurse-patient relationships, and Internet use for nursing practice. FINDINGS: Five related themes emerged: (a) varying degrees of Internet integration in the practice environment, (b) changing schools of thought, (c) developing Internet use for professional practice, (d) redefining relationships, and (e) new nursing skills. The two constitutive patterns are (a) integrating Internet into practice out of necessity and (b) reflecting historical changes in practice patterns influenced by technology. CONCLUSIONS: Nurses who use the Internet are developing new practice patterns that incorporate technology and foster nurse-patient partnerships. Practice environments either foster or hinder technology use. Nurse computer competency is essential. INTERPRETATION: Findings reflect the influence of adapting technology on practice. Internet use is a catalyst for redefining nurse-patient relationships into partnerships. The movement suggests a need for nurse Internet competencies, environmental support, and consideration for patient access (digital divide). Evaluation of content in nursing curricula and of patient competencies is advised. Further research on patient experiences is recommended.
Veterinary assistants being members of the Swiss Veterinary Association received a questionnaire in 1989. Informations concerning the search for employment, employment conditions, introduction into the job, working climate, field of activities, postgraduate education, professional aims and prospects for the future as well as the particular situation of women were collected. 2/3 of the assistants in practice and 4/5 of Faculty assistants found their jobs privately without any public advertisement. 3/5 of the assistants in a practice have been employed without a written contract. The mean working time without emergency calls and night work amounts to 45 hours a week in small animal practice and 50 hours in large animal practice. Salaries have been shown to be clearly higher in practice compared to universities. Postgraduate education, however, has obviously been missing in over 50% of assistants in practice but not at the Faculty. Most assistants in practice as well as at the universities strive for partnership practice, especially for both, small and large animals.
This article is the second in a series addressing the structuring of group medical entities, shareholder relationships, and general representation factors. In this article, a number of the legal and business considerations for entering into shareholder and partnership agreements are discussed, and various types of practice structures and recommended group practice agreement provisions are described.
Acute care nurse practitioner (ACNP) roles are increasing in number and scope with expanding opportunities available for collaborative practice. Negotiating for these positions is challenging, but manageable with knowledge about essential components of collaborative practice negotiation. Understanding the process of self-assessment and needs assessment will enable the ACNP to approach the task better equipped. Interview preparation is the key to presenting an employer with a professional, organized portfolio. The ACNP can achieve the goal of negotiating a collaborative practice partnership by demonstrating dependability, honesty, and sound nursing and medical practice. Continuity and detail are the means by which the ACNP enhances quality care in collaborating in patient care management. This article explores the process of negotiating a collaborative practice role and provides examples from physician and ACNP collaborative practice experiences.
Partnerships are relationships and are only as effective as the communication between participants. Partnerships imply building something new by bringing together varying elements to achieve mutual goals. Appreciative inquiry initiates change through questions derived from valuing. Leaders who use inquiry to initiate business planning to create academic and practice partnerships move away from traditional industrial models in healthcare to focus on the symbiotic, interdependent, and complex need for partnerships between education and practice as evidenced in exemplars.
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The substantial interest and investment in health partnerships in the United States is based on the assumption that collaboration is more effective in achieving health and health system goals than efforts carried out by single agents. A clear conceptualization of the mechanism that accounts for the collaborative advantage, and a way to measure it are needed to test this assumption and to strengthen the capacity of partnerships to realize the full potential of collaboration. The mechanism that gives collaboration its unique advantage is synergy. A framework for operationalizing and assessing partnership synergy, and for identifying its likely determinants, can be used to address critical policy, evaluation, and management issues related to collaboration.
In the United States, oral and pharyngeal cancers continue to result in significant morbidity and mortality. Dental professionals play a pivotal role in all facets of controlling the burden of oral and pharyngeal cancer-from efforts to prevent its occurrence, to ensuring that oral cancers are detected at the earliest possible stage, to treating these cancers, and to ensuring maximum quality of life and function for oral and pharyngeal cancer survivors. Individually and by making linkages within the community and beyond, dentists can help patients modify their risk of these cancers and can take steps to screen for them, thereby potentially improving survival and function of those who develop oral cancer. Creative partnerships between community dentists and academic and other research centers will help move knowledge of the biological processes involved in carcinogenesis and innovations in treatment into clinical practice. Partnerships between dental and medical professionals may also help efforts to reduce the morbidity related to oral and pharyngeal cancers. Local, state and national multidisciplinary initiatives are emerging that focus more broadly on risk factor control or oral and pharyngeal cancer issues. These many forms of cooperative approaches offer excellent opportunities to make a significant impact on reducing the incidence of and in treating these debilitating and disfiguring malignancies.
BACKGROUND: The General Practice Education and Training (GPET) board endorsed a framework for general practice training in Aboriginal and Torres Strait Islander health in September 2003. Training that conforms with the framework is required for accreditation of regional training providers. OBJECTIVE: This paper describes the first evaluation of the implementation of this framework by reporting on the extent to which seven key result areas (KRAs) of the framework have been addressed. DISCUSSION: The KRAs concerning delivery of Aboriginal and Torres Strait Islander training and recruitment and support of training posts were well achieved, while those concerning organisational and systems issues required further action. Good progress has been made towards implementation of the framework. Adequate funding and ongoing commitment to respectful and practical partnerships with the Aboriginal and Torres Strait Islander community controlled sector are required to further this.
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A major area of controversy and concern in current obstetrics practice is the management of breech presentation. Studies showing a threefold to fourfold increased morbidity rate in breeches delivered vaginally have led to striking increases in cesarean section rates. The present study comprises a review of all breech deliveries in a partnership practice through the years 1957 to 1976 to permit a follow-up period of at least 2 years. One hundred forty-one breech presentations (excluding twin pregnancies) from a total of 5,320 viable deliveries (2.6%) were managed by one of four obstetrician-gynecologists. Follow-up of the child for a period varying from 2 to 21 years was achieved in over 60% of cases. Results tend to confirm the increased hazard of vaginal delivery to the premature infant in a breech presentation but are equivocal in infants whose birth weight is greater than 2,500 gm. Implications of the study are discussed and comparison with a similar study, presented before this Society more than 25 years ago, is made.