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[The practice nurse in British Family practice. Lessons for Dutch experiments].

In the Netherlands, experiments are taking place in which nurses work in general practice with physicians. In the United Kingdom, so-called practice nurses have been working in general practice since the 1960's. In this article, the experiences in the United Kingdom with the practice nurse are outlined. The focus is on the lessons that can be learned from these experiences. In the United Kingdom, the majority of practice nurses are employed by general practitioners. The most important reason for introducing nurses into the general practice setting was to decrease the physicians' workload. The practice nurse in the United Kingdom has evolved from a 'cheap, task-oriented practice assistant' to a more or less autonomous colleague of the general practitioner. The practice nurses' activities vary greatly. Problems encountered in the United Kingdom primarily concern the lack of training, the absence of a clear definition of the function and responsibilities and the problems associated with working conditions which result from the employment contract with a specific general practitioner. The previously mentioned Dutch experiments show a great deal of variation in terms of the nurses' activities and their position within general practice. Consequently, the development of a clear definition of the function and an adequate training programme are also difficult in the Dutch situation. An additional point of consideration for the Dutch situation is the difference in tasks and responsibilities between the practice nurse and other nurses employed in primary care settings.

Clinical Competence↗

Personality traits valued by practicing nurses and measured in nursing students.

Human relationships are inherent in professional nursing practice, and are influenced by personality traits of the nurse. The purpose of this study was to develop a profile of personality traits desirable for nurses that could be used as a basis for preprofessional guidance and for teaching strategies that would promote the development of these traits. Nurses from four states indicated the level of personality traits desirable for nurses, based on Personality Research Form (PRF) definitions. The PRF was then administered to both associate degree (ADN) and baccalaureate degree (BSN) students. Although some differences were demonstrated, the level desired by the nurses was congruent with student scores, and the scores of ADN and BSN students at point of entry and on completion of their nursing education did not significantly differ for the majority of the traits measured.

Attitude of Health Personnel↗

Evaluating change in quality of life from the perspective of the person: advanced practice nursing and Parse's goal of nursing.

Advanced practice nurses (APNs) are challenged to evaluate their practice in light of goals guided by nursing theory. In this specific case study, a nurse consultant, using Parse's theory of human becoming, evaluated changes in the quality of life from the perspective of the person for patients suffering from genital herpes. The nurse consultant met with the group before (presession) and after (postsession) an APN's 10-week series of seven sessions (person/group-perspective intervention). Analysis of pre- and postsession data uncovered three patterns. These are described with implications for research and practice.

Adult↗

The chief of nursing practice: a model for nursing leadership.

The role and structure of the Canadian Health Care System and its facilities are changing rapidly. Regionalization, decentralization, and flattening of hierarchical structures have occurred in governments and institutions. Traditional management roles, including the Vice President/Director of Nursing have been eliminated. There is a need to create a new model of nursing leadership if nurses are to continue to provide quality patient care. This article describes the initiative at Women's College Hospital to meet the expressed needs of nurses by developing a unique nursing role. The development of the chief of nursing practice role is defined within the context of the changing environment and Kanter's theory of empowerment. The position of the chief of nursing practice is a role model for nursing leadership and one that is pivotal for the professional identity of nursing, and for the provision of high quality patient care.

Canada↗

Are practice nurses an unexplored resource in the identification and management of alcohol misuse? Results from a study of practice nurses in England and Wales in 1995.

Changes in the health promotional work undertaken in primary care, including the work needed to meet the 'Health of the Nation' alcohol targets, have led to a rapid expansion of the number of practice nurses in England and Wales. However, there has been little evaluation of this role. This study provides data, for the first time at a national level, about practice nurses' work in identifying and managing patients drinking above recommended sensible guidelines. Data were collected by postal questionnaire from all nurses in a 50% random sample of 1852 practices (drawn from a general practitioner (GP) national study, undertaken at the same time). 43% of nurses responded from 62% of the targeted practices. Respondents reported identifying a mean of 3.1 patients per month who were drinking above recommended sensible guidelines. These patients tended to be male, above 40 years of age and in contact with the nurse for the first time about this problem. Most patients were categorized as having a potential alcohol problem; few were classified as currently dependent. Very little intervention work was undertaken by nurses except for referral to the GP. If real progress is to be made in meeting the 'Health of the Nation' targets on population alcohol consumption, then primary care work in identifying alcohol misusing patients needs to be developed as a matter of urgency. The patients identified by practice nurses are those patients relevant to the 'Health of the Nation' alcohol targets. More emphasis needs to be placed on the valuable contribution practice nurses can make, particularly through the use of screening instruments and brief interventions.

Adult↗

Nursing's contribution to general practice: general practitioners' and practice nurses' views.

This study was instigated by the paucity of knowledge relating to the work of nurses employed by general practitioners in Australia and the phenomenal development of the practice nurse role in the United Kingdom. A mailed survey of general practitioners and practice nurses within one Division of General Practice in South-East Queensland, sought, among other things, their views about the current and potential contribution of nursing to general practice. Eighty-four out of 164 (51%) general practitioners and 37 out of 67 (55%) practice nurses responded to the survey. Results indicated that both general practitioners and practice nurses appreciated the value of nursing services in general practice and would sanction the employment of more nurses especially for the purpose of preventive care. The majority of nurses were agreeable to the notion that the nurse's role could, and should, be expanded to include autonomous functioning while most of the doctors were amenable to some extension of nursing practice but reticent or opposed to any independent interventions.

Attitude of Health Personnel↗

[To innovate the practical nurse; focus based on professional competencies (I)].

The Nursing practice has entered into a period of rapid, global changes which require firm support in order to maximize their role in the health field. Together with the transitional situation health systems are undergoing, this obliges nurses to search for new innovative methods to comply with their professional duties and for the creation of instruments that facilitate the increase in the quality treatment nurses provide, as well as the mechanisms through which excellence in educational preparation and professional compliance are recognized. In the following pages, the authors deal with this focus based on professional competencies as a tool which nears these objectives.

Certification↗

The NCLex Examination: preparing for future nursing practice.

One nursing organization that closely tracks the direction of healthcare and nursing practice is the National Council of State Boards of Nursing, Inc. As the developer of the National Council Licensure Examination for Registered Nurses (NCLEX-RN examination), maintaining currency of the examination is of primary importance to the National Council. The authors discuss recent trends in the NCLEX-RN Test Plan.

Computer-Assisted Instruction↗