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At least 433 records · Page 24Linked to original sources
PubMed2000

The place of nursing history in an undergraduate curriculum.

It has been stated that the history of nursing is, in itself, a suitable subject for research (Maggs 1996) but that historians of nursing have looked to the broader social sciences for their frame of reference. Over the past decade or more there has been debate as to the purposes of nursing history and its relevance to the education of modern nurses and to practice. There is also discussion as to the contribution nursing history has, or could, make to nursing theory and its development. Nursing history has been part of nursing curricula for many years in some shape or form, with variation in its timing, structure, content and the emphasis and importance placed on it by nurse educators. We have recently reintroduced nursing history to the curriculum in the form of a stand alone course. The aim of this paper is to describe the formal reintroduction of nursing history into the curriculum and its place in a newly developed honours undergraduate programme. A review of the literature will be undertaken which will outline the main areas of importance. The review will be followed by a discussion of the history of nursing course and its inception. Using points identified in the literature, the rationale for content and structure are made and the integration of history with theoretical and practical aspects of nursing is explained. The impact of the supporting sciences, both physical and behavioural, and issues surrounding students efforts to reconcile the art and science of nursing are analysed. The introduction has posed questions which are currently being addressed and changes will be made for the new academic year.This supports the philosophy of the Nursing & Midwifery School that history has relevance to the education of nurses and therefore a significant place in the curriculum.

Curriculum↗
PubMed2002

Nursing practice should be informed by the best available evidence, but should all first-level nurses be competent at research appraisal and utilization?

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) has for many years sought to promote the development of research knowledge and skills in registered nurses and has based its efforts on a particular model of the professional practitioner. This model has each registered nurse as a competent finder, appraiser and utilizer of research evidence. It has a vision of all registered nurses acting as autonomous practitioners, able to adapt their practice according to their own expert assessment of current research findings. Through its powers of strategic direction of nurse training and education, the UKCC has required the national boards to have approved education institutions prepare nurses for this role at both pre- and post-registration level. In this paper we argue that this model has proven ineffective. Our argument suggests that the technical complexity of research, and the skills and time required to find and integrate research evidence, renders such a model unattainable. Evidence from studies of clinical nurses indicates that little progress has in any case been made. Furthermore, the development of the apparatus of clinical governance and the basis of professional accountability further undermine the grounds for this approach. A modified approach is advocated based on the development of research specialists within nursing and the greater use of research-based clinical guidelines.

Attitude of Health Personnel↗
PubMed2001

Comparison of past and current barriers to novice nurse practitioner practice: The California perspective.

Novice nurse practitioners (NPs) face unique obstacles to practice. Few studies examine factors influencing early NP clinical performance. Therefore, this research project was designed to collect data from members of an NP professional organization who were asked to identify barriers encountered within the first 3 years of practice. Responses were received from 243 beginning and more experienced NPs. The top three barriers named were lack of public knowledge, lack of positions for NPs, and a lower salary than anticipated. The promotion of NP assets through expanded media coverage and individual educational efforts, the national standardization of the role, and the elimination of restrictive practice legislation can help reduce current barriers. Through the efforts of individuals, NP professional groups, and legislators, existing practice constraints can be mitigated, potential barriers anticipated, and solutions generated to ensure the continued success of this essential advanced practice role.

Adult↗
PubMed2003

Ethical and legal issues related to telepractice.

The subject of speech-language pathologists providing services over a distance via telepractice is attracting the attention of the profession. The new service delivery model will challenge us to exploit its potential without violating legal constraints or compromising our affirmative ethical responsibilities. This article provides an overview of the implications of current state licensure laws on telepractice and a look at the issues of competence, standard of care, privacy, informed consent, and the use of support personnel. Several principles are offered to guide the practitioner and additional resources are suggested.

Allied Health Personnel↗
PubMed1989

Controlling health expenditures--the Canadian reality.

Canada and the United States have conducted a large-scale social experiment on the effects of alternative ways of funding expenditures for health care. Two very similar societies, with (until recently) very similar systems of providing health care, have adopted radically different systems of reimbursement. The results of this experiment are of increasing interest to Americans, because the Canadian approach has avoided or solved several of the more intractable problems facing the United States. In particular, overall health expenditures have been constrained to a stable share of national income, and universality of coverage (without user charges) eliminates the problems of uncompensated care, individual burdens of catastrophic illness, and uninsured populations. The combination of cost control with universal, comprehensive coverage has surprised some American observers, who have questioned its reality, its sustainability, or both. We present a comparison of the Canadian and American data on expenditures, identifying the sectors in which the experience of the two nations diverges most, and describing the processes of control. In any system, cost control involves conflict between providers and payers. Political processes focus this conflict, whereas market processes diffuse it. But the stylized political combat in Canada may result in less intrusion on the professional autonomy of the individual physician than is occurring in the United States.

Attitude of Health Personnel↗
PubMedDate not supplied

Accelerated second degree advanced practice nurses: how do they fare in the job market?

Accelerated, nontraditional, advanced practice nursing programs are an alternative way to increase the supply of nurse practitioners. This study profiles demographic and job characteristics of second degree, non-nurse college graduates who pursued graduate degrees in nursing. Graduates' sex, age, income, previous education, nursing experience, factors describing the scope of the advanced practice role, and quality of the educational experience were studied. Data were collected from 29 graduates (57%) from Virginia Commonwealth University's accelerated second-degree nursing program from 1995 through 1999. The findings have implications for nursing educators, health care administrators, employers, and other persons who plan and recruit for this type of nursing education program.

Adult↗
PubMed1998

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.

Abortion, Induced↗
PubMed2006

Portfolio as a tool to stimulate teachers' reflections.

Portfolios are increasingly being used to stimulate teachers' reflections. Frameworks for reflection on teaching often emphasize competencies and behaviours. However, other aspects of teacher functioning are also important, such as the teaching environment and individual teachers' beliefs, professional identity and mission. In a study among five medical school teachers, we explored how a portfolio stimulated reflections on the various aspects of teaching functioning. Outcomes of written portfolio assignments were collected and analysed to identify examples of reflections on the various aspects of teacher functioning. Examples of reflections on all aspects of teacher functioning were found, although examples of reflections on competencies were easier to find than those on beliefs, identity and mission. This study might help teachers and their trainers and coaches to recognize different aspects of teacher functioning when discussing portfolios for professional development purposes. However, further development of assignments and other methods to stimulate reflections on beliefs, identity and mission are needed. Furthermore, apart from the content of teachers' reflections, teachers' reflection processes should be researched, as well as the effects of portfolio meetings with peers and coaches.

Education, Medical↗
PubMedDate not supplied

Perceptions of barriers to psychiatric-mental health CNS practice.

This descriptive study of practice barriers compared the perceptions of 67 psychiatric/mental health clinical nurse specialists (PMH-CNSs) with those of 767 nurse practitioners (NPs) in a single state. In addition, it contrasted the barriers identified by the rural and urban PMH-CNS study participants (n=14 and 53, respectively). Though all participants found the practice climate moderately restrictive on a 5-point Likert scale (1=very restrictive to 5=not restrictive), the PMH-CNSs found the practice environment significantly more restrictive than the NPs (3.13 versus 3.61, p<.001). Lack of public knowledge of their advanced practice role was the top-ranking practice barrier for both NPs and PMH-CNSs (60% and 44%, respectively). Lack of understanding of their role was the next highest in rank (PMH-CNSs at 49%; NPs at 39%). CMH-CNSs noted resistance from physicians and/or psychologists as their third-highest barrier (42%); the NPs did not rank this barrier in their top five. Rural PMH-CNSs perceived a lack of a peer network as a considerable barrier (57%); however, urban PMH-CNSs did not rank this in their top barriers, indicating that rural professional isolation needs to be addressed. These findings indicate that efforts to educate the public and other professionals about advanced practice nursing roles and issues must be a priority, and other barriers such as salary and isolation continue to hamper the role success of PMH-CNSs.

Attitude of Health Personnel↗
PubMed2006

Mozambican midwives' views on barriers to quality perinatal care.

Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures.

Adult↗