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A study comparing the regulation and control of the professional practice of nurses in Brasil, Argentina, Uruguay and Paraguay, delineating their particularities, differences and similarities in the perspective of the implementation of the Cone Sul Common Market, which presupposes the free circulation of workers in the workplaces of the member-countries of the Ascnsion Treaty.
This study is a part of a more extensive project that proposes to rescue significant aspects related to nursing assistance evolution from the 1950s to the 1990s. Aiming at accomplishing this objective, the authors used the technique of oral declaration with active and retired registered nurses, in the context of a school-hospital at the state of São Paulo. The present study emphasizes the outcomes referring to the 1950s. The results show that the nurse's efforts are evident in the struggle for profession's recognition and prestige; there are intense and deep transformations related to nurse's new roles and their leadership as a member of the nursing staff and a member of the medical team.
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Professional prestige was determined using the psychophysical methods of magnitude estimation and cross-modality matching with line lengths and dynamometric forces as responses. The main results revealed that: (a) the rankings order resulting from all methods employed provide degrees of prestige which are in close agreement with the different professions (w = 0.94), (b) the non-metric continuum of professional prestige exhibits prothetic characteristics, (c) the variability of estimations is a linear function of the estimation of magnitudes, thus confirming that Ekman's law is also valid for non-metric continua, (d) the exponents obtained using matchings of number, line lengths and force of hangrip were not significantly different from the exponents predicted by the transitivity property of scales and, finally (e) the data furnish a scale of professional prestige which, at the level of ratio measurement, is valid, stable and consistent.
The formation of nursing professionals has been a concern through nursing history in our country. Within the context of development of nursing history, authors analysed the evolution of the legislation about the formation of nursing professionals at the secondary level as well as the legislation about their practice.
In this study we identify and analyse articles published in national and international journals, that used the term "critical thinking" in the title or summary. The aim of the analysis was to seek answers to educators' queries as to how to improve teaching-learning the process in nursing. We analysed 52 articles published in the indexes Comprehensive Medline, Lilacs and Cinahl, in the last five years, from July, 1992 to July, 1997. Data analysis showed that critical thinking should be implemented in nursing education, what demands syllabus planning and teaching-learning strategies that will favour active participation by both educators and learners.
The authors present the experience of teaching pediatric nursing at the Universidade Federal de Mato Grosso do Sul (UFMS), Brazil. They carried out a qualitative analysis of the learners' evaluation for the year 2000, from which two categories emerged: "being a different experience" and "changing the way the learners see the child and the family". They conclude that choosing the person-centered teaching approach has been of fundamental importance for the learner to achieve personal and professional autonomy.
PURPOSE: The implementation of supplementary prescribing by pharmacists within primary care trusts (PCTs) and secondary care trusts (SCTs) in England was studied. METHODS: A survey was developed and sent to pharmacists in PCTs and SCTs in England who would oversee the implementation of supplementary prescribing by pharmacists. RESULTS: The response rate was 68% for both surveys. The majority of SCTs and PCTs intended to implement supplementary prescribing by pharmacists by the end of 2005 (57% and 56%, respectively). The majority of SCT respondents did not believe that it would be more difficult to recruit designated medical practitioners to supervise supplementary prescribing training for pharmacists as opposed to nurses (67%, n = 43), whereas the largest group of PCT pharmacists believed it would be (47%, n = 86). Within secondary care, the clinical areas in which pharmacists were intending to work as supplementary prescribers were those where they already had established roles. Within primary care, the main clinical areas for pharmacists were influenced by those areas in the new General Medical Services contract Quality and Outcomes Framework for general practitioners. CONCLUSION: A survey investigating the implementation of supplementary prescribing by pharmacists in England found that there were significantly more barriers to its establishment within primary care than secondary care settings. Within primary care, supplementary prescribing is being implemented to develop new services. Within secondary care, the supplementary prescribing model is more often used to legitimize services already being provided.
PURPOSE: The clinical and financial outcomes of a pain clinic managed by a pharmacist with prescribing authority are described. SUMMARY: Pharmacist clinicians in a for-profit, integrated health system recently received permission to bill for their services in certain ambulatory clinics. A pharmacist clinician, who had an individual Drug Enforcement Administration number and whose services are billable under New Mexico law, was chosen to assume the medication management responsibilities in a clinic where 90% of the patient population is treated for chronic non-cancer-related pain. No additional personnel were needed, and no additional space was required, eliminating overhead for the space and utilities needed for operating a new clinic. With the ability to bill for the pharmacist clinician's services, a new model for justification of clinical pharmacy services was developed for the ambulatory care clinics. The revenue generated was tracked by a medical billing system, and clinical outcomes were tracked using the clinic's database for patients' individual visual analogue scale (VAS) pain scores. Between June 2004 and June 2005, an average of 18 patients were seen by the pharmacist clinician each day. The clinic generated 107,550 dollars of actual revenue and saved the health plan over 450,000 dollars. There was a consistent decrease in mean VAS pain scores with continued visits. CONCLUSION: Patients with chronic non-cancer-related pain were managed effectively by a pharmacist with prescribing authority and refill authorization in a pain management clinic. The favorable clinical outcomes, revenue generated, and cost savings achieved justified the pharmacist clinician's services in this health system.
This article draws on a body of research conducted by the author over the past ten years on the social organization of nursing work. It explores questions surrounding nurses' contemporary labor process control and its meaning for nurses' professionalization and proletarianization. Both are dynamic processes, changing as public administration of the Canadian health care system changes and as nurses are successful in winning more complete self-regulation. Nurses are currently being articulated more and more securely to dominant ideas of public sector management through textually mediated technologies. Nurses find new upwardly mobile careers and challenging, responsible, and more respected work. However, as the generation of objective information for professional accountability, cost-accounting, and managerial decision-making becomes unified in computerized patient information systems, producing and using such information becomes a central and determining core of everyday nursing work. It organizes nurses into a "managed" practice of patient care, contradictory for them in many ways. Outstanding among these contradictions is a new professionalized standpoint of cost-efficiency that subordinates nurses' traditional interests and grounding of their work in the standpoint of care.
Eight interrelated reasons for the decline of the golden age of doctoring are discussed in this article. Major extrinsicfactors (generally outside the control of the profession) include (1) the changing nature of the state and loss of its partisan support for doctoring, (2) the bureaucratization (corporatization) of doctoring; (3) the emerging competitive threat from other health care workers; (4) the consequences of globalization and the information revolution; (5) the epidemiologic transition and changes in the public conception of the body; and (6) changes in the doctor-patient relationship and the erosion of patient trust. Major intrinsic factors are (7) the weakening of physicians' labor market position through oversupply; and (8) the fragmentation or weakening of the physicians, union (AMA). Despite the recent sociopolitical transformation of modern U.S. medicine, our thinking remains wedded to a now inadequate theoretical approach. A future sociology of the professions can no longer overlook now pervasive macrostructural influences on provider behavior (corporate dominance). Until these influences are appropriately recognized and incorporated in social analyses, most policies designed to restore the professional ideal have little chance of success.
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Staff nurses make ethical decisions daily. It is important that nurses know how to manage those decisions appropriately so that clients' ethical rights are honored without compromising the nurse's own moral conscience. In this phenomenological study, 19 staff nurses described their experiences in making ethical decisions in their practices. The interviews were transcribed and analyzed using Giorgi's phenomenological steps. The description of the nurses' experiences identified two distinct components of the ethical decision-making process: deliberation and integration. The findings suggest that nurses need to: a) recognize the ethical nature of their work, b) discern which ethical decisions are theirs to make, and c) acknowledge their authority to make ethical decisions in their practices. These findings have important implications for the continuing education of nurses regarding ethical decision-making.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
An important process in any profession is the development of professional identity. Understanding how students experience professionalism is important to provide appropriate educational experiences to foster this aspect of professional socialization. Therefore, this study investigated baccalaureate student nurses' perspectives of what it means to be professional. This qualitative study was based on Pollio, Henley, and Thompson's interpretive framework, an existential-phenomenological approach. The purpose of the interpretation was to recognize patterns or themes in an experience. Figural experiences in one's life emerge against a backdrop, or ground. Sixty-nine baccalaureate nursing students at different educational levels participated. They described specific experiences in which they felt professional. The student experience of being professional was one grounded in a world of self and others. Three interrelated themes emerged from this ground-belonging, knowing, and affirmation. The ground of self and others provides the backdrop of the experience. It is through self and others that the figural themes are experienced. The themes are inherently inter-related. For example, the experiences of belonging and knowing were affirming to students, and affirmation enhanced their sense of knowing and belonging. Implications of the findings are explored.