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PubMed2004

The relational core of nursing practice as partnership.

BACKGROUND: Consideration of the relational core of nursing has gained significance in today's health systems, where the work of nurses is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. This has led to disregard for individual experiences of living life with diverse health conditions. AIM: The aim of this paper is to articulate the relational core of nursing practice as partnership. DISCUSSION: The relational core of nursing practice is explicated as a process of professional partnership, focusing on the evolving dialogue between nurse and patient. In partnership, the dialogue is open, caring, mutually responsive and non-directive. The nurse attends to that which is of concern to patients in relation to their health predicaments and the meaning in the health experience unfolds. Nurse and patient reach insight that represents more useful ways of comprehending and acting on their health predicaments. CONCLUSIONS: Partnership represents theoretically-driven practice that invites nurses to meet patients where they are in understanding their health predicaments and what can be done about them. As such, partnership strengthens the resolve of nurses to resist the pressures of contemporary health service delivery to provide a technical form of practice and it protects the relational core of a fully professional practice.

Clinical Competence↗
PubMed1993

The importance of the practicing nurse in nursing research.

Most research findings never reach the practicing nurse. However, many scientific findings would enhance quality of care if nurses knew about them and incorporated them into their practice. To make nursing research practice based, medical-surgical nurses must identify pertinent questions for research and use the findings in practice and evaluate subsequent outcomes.

Clinical Nursing Research↗
PubMed2006

Towards a strong virtue ethics for nursing practice.

Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.

Attitude to Health↗
PubMed1990

The perception of Swedish nurses and nurse teachers of the integration of theory with nursing practice. An explorative qualitative study.

Nursing education in Sweden has undergone quite a few changes during the last decade. The aim has been to make nursing more holistic, individualised and health-oriented. Social competence, systematic problem solving and research have also been emphasised. These changes in nursing education have led to new demands on nurse teachers. Nurse teachers, directors of nursing education at three nursing schools and a few nurses were interviewed about the problems they experienced in relation to the new demands. The main problems reported were: 1) students inadequately prepared for nursing education, 2) students' attitudes to the social and health-oriented content of the first course at nursing school, 3) integration of research and nursing, 4) resistance to a more theory-based and nurse teacher-dominated nursing education, 5) integration of nursing theory and nursing practice and 6) incompatible demands on the clinical nurse teacher.

Attitude of Health Personnel↗
PubMed1980

A practice nurses' course--content and evaluation.

Practice nurses need special training to extend knowledge and skills well beyond those of general professional training in order to function competently, with assurance, and with safety. The content and evaluation of one such programme is described.

Community Health Nursing↗
PubMed1995

Building consensus for nephrology nursing practice.

Building consensus for nephrology nursing practice was the theme for the American Nephrology Nurses' Association's (ANNA's) 1994 Clinical Concerns Meetings in Chicago and LaJolla, California respectively. This article emphasizes the importance of consensus building, traditional approaches to consensus conferences, and the inherent risks in conducting such a conference. Additionally, the consensus conference design and steps leading to a final working document are presented by members of the Clinical Concerns Planning Committee.

Consensus Statements as Topic↗
PubMed1994

Case management and nursing practice.

Does adopting a case management model alter nursing practice? The authors examine the effect case management has on nurse-client relationships and nurse-colleague relationships and explore how nurses are using case management as a vehicle to achieve professionalism. The article is based on a literature review of case management for community-dwelling elderly residents and interviews with 17 community-based nurses practicing as case managers in Canada.

Canada↗
PubMed1995

Education of the advanced practice nurse in oncology.

PURPOSE/OBJECTIVES: To review the education of the advanced practice nurse (APN) with a focus on curriculum and issues related to the oncology specialization. DATA SOURCES: The State-of-the-Knowledge Conference on Advanced Practice in Oncology Nursing, journal articles, monographs, and authors' personal experiences. DATA SYNTHESIS: APN education is a current issue in nursing, as well as in the specialty of oncology nursing. Current trends in the delivery of health care require reform of graduate education in nursing to better prepare APNs to shape and respond to the healthcare needs of the public along the entire cancer care continuum. CONCLUSIONS: APN education remains a dynamic, ever-evolving enterprise. The Oncology Nursing Society (ONS) and the American Cancer Society (ACS) have taken a proactive stand on APN education by revising master's curriculum guidelines and supporting the conference. IMPLICATIONS FOR NURSING PRACTICE: APN education in oncology will be an ongoing area of exploration for both ONS and ACS, as well as for leaders in oncology nursing. Development of graduate, postgraduate, and continuing education programs at the APN level of expertise will support high-quality advanced practice in oncology nursing. The feedback mechanisms among practice, education, and research will provide educational programs that will make a difference in the care of patients with cancer.

American Cancer Society↗
PubMed2001

Patients' and practice nurses' perceptions of secondary preventive care for established ischaemic heart disease: a qualitative study.

A significant proportion of patients with established ischaemic heart disease remain unrecognized in general practice and those who are receiving treatment are experiencing sub-optimal care. The provision of coronary prevention by practice nurses may be an important strategy to improve the quality of this care, and this is feasible and effective. This study explored what occurred during patients' initial assessment for secondary prevention of ischaemic heart disease with a practice nurse and investigated patients' and practice nurses' views ofnurse-led clinics in primary care. Nurses were effective in history taking and offering reassurance and dietary advice, yet were less confident in discussing patients' understandings of heart disease and related medication. Practice nurse-led coronary preventive care is acceptable to both nurses and patients. Further practice nurse education is required in heart disease, cardiac medications and skills necessary for exploring and challenging patients' understandings of these issues.

Adult↗
PubMedDate not supplied

Analysis of a decade of nursing practice research: 1977-1986.

The purpose of this study was to analyze the research focus, theoretical bases, research designs, statistical methods, and research findings of nursing practice research, 1977-1986. A secondary purpose was to assess the fit of nursing practice research topics within the North American Nursing Diagnosis Association's (NANDA) taxonomy. The sample consisted of 720 articles that met the definitional criteria of nursing practice research from six major refereed journals in nursing that primarily publish nursing research. Findings showed that 95% of research in nursing in the last decade was conducted by nurses as first authors, over half with doctoral degrees. Funded research increased as well as the trend toward multidisciplinary research and multisite studies. One-third of the studies focused on nursing intervention, and two-thirds were assessment-oriented. Although use of nursing conceptual models increased over the decade, theories or models from psychology, physiology, and sociology were used most often. There was an increase in use of sophisticated research methods and better reporting of reliability and validity. The use of NANDA as a taxonomy for classifying nursing practice research was assessed.

Authorship↗
PubMed1992

The nature of dilemmas in dialysis nurse practice.

Dilemmas are a part of nurse practice. In situations where a problem potentially has two or more unsatisfactory resolutions, the nurse chooses which course of action to take. The decision to choose constitutes a dilemma. This study focuses on the dilemmas faced by nurses in dialysis units and the context in which they occur. A qualitative design was employed, using open interviews with eight nurses currently employed in dialysis nursing. This approach was taken in order to explore and gain in-depth understanding of the dilemmas in practice. Analysis reveals that dilemmas encountered in dialysis nursing emerge from conflicts in relationships with other people in the work environment. The dilemmas relate to the nurses' perception of the limited power they have in the determination of their practice. This powerlessness is reinforced by their perceived and real isolation from nurses working outside their area of practice. Traditionally, literature on dilemmas in nursing has focused on the development of ethical frameworks to guide practice and the resolution of dilemmas. However, the findings of this study suggest that if nurses are to deal with dilemmas effectively, both for the nurse and the patient, there must be an examination of the structural constraints affecting their practice. Models that are employed by nurses to guide practice must account for the structural elements in the work environment.

Adaptation, Psychological↗
PubMed2005

Nurse practice environments and outcomes: implications for oncology nursing.

PURPOSE/OBJECTIVES: To examine practice environments and outcomes of nurses working in oncology units or Magnet hospitals and to understand the association between the two. DESIGN: Secondary analysis of survey data collected in 1998. SETTING: Medical and surgical units of 22 hospitals, of which 7 were recognized by the American Nurses Credentialing Center Magnet program. SAMPLE: 1,956 RNs, of whom 305 worked in oncology units. METHODS: Chi-square tests compared nurse-reported outcomes by work setting, analysis of variance tested practice environment differences by setting, and logistic regression estimated the effects of practice environment, specialty, and Magnet status on outcomes. MAIN RESEARCH VARIABLES: Practice environments, emotional exhaustion, job satisfaction, and quality of care. FINDINGS: Oncology nurses had superior outcomes compared with nononcology nurses. Emotional exhaustion was significantly lower among oncology nurses working in Magnet hospitals. Scores on the Collegial Nurse-Physician Relations subscale were highest among oncology nurses. Outcomes were associated with Practice Environment Scale of the Nursing Work Index scores and Magnet status. Oncology nurses with favorable collegial nurse-physician relations were twice as likely to report high-quality care. CONCLUSIONS: Oncology nurses benefit from working in American Nurses Credentialing Center Magnet hospitals. Adequate staffing and resources are necessary to achieve optimal outcomes. Collegial nurse-physician relations appear to be vital to optimal oncology practice settings. IMPLICATIONS FOR NURSING: In addition to pursuing American Nurses Credentialing Center Magnet recognition, nurse managers should assess practice environments and target related interventions to improve job satisfaction and retention. High-priority areas for interventions include ensuring adequate staff and resources, promoting nurse-physician collaboration, and strengthening unit-based leadership.

Adult↗
PubMed1999

The education of advanced practice nurses: a contemporary approach.

The Advanced Practice Nursing of Adults and the Elderly graduate program at San Diego State University School of Nursing prepares experienced professional nurses with primary and specialized care (acute or critical care) knowledge and skills to deliver health care to adults and elders across practice settings as nurse practitioners and clinical nurse specialists. Emphasis is placed on health care that is research based and congruent with national standards of practice. This approach to graduate education is congruent with recommendations of professional nursing organizations and responds to the educational needs of professional nurses and the health care needs of adult and elders.

Acute Disease↗
PubMed1999

Continuing education for advanced practice nurses.

Continuing education (CE) enables the advanced practice nurse (APN) to be apprised of practice issues and meet recertification requirements. Opportunities for obtaining CE program credits for APNs have expanded, yet uncertainty exists regarding specific program requirements for obtaining state and national certification. To obtain accurate information related to state requirements for CE for APNs, all 50 state boards of nursing were contacted by telephone in July 1998. Responses were received from all 50 states by telephone or facsimile transmission. This article outlines information related to CE for APNs including state renewal and national recertification requirements. Factors to consider when deciding on CE offerings in advanced practice nursing are also discussed.

Certification↗