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PubMed1998

[The role of local health departments in reducing inequalities in health in Switzerland].

Examples from Switzerland: In Switzerland, as in other countries, several studies have demonstrated social inequality in health. The aim of this study is to demonstrate practical approaches to reducing these differences, as they offer themselves on the local level, and to analyse the implications for the functioning of local departments of Public Health. Case studies, mainly from the health department of the city of Bern, are used to demonstrate measures taken 1. to identify and correct unmet needs of the socially disadvantaged disabled elderly; 2. to find children from marginal groups who failed to be immunised before entering school age, and to arrange for them to be immunised; and 3. to include psychosocial measures when routine school health examinations have led to observations of a biomedical nature. Recent difficulties are pointed out which developed in this connection as a consequence of the privatisation of traditional Public Health functions. The examples show that considerable effort is needed if local health departments attempting to correct social inequalities try to solve individual problem cases. The task is often multidisciplinary. It involves other administrative sectors such as education, social services and housing construction, and is greatly influenced by measures taken on the Federal or Cantonal (Federal Provincial) level. Whereas demonstrating social inequalities through periodic health reporting can be seen as belonging to the traditional activities of health departments, eliminating or reducing the inequalities not only requires a far-reaching re-orientation of local Public Health services, but also a re-definition of the job description and training of Public Health physicians; and as this process continues, it appears that health departments in Continental Europe will increasingly be led to adopt approaches developed previously by Public Health departments in Anglo-Saxon countries.

Community Health Services↗
PubMed1976

1974 Arizona P.A.C.E. participation.

Members of the Arizona State Society for Medical Technology were contacted to ascertain their knowledge of the P.A.C.E. program as well as to obtain release of the transcripts for those who participated during 1974. Observations regarding reported credits were noted. The Analysis of Variance test with Scheffe comparison was utilized to determine if any characteristic accounted for the difference in total continuing education hours reported. It was concluded that residence location, marital status, sex, age, degree level, length of membership in ASMT, years experience, employment extent, place of employment, and number of beds at place of employment had no significant effect on the total hours reported. A significant difference in total hours reported was noted for those individuals who reported either CEU or college credits. A significant difference was also noted in the total hours reported with respect to job description.

Arizona↗
PubMedDate not supplied

Specialty practice entrepreneur: the advanced practice nurse.

There are many opportunities in the health care arena to make a difference. The structured sense of change is "old school." New "surfers" of the system will be entrepreneurial in spirit, energy, and flexibility. There is no job description for the perfect person, only a sense of excitement and innovation that gives one the feeling energetic change is about to happen. In nursing, the risk takers are abundant in the APN role. It is the reason why they walk the line of provider/nurse. Making a difference to patients is important. Riding the waves of clinical care is the excitement. The final results are "the big waves" of life--a patient's life. A provider who defines the reality of practice creates a vision and skillfully bridges the road between the two. Design the surfboard--catch the wave.

Entrepreneurship↗
PubMed2001

Historical cohort study of US man-made vitreous fiber production workers: VII. Overview of the exposure assessment.

Data and procedures used to reconstruct the history of exposures at each of the 15 plants (19 distinct sites) are presented. The assessment consisted of five steps: (1) develop a Technical History of operations, stable periods, and time points of changes relevant for exposures, and identify the presence of potentially confounding co-exposures; (2) develop a set of unique department-job names with descriptions and a Job Dictionary for all verbatim names in work histories; (3) collect all company and other exposure data (> 1600 observed), and develop quantitative fiber, formaldehyde, and silica exposure estimates; (4) integrate estimates with the Technical History to make Exposure Extrapolation Tables; and (5) use the the Tables with job data to develop an Exposure Matrix for each plant. Nineteen Exposure Matrices were made, with 82 to 621 lines, covering up to 54 years of operations.

Air Pollutants, Occupational↗
PubMed1984

The politics of stress: the case of air traffic control.

Analysis of the 1981 Professional Air Traffic Controllers Organization strike suggests that workers who employ the concept of stress to describe undesirable job conditions risk unexpected negative consequences. In deciding not to make subjective claims that can only be addressed in political terms, workers necessarily appeal to outside experts to provide scientific, objective descriptions of job conditions. Unfortunately, different experts define stress in strikingly different ways, allowing for a kind of shell game in which the very existence of stress can become problematical. In addition, the stress experts have been unable to offer more than weak data to support the theories that link difficult working conditions to pathological outcomes. Thus workers are likely to lose labor disputes that depend on the stress discourse. A major reason for such an outcome is that job conditions, as part of the social world, lend themselves poorly to a form of inquiry designed to investigate the physical world.

Aviation↗
PubMedDate not supplied

The preceptor experience: a qualitative study of perceptions of nurse preceptors regarding the preceptor role.

This qualitative, exploratory, and descriptive survey was undertaken to identify benefits and disadvantages of the preceptor role as perceived by nurse preceptors. Information regarding rewards preceptors perceived as desirable also was obtained. Findings from this study can be used to develop preceptor programs that increase job satisfaction for preceptors and improve the learning environment for orientees.

Adult↗
PubMedDate not supplied

Use 'em or lose 'em: the licensed practical nurse.

This article examines the process our gastroenterology unit has undergone in redesigning and enhancing the role of the licensed practical nurse. Within the department, there had existed some dissatisfaction among the licensed practical nurses regarding their role. The unit norm was to use these nurses as healthcare technicians or associates in the procedure and reprocessing rooms. The licensed practical nurses struggled with the restriction of their role and the unit reexamined the appropriate usage of licensed practical nurses. In this article, a literature review has been provided along with a description of the process of developing orientation tools and training of the licensed practical nurses to new roles. Barriers to staff acceptance has also been highlighted. Enhancement of the licensed practical nurse role has had a positive impact on our unit. This practice change has improved the job satisfaction of the licensed practical nurse as well as provided greater unit flexibility and improved teamwork within the department. Alice, a licensed practical nurse (LPN) with 30 years of experience, joined the gastrointestinal (GI) department 7 years ago. She recently corrected my introduction of her as "the tech" by explaining to our patient that: "I am a licensed nurse who will assist the doctor." This simple statement made me realize that Alice was actually a nurse! This initiated the exciting and somewhat painful process of reevaluating our use of staff, individual staff skills and competencies, and staffing patterns within our GI unit.

Clinical Competence↗
PubMedDate not supplied

Predictors of job satisfaction in remote hospital nursing.

This research examined the relationship between the content of work, the work environment and job satisfaction among nurses working in a teaching hospital located in a remote area of Central Australia. Using the results of recent meta-analyses of job satisfaction, a conceptual framework was developed that predicted that work content (variety, autonomy, task identity and feedback) and work environment (ward facilities, collaboration with medical staff, cohesion amongst nurses, staffing, pooling and respected by others) would influence job satisfaction. A descriptive survey of 135 nurses employed in a 170 bed hospital was undertaken. Strongest predictors of job satisfaction were job variety, feedback and collaboration with medical staff. Other moderate correlates were cohesion amongst nurses and task identity. This study demonstrated that feedback from colleagues and supervisors should never be trivialised as a strategy to improve job satisfaction. Furthermore, the need to be considered as part of the health care team by the medical profession can be influenced by proactive workplace strategies and policies.

Adult↗
PubMed1994

Career path to CFO: selection, training, and placement.

Not long ago, chief financial officers (CFOs) in hospitals could focus almost exclusively on financial accounting. Today, however, financial managers must tend diverse tasks of coordination, education, and professional specialization. The authors suggest that those who desire the position of CFO would do well to couple accounting expertise with a capacity to understand ethics and mores, economics, descriptive and predictive statistics, people from diverse socioeconomic and cultural backgrounds, as well as features of disease, its prevention, and course of treatment.

Career Mobility↗
PubMedDate not supplied

Leadership for psychiatrists.

OBJECTIVE: This article introduces the prospective leader to a set of questions and relevant leadership literature that aid in the process of deciding whether to accept a leadership position. METHOD: The author conducted a review of literature and discussion with leaders in psychiatry and other medical disciplines. RESULTS: The questions posed and leadership literature discussed provide a useful set of guidelines for potential leaders in deciding whether to accept or continue in a leadership position. CONCLUSIONS: Having access to mentoring, a clear description of "expected results," personal appreciation of leadership style, a description of available resources, a leadership vision in line with the institutional vision, and an appreciation of the necessary time commitments are fundamental in deciding whether to accept a leadership position.

Academic Medical Centers↗
PubMed2000

Intensive care nurses' experiences of caring. Part 2: Research findings.

In considering the concept of caring, this second paper presents the research findings obtained from a phenomenological study conducted to answer the question 'what is caring for nurses working in intensive care?'. Unstructured, in-depth interviews were conducted to collect data on the experiences of nine staff nurses, who volunteered to participate in the study. Three major themes were drawn from the data using Colaizzi's procedure of inductive reduction. These were 'being involved', 'sustaining' and 'having frustrations'. A resultant description of caring identified that these nurses participated in delivering three types of caring involving physical, technical and emotional labour. These were 'being close', 'being there' and 'doing to'. Implications for nursing practice, education and further research are suggested.

Adaptation, Psychological↗
PubMed1999

Evolving role descriptions of the acute care nurse practitioner.

Currently, more than 1,200 advanced practice nurses have sought certification as acute care nurse practitioners (ACNPs). Surveys of practicing ACNPs have shown that the role is expanding in terms of practice settings and role components. This article reports on the results of ongoing survey with ACNPs that portray the role of the ACNP as an evolving career opportunity for advanced practice nurses.

Acute Disease↗
PubMed1997

Neonatal nurse practitioner role satisfaction.

The article reports a descriptive study utilizing a triangulated approach to explore the role satisfaction of a nationwide random sample of 315 neonatal nurse practitioners (NNPs). Role satisfaction was found to be high, and practice philosophy tended toward a medical orientation. Those NNPs who were master's prepared and who reported to and were evaluated and paid by departments of nursing were more likely to have a nursing practice philosophy. Intrinisic factors related to satisfaction included autonomy, patient management, relationships with colleagues and families, role diversity, and a sense of accomplishment. Implications for administrators and NNPs are discussed.

Adult↗
PubMedDate not supplied

British paediatric and American pediatric nurses: how well do we know each other?

ISSUES AND PURPOSE: To identify the similarities and differences between pediatric nurses in the United States and Britain, and to compare knowledge of each other's healthcare systems. DESIGN AND METHODS: A descriptive comparative study of 55 U.S. pediatric nurses and 37 U.K. paediatric nurses. Knowledge tests were constructed as parallel forms of items about each healthcare system. "Self-knowledge" and "other-knowledge" scores were compared. RESULTS: British nurses' scores were higher for self and other than were U.S. nurses' scores. Individual items suggested that U.K. nurses were more aware of U.S. systems than U.S. nurses were of U.K. systems. PRACTICE IMPLICATIONS: The U.S. and U.K. health systems are equally progressive, yet fundamentally different. To collaborate effectively, we must understand the similarities and differences.

Health Knowledge, Attitudes, Practice↗