Nursing personnel and the concept of care: a nursing administrative viewpoint

In this article the importance of caring in nursing management was researched. A survey was undertaken between 1992 and 1994 with the purpose to investigate viewpoints of nurse managers and experiences of nurses regarding caring concepts. The data was collected by means of a questionnaire consisting of an adjusted Nyberg Caring Assessment Scale (Nyberg 1989) and other caring concepts selected from the literature. The survey was conducted among respondents of private hospitals in Pretoria. It was clear from the data analysis that nurse managers and nurses regarded caring as an important concept in nursing management. Perceptions of nurse managers regarding caring concepts and the experiences of nurses on caring in nursing management, differed substantially. It was clear that nurse managers and nurses experienced a need for training with regard to caring in nursing management.     

Differentiated levels of nursing work force demand

In addition to reviewing the literature about the extent to which basic nursing education is related to actual nursing practice, this article investigates the extent to which the relationship between nursing practice, education, and experience varies across specific health care settings. The literature presented no consistent or systematic association between type and amount of previous nursing experience and current nursing practice. However, the literature generally provided evidence of a consistent and systematic association between baccalaureate preparation and level of registered nurse (RN) practice. The review of practice and organizational differences across the hospital, nursing home, and ambulatory care sectors suggests that baccalaureate-prepared RNs in hospitals may have a more strongly differentiated role relative to those in nursing homes and ambulatory settings. If baccalaureate-prepared nurses continue to be perceived as capable of more complex and independent practice, and if employers believe that they can increase revenues by increasing the quality of nursing care or can save money by shifting to RNs some responsibilities now held by more costly personnel (such as physicians), then demand for baccalaureate-prepared nurses may increase.     

Development of a perioperative nursing diagnoses flow sheet

Traditionally, health care professionals in the preoperative, intraoperative, and postoperative phases of care have used perioperative records that focus on the technical aspects of the care provided (eg, blood pressure, pulse measurements; equipment used) and leave room for only short narratives to document nursing care. Such formats often do not document the multitude of activities or interventions perioperative nurses provide. The question raised at the DePaul Health Center, St Louis, was: "Where do we document our nursing diagnoses and plan of care?" The response was to create a nursing diagnosis task force that investigated the feasibility of a form professional nurses could use in all phases of patient care. This investigation led to the development, implementation, and universal use of a perioperative nursing diagnoses flow sheet within the surgical services department.     

Perioperative nursing interventions for intravascular stent placements

Keeping abreast of changing surgical technologies is among the more challenging aspects of perioperative nursing. Because peripheral vascular disease is a leading cause of lower extremity disabilities that require surgical interventions, new procedures and techniques are being developed continually. These procedures involve the insertion of intraluminal structural supports into patients who have had mixed or unsuccessful results from angioplasty. Perioperative nurses are an integral part of vascular surgery teams performing the insertion of intravascular stents. To function effectively, perioperative nurses must understand the concepts of intravascular stent procedures, nursing diagnoses, and nursing interventions that promote optimal patient outcomes.     

Intravenous therapy: current practice and nursing concerns

The field of intravenous (i.v.) therapy has been subject to major change, with increasing numbers of nurses taking on the high profile, technical aspects of care. The transfer of previously medicalized tasks such as cannulation has been welcomed by nurses who are keen to develop practical skills in order to embrace the concept of holistic patient care. This literature review aims to clarify the role of the nurse in i.v. therapy, exploring cannulation as a specific issue. Legal and professional aspects are discussed in terms of extended/expanded practice and practical aspects in terms of i.v. access and maintenance. Discussion focuses on a team approach to the management of i.v. therapy. Finally, the nursing process is applied to an i.v. therapy scenario. Exploration of the nursing issues enables practitioners to justify the expansion of individual practice in order to deliver holistic care and improve standards of service. The review concludes that nurses cannot afford to lose sight of the caring component of their role as a result of immersion in the culture of technical skill acquisition.     

Caring in nursing: a multivariate analysis

The dimensions underlying the perceptions of caring among nurses were investigated using the Edinburgh Caring Dimensions Inventory (CDI). Exploratory and confirmatory factor analysis techniques were used. While there was a general caring factor on which the majority of the items in the CDI loaded, there were two separable major dimensions to caring, namely 'psychosocial aspects' and 'professional and technical aspects'. In addition, two smaller dimensions were identified that were both related to self-giving, and it is postulated that these refer, respectively, to appropriate and inappropriate self-giving in nursing.     

The practice of nursing theory in the operating room

Nursing theory is a set of ideas, experiences, or observations regarding how and why nurses engage in certain activities and exhibit various behavioral attributes in providing patient care. The individualized caregiving activities perioperative nurses express during all phases of the surgical experience are supported by nursing theory.     

Cultural implications for nursing care of the Amish

The Amish are a conservative Protestant religious sect with a unique set of culture and traditions. In order to provide culturally appropriate and sensitive health care, it is imperative for nurses and other health care providers to have a basic understanding of variations of Amish lifestyle from other cultural groups. Application of Giger and Davidhizar's Transcultural Assessment Model provides information and nursing implications to assist nurses and other health care personnel when caring for Amish clients.     

Considering nursing resource as "caring time'

The present constrained economic climate faced by health care agencies underscores the need for nurse administrators to have an in-depth appreciation of how nursing services are being used. The purpose of this investigation was to increase the understanding of nursing as a resource. Using phenomenological research methodology, the investigator purposefully selected six patients and a chain sample of 14 professionals responsible for their care, including nurses, nurse managers and physicians. Data collection methods included in-depth interviews, document reviews, and participant observation. The inductive interpretation depicts the nature of nursing resource to be "caring time'. Caring was understood primarily in terms of time and was experienced by all participants as "spending time'. Caring time was spent through "being with' and "doing to/doing for' the patient. Study participants experienced tension with regard to how best to spend precious "caring time'. Nursing resource was inextricably linked to both quantitative and qualitative expressions of nursing, and "being with' patients was a highly valued, under-allocated, and unintentionally provided component of nursing resource. The researcher concluded that nursing administrators, nurse managers and practitioners all have leadership roles to play in achieving recognition, allocation and promotion of caring time within their agencies.     

Is the quest for evidence-based care detrimental to children's nursing?

Evidence-based care and the expanded role of the nurse are inexorably linked. Facets of this are found in every specialist area of nursing. Children's nurses are no exception and they have proved their commitment to family-centred care over a period of many years. However, within the ranks of nurse educationalists now employed by the universities and not the NHS new tensions have emerged. The research-led ethos of the universities demands that nurses demonstrate expertise in the field of scientific enquiry. Although the philosophy of caring and research are not incongruent, there exists the potential that family empowerment may take a back seat to academic prowess. This article examines the background to this dilemma.     

Nurse-managed centres: an innovative structure for nursing education and care

The development of nursing centres in the USA began in the late 1800s with the concept of community-based nursing care provided by district and visiting nurses. Primary roles included health promotion and safeguarding hygiene in addition to caring for the sick. Established in 1893, the Henry Street Settlement in New York, a public health nursing system providing direct access to health care, became a model for other agencies in the USA.     

Perioperative nursing challenges for the Russian emigré nurse

Three San Francisco organizations participated in an integration program that focused on the design, implementation, and evaluation of a unique training project that prepared Russian émigré nurses for employment in the US health care industry. The Russian Nurse Project is a unique program that affiliates émigré nurses with specific language and cultural skills and focuses on the increasing Russian immigrant patient population. The project's implementation and diversity strategies, as they pertain to the perioperative areas of nursing practice in this country, are described.     

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.     

The lived experience of nursing students in caring for suffering individuals

Most nursing school curricula address the pathologic nature of illness, the nursing care of clients who are ill, the prevention of illness, and the promotion of health. There seems to be minimal discussion, however, both in nursing curricula and in textbooks, of the alleviation of suffering or of how nurses know that someone is suffering. The article describes a phenomenologic analysis of 12 nursing students' lived experiences of caring for individuals who were suffering. The voices of the students as they chronicled their experiences are exemplars of clinical scholarship as described in the literature.     

Competency validation for cross-training in surgical services

Cross-training is a cost-effective means of maximizing the potential of staff members and available resources. The responsibility to provide quality patient care should not be compromised by cross-training efforts. Surgical services department staff members at Deaconess-Nashoba Hospital, Ayer, Mass, developed a competency validation project for nurses involved in the cross-training program. They accomplished this by implementing current nursing standards and practices and promoting continuity of patient care through the preoperative, intraoperative, and postoperative phases. Perioperative nurses and health care facilities have the responsibility to provide safe, effective, and efficient care to all patients. By assessing competencies for perioperative nurses, staff members can enhance their commitment to caring for their profession and their communities.     

The AIDS epidemic: caring for caregivers

AIDS has become a global health problem for individuals, families and health care providers. This disease has a tremendous impact on the physical and psychological well-being of these groups. Nurses are on the front line providing physical care and support for these patients and their families; but nurses also need support and caring as they carry out their important nursing roles. This article addresses the effects of AIDS on nurses and presents a model for nursing administrators to establish and maintain a supportive, caring environment for nurses.     

Who holds the baby in the neonatal unit?

This article explores the role of non-nurses within the neonatal unit (NNU). Nursery nurses and health-care support workers (HCSW) or auxiliaries may be employed in the NNU and the term 'non-nurse' is used to describe them all. To satisfy professional curiosity a small survey of NNUs in England was undertaken to identify the role of non-nurses in caring for babies in the NNU. The results demonstrate that not all NNUs have delineated separate roles for nurses and non-nurses. The ENB and the UKCC have responsibilities in the shaping of the nursing profession and the creation of specialist and advanced nursing practitioners and HCSWs are fashioning the process. This article will address some of these issues within the NNU and the wider sphere of nursing and midwifery.