Transcultural nursing practice described by registered nurses and baccalaureate nursing students

Using Leininger's Theory of Culture Care Diversity and Universality as a framework, this research examined transcultural practices of nurses and students. A survey was administered to a convenience sample of registered nurses and senior baccalaureate students with 767 usable questionnaires returned. Neither group expressed confidence in their ability to care for culturally-diverse patients. Registered nurses (RNs) reported assessing cultural factors and modifying practices more frequently than did students. Respondents reported their beliefs about transcultural nursing were influenced by being with people of other cultures, their own personal values, and education. Analysis of the open-ended questions revealed two major themes. First, both nurses and students perceive an overwhelming need for transcultural nursing. Second, nurses and students respond to cultural challenges by modifying their care. Modifications are based on language and communication, pain perception and relief, religious and spiritual dimensions, gender and family roles, and other values. Results suggest that nurses and students are aware of culture, recognize that culture influences the care they provide, and modify their health teaching and nursing care based on culture. The use of a conceptual framework to help make modifications in care was not mentioned.     

Ethical conflicts reported by certified registered rehabilitation nurses

Psychological and neuropsychological assessment of children is focused on behavioral disorders of various dimensions (e.g., abilities and limits of perceptual, expressive, cognitive and emotional functions). Additionally neuropsychological diagnosis attempts to explain relationship between behavioral and brain states. The purpose of diagnosis formulated in this way requires careful selection of test procedures and overall integration of different kinds of data. Especially, severally handicapped cases need this kind of diagnostical approach. Limits of valid diagnostic conclusions are determined by many factors that affect coherent interpretation of the test scores (e.g. the lack of a consistently employed neurologic model of brain development to relate to behavioral functions, significant impairment with coexisting sensory and motor deficits, the different effects of brain lesion depending on age of onset, the interference of maturational and experimental variables with manifestation of brain damage).     

Perceptions and practice of universal blood and body fluid precautions by registered nurses at a major Sydney teaching hospital

Detection of Newcastle disease virus (NDV) and avian pathotyping of NDV isolates are extremely important because the appearance of virulent virus has significant economic consequences in terms of vaccination, eradication, and the ability to export poultry products. By using nucleotide and amino acid (aa) homology analysis, we could demonstrate that a NDV broiler isolate is a velogenic virus. This analysis was done after mean death time and intracerebral pathogenicity index tests gave inconsistent results. By establishing a nucleotide sequence dendrogram, we found that the disputed Ber-Tuvia was clearly in the same group as the known Herev-Laet, a velogenic isolate. The difference between Ber-Tuvia 92 and the Herev-Laet velogenic isolate was 6% as opposed to > 16% of the meso- and lentogenic isolates. The Ber-Tuvia isolate contains the Arg/Arg and Lys/Arg aa at positions 112, 113 and 115, 116, respectively, in the fusion protein cleavage aa sequence, which is typical for virulent NDV isolates.     

In-laboratory removal of femoral sheath following protamine administration in patients having intracoronary stent implantation

Two hundred twenty-eight patients with successful coronary stent implantation were randomized either to protamine administration and femoral sheath removal (group I, n = 117) or no heparin neutralization and delayed sheath removal (group II, n = 111). The hospital stay after treatment was shorter in patients receiving protamine; therefore, protamine use for neutralizing circulating heparin may be safely administered immediately after stent implantation.     

Retaining registered nurses in rural community hospitals

In rural practice settings where the task of recruiting new employees is exceedingly difficult, the first step in surviving the nursing shortage should begin with maintaining existing resources. Based on a survey of 2,488 staff registered nurses working in rural community hospitals, the authors compare personal, demographic, and practice characteristics of nurses by their self-reported intentions to stay in their present positions. Specific areas of job dissatisfaction that best distinguish those who anticipate leaving in 1 year from those committed to remaining in their present job for 5 years or more are identified.     

From frustration to red fury: a description of work-related anger in male registered nurses

This article is Part II of a three part article. Part I described work-related anger experiences of female registered nurses, and in this article findings from a companion study of male RNs are presented. In phenomenological interviews, male nurses describe their work environment as hostile, causing them to be on the defensive and less productive. Sources of angle included attacks from physicians, coworkers, and managers; lack of assistance and support from peers; and differential treatment based on gender. The men stated they were called upon for physical tasks rather than for their nursing knowledge. Severed relationships and feelings of guilt, powerlessness, isolation, humiliation, and incompetence were concomitant with, or consequences of, anger. Part III provides recommendations for channeling anger constructively.     

Ratings of the performances of practicing internists by hospital-based registered nurses

PURPOSE: To examine the feasibility and reliability of ratings completed by hospital-based registered nurses of the humanistic qualities, communication skills, and selected aspects of the clinical skills of practicing internists. METHOD: In 1988-1989, registered nurses who worked in the same 175 hospitals as 232 internists with admitting privileges at these hospitals rated the internists' performances. The nurses were selected from medicine floors, specialty floors, and intensive care units and/or critical care units, using lists provided by head nurses. A total of 1,877 rating questionnaires with 13 performance categories were collected (with a mean of 8.01 nurses per internist). The ratings were analyzed to determine measurement characteristics and the relationships of the nurses' demographic characteristics to the ratings. In addition, for each of ten performance categories for 152 of the internists, the average rating each internist received from nurses was compared with the average rating each internist received from peer physicians. Statistical analysis used Pearson correlations, canonical correlations, factor analyses, Student's t-tests, analysis of variance, and stepwise multiple regression. Finally, the internists themselves, including physicians who were not actually rated by the nurses, were asked to complete a brief questionnaire that included questions about their opinions of the use of nurses' ratings. RESULTS: The nurses' ratings correlated moderately strongly with the peer physicians' ratings and had a common structure. However, the nurses' ratings were lower for several humanistic qualities, including respect, integrity, and responsibility, and their ratings were higher for medical knowledge and verbal communications. Across the 13 performance categories, approximately 10-15 ratings from nurses were needed to obtain a reliable assessment of an internist's humanistic qualities and communication skills. Many internists felt that nurses' ratings should be used equally with, or at least as a lesser contribution to, ratings by peer physicians of humanistic qualities and communication skills. CONCLUSION: Nurses' ratings appear to provide a feasible and reliable method of evaluating the internists' communication skills and humanistic qualities, when used in conjunction with ratings by peer physicians.     

Effectiveness and patient satisfaction with screening flexible sigmoidoscopy performed by registered nurses

CONTEXT: In December 1995, reported Salmonella enterica serotype Newport (SN) infections increased sharply in Oregon and British Columbia but not elsewhere in North America. Similar unexplained increases had been noted in 6 other states in the fall of 1995. OBJECTIVE: To determine the source of the outbreak(s). DESIGN: Case-control studies, environmental investigations, bacterial subtyping, and surveillance information review. SETTINGS: Oregon and British Columbia communities (winter 1995-1996) and Georgia, Oklahoma, Pennsylvania, Vermont, Virginia, and West Virginia (fall 1995). PARTICIPANTS: Oregon and British Columbia residents with culture-confirmed SN infections and onset from December 1, 1995, through February 29, 1996, and healthy community controls. MAIN OUTCOME MEASURES: Odds ratio (OR) of illness associated with exposures; distribution patterns and culture of alfalfa seeds and sprouts; subtyping of SN isolates. RESULTS: We identified 133 cases in Oregon and British Columbia; 124 (93%) occurred in patients older than 18 years; 87 (65%) were female. Case patients were more likely than community control subjects to report having eaten alfalfa sprouts in the 5 days preceding illness (41% [17/41] vs 4% [3/75]; OR, 17.0; 95% confidence interval, 4.3-96.0). Case isolates shared a distinctive pulsed-field gel electrophoresis (PFGE) pattern. The SN was grown from seeds and alfalfa sprouts. The distribution of 1 seed lot to multiple growers corresponded to the distribution of cases. Distribution of a second seed lot from the same European wholesaler corresponded to the location of the fall outbreak, which was characterized by a similar demographic profile. The PFGE pattern of fall outbreak isolates and confiscated sprouts and seeds was indistinguishable from the Oregon and British Columbia outbreak and differed from background isolates. CONCLUSIONS: The SN-contaminated alfalfa seeds were distributed to multiple growers across North America in 1995 and resulted in a protracted international outbreak scattered over many months. Current sprouting methods are inadequate to protect consumers from such events. Alfalfa sprouts may be an elusive but important vehicle for salmonellosis and other enteric infections.     

The practice of health education in acute care settings in Hong Kong: an exploratory study of the contribution of registered nurses

A multiple case study design was used to explore the practice of health education in acute care settings in Hong Kong. Two case studies, a medical ward and a surgical ward, were selected to reflect the real setting in which nurses carry out health education in acute care. Data collection methods involved the use of non-participant observation and semi-structured interviews. Seven nurses and eight patients were interviewed to explore their understanding of health education concepts, the use made in the wards of health education and the factors influencing such practice in the acute settings. Individual and cross-case analysis showed that respondents' understanding of the concept of health education was limited to patient information-giving. Although the importance of health education in acute patient care was acknowledged, the degree to which health education featured in nurses' practice was minimal. Many available opportunities for health education were missed and factors such as nurses' busy-ness and the associated lack of time and staff were identified as influencing health education practice in these acute care settings. Implications for practice and future studies were discussed in the light of these findings.     

Testing a model of absence and intent to stay in employment: a study of registered nurses in Malta

This review presents the major animal models usually used for the study of the pathological processes related to insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM) and to the main diabetic complications. These models can be observed spontaneously or can be obtained by selective cross-breeding or toxic exposure (chemical or viral), as well as genetically induced. They reproduce some aspects of the human pathology without combining them all in a single model. Consequently, a pertinent pharmacological approach may compare the results obtained with several models. The examination of the recent results obtained with transgenesis does not allow these animal models to replace more classical ones but they may constitute a future challenge for gene therapy despite the multifactorial aspect of diabetic disease.     

The roller coaster supply of registered nurses: lessons from the eighties

The strong labor demand of the eighties for nurses has evaporated under reform proposals and cost constraints. In this study, the 1984 and 1988 National Sample Surveys of Registered Nurses (NSSRN) were used to examine the labor supply of nurses. Ordinary least squares and logistic regression analyses indicated that the responsiveness of registered nurses to the wage was greater than previous research has indicated. If wage growth is slow relative to other occupations due to a decreased demand for nurses, registered nurses will in turn reduce their supply of labor more than previous research has indicated. Whether the response by nurses will balance the reduction of demand by employers remains to be seen.     

Declarations by registered nurses from the 1980s: an aid to the understanding of nursing today

This study is part of a more extensive project that aims to rescue significant aspects related to the evolution of nursing care from 1950s until 1990s. This study was developed using the technique of oral declaration by active and retired registered nurses, in the context of a school-hospital from the interior of the S?o Paulo State. The present study particularizes the outcomes regarding to 1980s. As result becomes evident the undertaken effort by nurses in the struggle for profession's recognition and prestige; intense and deep transformations related to nurse's new roles as leadership of the nursing staff and members of the medical team.     

Evaluating domestic partner abuse in a family practice clinic

BACKGROUND AND OBJECTIVES: Although national surveys indicate that approximately 2 million women are victims of severe physical aggression by their partners each year, these women are underidentified by physicians. The assessment by medical personnel of partner abuse is hampered by lack of a simple and reliable instrument that systematically and quickly determines the occurrence and effect of abuse among patients. METHODS: Ninety (58% of an eligible pool) consecutive, consenting, eligible female patients at a suburban family practice clinic at a tertiary university hospital completed the Partner Abuse Interview to evaluate the 1-year prevalence and effect of abuse. RESULTS: The Partner Abuse Interview required as little as 3 minutes to administer. Results obtained with the interview instrument were internally consistent. Interrater reliability was high for the diagnosis of partner relationship problems with physical abuse by males, as reported by females. Approximately 15% of the women reported having sustained injury or being fearful of their partners as a result of their partners' physical aggression in the past year. CONCLUSIONS: The Partner Abuse Interview is a simple and reliable instrument that could be adapted for use by medical personnel to assess incidents of abuse among patients.     

Ombudsman: a new role for advanced practice nurses in psychiatric-mental health nursing

TOPIC: The role of ombudsman for advanced practice nurses in psychiatric mental health nursing. PURPOSE: To describe the role of ombudsman and its fit with nursing as seen in the Price Spratlen Ombudsing Model. SOURCE: The author's own experiences as both an advanced practice nurse and an ombudsman. CONCLUSION: Because of downsizing, reorganization, and a general trend toward mutual distrust in large organizations, being an ombudsman has been named one of the "25 hottest careers." Advanced practice nurses in psychiatric mental health nursing, by virtue of their knowledge of interpersonal, preventive, and systems theories, are in a unique position to fill this role.     

Through the looking glass: the labor market for registered nurses in the 21st century

From the 1950s through the early 1990s, nurses enjoyed employment security. Now supply outstrips demand and nursing student enrollments are declining. What are the forces at work and how can the rules of the marketplace be used to predict the future?     

Evaluating societal change in attitude.

Presents a probabilistic response model for assessing attitude data from national surveys. The attendant statistical analysis by generalized least squares adjusts for the heterogeneous variances and covariances characterizing the data in such surveys. The flexibility of this approach in survey analysis is illustrated using attitude data from the Netherlands' Social and Cultural Report 1980. Estimation and testing procedures applied to these data demonstrate sharp shifts during the last decade toward easing social constraints on the feminine role. This illustration is suggestive of the types of lawful relationships that are demonstrable at the societal level of analysis. Other possible applications of the approach are suggested. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nurse practitioners, practice nurses and nurse specialists: what''s in a name?

Nitric oxide (NO) readily makes corresponding complexes not only with ferrous iron but also with ferric iron. However, NO-ferric complexes of many heme proteins were unstable, while horseradish peroxidase formed the very stable NO-ferric porphyrin complex with a shift of the Soret band of the absorption wavelength from 396.5 nm to 420.0 nm. The concentration of NO in aqueous media could be monitored by measuring the absorption changes, and the detection limit was 10 nM. The simple procedure is convenient for concentration determination of NO solution.     

End-to-side neurorrhaphy with removal of the epineurial sheath: an experimental study in rats

Terminolateral neurorrhaphies were used up to the beginning of this century. After that, they were no longer reported. We tested the efficacy of a new type of end-to-side neurorrhaphy. A group of 20 rats had the peroneal nerve sectioned, and the distal ending was sutured to the lateral face of the tibial nerve after removing a small epineural window. All experiments were made on the right side, the left one remaining untouched in half the animals of each group. The other half was denervated by sectioning and inverting the endings of the peroneal nerves. In this way, tibial cranial muscles were either normal or denervated on the left side and reinnervated through end-to-side neurorrhaphies on the right side. After 7.8 months, the animals were subjected to electrophysiologic tests, sacrificed, and the nerves and muscles were taken for histologic examination. A response of the tibial cranial muscle was obtained in 90 percent of the animals. The distal ending of the peroneal nerve showed an average of 861 nerve fibers. The average areas of the reinnervated tibial cranial muscles were (microns 2) 1617.81 for M2n (when the contralateral side was normal) and 1579.19 for M2d (when the contralateral was denervated). We conclude that the terminolateral neurorrhaphy is functional, conducting electrical stimuli and allowing the passage of axons from the lateral surface of a healthy nerve, to reconstitute the distal segment of a sectioned nerve. The absence of an incision on the axons of the donor nerve was no impediment to axonal regeneration or to the passage of electrical stimuli. The results demonstrate the possibility of using end-to-side and terminolateral neurorrhaphies for reconstituting neural lesions when only a distal end is available; the reinnervation can be obtained from the lateral face of a healthy nerve.     

Evaluating critical thinking in clinical practice

Although much has been written about measurement instruments for evaluating critical thinking in nursing, this article describes clinical evaluation strategies for critical thinking. Five methods are discussed: 1) observation of students in practice; 2) questions for critical thinking, including Socratic questioning; 3) conferences; 4) problem-solving strategies; and 5) written assignments. These methods provide a means of evaluating students' critical thinking within the context of clinical practice.