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.     

Identification of a new P450 subfamily, CYP4F1, expressed in rat hepatic tumors

This study focused on the belief of some nurse educators that caring cannot be taught directly and is learned by students from faculty role-modeling and faculty student interactions in clinical, classroom, and other situations. The purpose was to further explore these beliefs to determine if nursing students perceived that they learn caring behaviors through observing role-modeling by faculty, as well as to explore students' perceptions of other means by which they learn about caring. Since opportunities for faculty to model nurse caring behaviors in the clinical setting are varied and serendipitous, a videotaped scenario simulating a patient care situation, using professional actors, was created and shown to nursing students. The videotape was seen by 137 BSN and ADN students who then recorded their perceptions on a two-page open-ended questionnaire developed by the researchers. Results from this study indicated that students do learn about caring from faculty role-modeling, as well as from health care staff they encounter, often in a very paradoxical way. Many interesting and unintended results also occurred through the use of this research approach.     

Investigations of antisense oligonucleotides targeted against bcl-2 RNAs

The purpose of this article is to describe how nurse instructors understand nursing and the necessary conditions for high quality nursing care. The approach of the study was inductive and based on phenomenology and a sociological field research method, i.e. grounded theory. It emerged that the core of nursing is a process, termed here caring, with three stages. Three types of caring emerged. Understanding the client, the art of nursing, co-operation between the nurse and other health care professionals were found to be necessary conditions for a high quality nursing care and it was also found that it is not possible to separate caring from the society and its history.     

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.     

Nursing by agreement: a contractarian perspective on nursing ethics

Contractarianism has primarily been a political theory. A good argument can be made for its application to individual and professional ethics. A contractarian perspective on nursing ethics not only provides useful insights into the central relationship in nursing--the nurse and the patient--but also allows understanding of that relationship in the context of other relationships involving the nurse, the nursing profession, and the health care organization. While the nurse-patient contract is limited, its greater moral depth gives it moral priority.     

Can the art of caring survive?

The direction that health care has taken in the past few years indicates an urgent need for new models of thinking and new interventions in health care institutions. Despite all of the changes, the nurse remains the one social being the patient can rely on for interpersonal relationships. Can the art of caring, which is at the root of nursing, survive present-day economic pressures? Is it still a useful, accessible and important tool for therapeutic contact? This article, written as a testimonial, gives the author's insights, examples and a short case history on the subject of caring. The author discusses organizational frameworks of health care institutions and encourages readers to review their own nursing practice as a means of improving within their own institutions. Key elements of caring such as altruistic values, sensibility to oneself and others, and the trust-hope relationship are presented. The author's objective is to invite further discussion and promote awareness of the threat to the art of caring.     

The approaches to learning of student nurses in the Republic of Ireland and Northern Ireland

In recent years during a period of change in nurse education, there has been an increased interest in educational theory and nurse educators have examined and questioned the fundamental principles upon which the system of education is constructed. In nurse education it is likely that no single theory of learning can account for all aspects of learning and there are reflections of many learning theories in the nursing curriculum. The literature in the area of student learning is complex and wide ranging and is poorly represented in the nurse education literature. In recognition of a lack of understanding and clarity on learning approaches in nurse education during a period of unprecedented change in Irish and United Kingdom (UK) nurse education, this paper aims to highlight the importance of understanding student nurse learning. A study is described which investigated the approaches to learning of student nurses from the Republic of Ireland, who were receiving a traditional apprenticeship training, and student nurses from Northern Ireland in a Project 2000 programme. On comparative statistical analysis significant differences were identified between the two groups in their approaches to learning. It is concluded that students' constructs of learning in nurse education are primarily dependent on their interpretation of the demands of the task, on assessment, teaching and the learning environment. The study provides nurse educationalists with important evaluative information from the students' perspective. It suggests that the way forward is to identify the significant contextual factors influencing student learning and to incorporate them into the nursing curriculum. Such an approach will serve to focus the system on variability in the quality of learning rather than on stability in human attributes.     

Enhancing self-care parenting

The interaction between parents and infants is contingent upon the parents' understanding of their infant's behavior and what the infant is trying to communicate through specific behaviors. The Synactive Model of Newborn Behavioral Organization and Development provides a theoretical base to identify and classify infant behaviors. Parents need to have an understanding of sleep/wake states, infant behaviors, and infant cues in order to have a positive parenting experience. The advanced practice nurse has the opportunity to educate parents regarding their infants' behaviors and appropriate interventions, which can lead to increased parental confidence, competence in interacting with their infants, and positive self-care parenting.     

Stereotyping and evaluation in implicit race bias: Evidence for independent constructs and unique effects on behavior.

Implicit stereotyping and prejudice often appear as a single process in behavior, yet functional neuroanatomy suggests that they arise from fundamentally distinct substrates associated with semantic versus affective memory systems. On the basis of this research, the authors propose that implicit stereotyping reflects cognitive processes and should predict instrumental behaviors such as judgments and impression formation, whereas implicit evaluation reflects affective processes and should predict consummatory behaviors, such as interpersonal preferences and social distance. Study 1 showed the independence of participants' levels of implicit stereotyping and evaluation. Studies 2 and 3 showed the unique effects of implicit stereotyping and evaluation on self-reported and behavioral responses to African Americans using double-dissociation designs. Implications for construct validity, theory development, and research design are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using Peplau's theory in nurse-patient relations

In caring for a person suffering from depression, Peplau's theory of "Interpersonal Relations" was found to be both effective and representative of what psychiatric nurses do. Peplau's work, initially published in 1952, continues to make a major contribution to nursing knowledge and deserves the significance that it is being given in the 1990s. Below, a report on the learning experience for both the patient and the carer.     

Nurses' perceptions of factors influencing the use of a pain program

Factors that, according to nurse participants, influenced the application of what was learned in a pain program were explored by means of qualitative interviews. Participants indicated that the correspondence between the program and their personal view on pain management, attitudes toward the program and innovations in general, self-efficacy perceptions, and (un)familiarity and taboos with respect to program items influenced what they put into practice. In addition, participants indicated that interactions with colleagues, nursing managers, patients, and physicians affected their application of the program. Furthermore, organizational factors, such as limited time and lack of formal program implementation, were mentioned as influential.     

Caring

Many nurse scientists consider caring to be the core concept of nursing practice. This article describes the caring process that occurs when a nurse and a client interact in a nursing care situation. This interactional process has five integrating phases: co-presence, experience-sharing, caring acts, caring-perception, and mutual care-receiving. The authors provide a specific example that illustrates this caring process. The difficulties inherent in the caring process relate to one, or a combination of, three factors: the nurse, the client, and/or the circumstances. Nurses must be cognizant of the client's expression of subtle clues that indicate the need for caring. They also need to learn to recognize their own personal signals that might prevent them from engaging in the caring process. For caring, in its full context, can only occur when nurses know how to care for themselves. Nurses face unpredictability and challenges in their practice on a daily basis. In order to promote caring they must learn to promote an environment that nurtures this process. The authors discuss the essential characteristics of a favorable caring environment and present the conditions that can enhance quality nursing. The challenges that caring nurses face are counterbalanced by the value they attribute to this basic human need and the profound human benefits that caring brings.     

Videothoracoscopy for diagnosis and treatment of respiratory tract diseases

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.     

Protection against myocardial ischemic/reperfusion injury by inhibitors of two separate pathways of Na+ entry

Critics of Kohlberg's moral theory today focus on the content of his theory and more specifically on its justice-orientated moral concept. This has led to the well-known 'justice-care debate'. The purpose of this article is to critically examine the validity of Kohlberg's moral theory for research in nursing ethics from a caring perspective (referring to the content) as well as from a cognitive-structural perspective (referring to the basic assumptions of the model). The analysis points to the usefulness and value of the cognitive-structural model to empirically study nurses' ethical behaviour; the content of Kohlberg's model, however, needs to be adapted by adding a caring perspective as well as some personal and situational variables. An adjusted version of Kohlberg's model is proposed and discussed.     

On impostorship, cultural suicide, and other dangers: how nurses learn critical thinking

Critical thinking is an important idea whose time seems to have come for nursing education. However, as a newly fashionable buzzword, it is in danger of being uncritically accepted, of being regarded as the panacea for all problems of nursing practice. This article goes behind the positive rhetoric of critical thinking to explore how this process manifests itself in the lives of nursing practitioners, nurse managers, administrators, and educators. Drawing on nurses' own stories of what happened as they challenged conventional professional or organizational assumptions and as they explored alternative perspectives on nursing practice, a picture of critical thinking "from the inside" emerges. Themes of impostorship, cultural suicide, lost innocence, roadrunning, and community emerge as defining features of the critical thinking process. It becomes clear that critical thinking is a strongly emotional as well as cognitive process, and that it carries considerable political dangers for its protagonists.     

Patient's capable of managing--basic process of psychiatric nursing in a hospital environment

The aim is to describe the basic process of psychiatric nursing in a hospital environment and to produce a practical theory of psychiatric nursing by the grounded theory method. The data were collected by means of observation and interviews and analysed simultaneously, so that the preliminary results and experience gained in the field shaped the data collection process. The data were subjected to continuous comparison analysis and classified into categories by open coding. The basic process was identified by means of axial coding and theoretical memos. The selective coding consisted of related categories grouped around a core category. The basic process of psychiatric nursing involves the patient's needs for care, the helping methods available and the objectives of care. The patient needs help because of his/her inability to manage in daily life, and the role of nursing is to help the patient to manage. The basis of psychiatric nursing lies in caring for the needs of the patient by employing various helping methods. Patient management consisted of three categories, each subsuming three subcategories. Examination of the content of these led to the identification of different types of psychiatric nursing, labelled as confirming, educating and catalytic. The results suggest that collaborative methods in psychiatric nursing enable and support the patient's participation in his/her care and show that both nurses and patients consider collaboration a good helping method, although requiring a change in attitudes and activities for both the nurse and the patient. In spite of changes in psychiatric nursing, there has been no essential development, as most of the care provided is still normative and traditional and the patient is a passive recipient.     

Application of caring theory in primary care: a challenge for advanced practice

That caring is central to nursing is now axiomatic. But has this concept been transferred to advanced nursing practice in primary care? The following article will present reflections on the use of caring in advanced practice in primary care. It is suggested that the nurse practitioner's and other advanced practice nurses' (APNs') use of caring sets nursing's contributions to primary care apart from other providers' practice. A vision is discussed in which professional caring frames the delivery of primary care's nursing therapeutics. How-tos are suggested for delivering professional caring in today's hectic health care environment. Ways the APN can create strategies for renewing caring energy are presented.     

Applying nursing theory to perioperative nursing practice

The perioperative nursing role has evolved from that of task-oriented specialists to patient-centered professionals. The concept of caring is significant to perioperative nurses and is manifested by the many caring behaviors perioperative nurses demonstrate toward surgical patients. This article describes how the element of caring is an essential function of perioperative nursing and relates the perioperative nursing role to the work of three nursing theorists (le, Florence Nightingale; Virginia Henderson, RN, AM; Carol L. Montgomery, RN, PhD).