Rural school nurses' attitudes about AIDS and homosexuality

The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.     

Reaction of different cell populations in mouse thymus to a single gamma-irradiation

Acute care facilities are no longer viewed as the center of the health care network. Efforts to reduce hospital length of stay will continue to spur the growth of care delivered in homes. With the downsizing of many hospitals, the need for nurses in acute care settings will decline. Many acute care nurses are finding themselves seeking employment opportunities in home health care settings. The purpose of this study was to examine nurses' experiences when they change from hospital-based practice to home health care nursing. The qualitative mode of inquiry was used to conduct taped-recorded interviews of 25 baccalaureate-prepared nurses in a large metropolitan area. Stressors experienced by the nurses were identified as well as adaptations required to minimize role stress. Continuing education programs can provide information and skills needed to improve nurses' competencies to function in a health care system projected to be more community-based, which includes home health care.     

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.     

The communication gap in the ICU--a possible solution

Presentations by nurses on ward rounds was introduced to improve multidisciplinary collaboration in the development of quality patient care. A second objective was to reduce nurses' passivity on the medical ward round and encourage them to play a more active role. Two questionnaires ascertained nurses' views, the first on implementation of presentations, and again after 6 months' active participation. Nurses were originally apprehensive about their new role, but then became aware of the positive aspects that the change brought to their working environment. The implications for medical staff were also considered.     

The correspondence of patient satisfaction and nurse burnout

This study examined the relationships of nurse burnout, intention to quit, and meaningfulness of work as assessed on a staff survey with patient satisfaction with nursing care, physician care, information provided and coordination of care, and outcomes of the hospital stay assessed post-discharge. Sixteen inpatient units from two hospital sites formed the data base and included 605 patients and 711 nurses. Patients' perceptions of the quality of each of the four care dimensions corresponded to the relationships nurses had with their work. Patients on units where nurses found their work meaningful were more satisfied with all aspects of their hospital stay. Patients who stayed on units where nursing staff felt more exhausted or more frequently expressed the intention to quit were less satisfied with the various components of their care. Although nurse cynicism was reflected in lower patient satisfaction with interactions with nursing staff, the correlations between cynicism and other aspects of care fell below statistical significance. No significant correlations were found between nurse professional efficacy and any of the patient satisfaction components measured. The implications of the relationship between patient satisfaction and nurses' perception of their work is discussed.     

Motivational forces affecting participation in post-registration degree courses and effects on home and work life: a qualitative study

Over the past decade, pre- and post-registration education for nurses and midwives in the United Kingdom has undergone major change, creating an atmosphere where continuing professional development is a matter of priority for individual health care staff. Against this context of change, and as part of a larger study of continuing education and training in the National Health Service, a cohort of participants in a part-time health studies degree course were interviewed using a semi-structured schedule. Twenty-nine nurses, midwives and allied professional staff described their motives for participation in the course and its effects on their professional and personal lives. Data collected in interviews were analysed using qualitative methods and revealed that participation was encouraged by both professional and personal factors. For many staff participation was prompted by negative feelings about themselves and their professional status. Participation in the course was associated with (largely negative) changes in home and family life and most participants faced additional financial burdens. The findings of the study have implications for policy relating to the funding of continual professional education for nurses and other health care staff. Health care staff are receiving mixed messages about continuing education from policy makers and employers. Dependence on willingness and ability to pay for post-registration degree-level studies is unlikely to be an efficient or equitable means of ensuring lifelong learning for healthcare staff.     

Critical thinking's role in perioperative patient safety outcomes

Despite education, training, tools, and standards, patient safety issues continue to be of concern when it comes to perioperative care. The problem of intraoperative injuries, therefore, may lie in perioperative nurses' implementation of safety measures that require critical thinking. This qualitative study lends insight into the critical thinking or decision-making processes of nurses who implement these perioperative safety measures. Findings from this data analysis have led to perioperative recommendations that may enhance patient safety outcomes.     

Nurses' knowledge of infection control

The article is based on a research study examining infection control in nurse education and practice. A survey of a large population was carried out to establish the perceived importance of microbiological knowledge to nurses and to ascertain whether this knowledge was present. The results suggest that although microbiological knowledge is considered necessary for safe infection control practice, nurses' actual knowledge falls far short of the level required for 'informed' practice. What this implies in relation to patient care, and recommendations regarding education and practice, are discussed.     

A study of hospital nurses' attitudes toward continuing education in Kaohsiung City, Taiwan

The purpose of this study was to investigate hospital nurses' attitudes toward continuing education. Continuing education was defined as non-credit organized educational programs designed for nurses by hospitals, nursing institutions, or other related organizations to maintain or improve professional competence. It included "in-service education", "on-the-job training", and other synonymous educational activities. Six hundred and seventy-four randomly selected hospital nurses in Kaohsiung City participated in this study. The data was collected by delivering a 34-statement questionnaire through the directors of nursing. Cronbach's Alpha Coefficient was applied to determine the reliability with a value of 0.79. Factor analysis and a group of experts' suggestions were applied to determine the validity. Frequency distribution, Analysis of Variance, Scheffe' test, and Multiple Regression Analysis were conducted to analyze the research questions. The level of significance was set at 0.05 or less. The results indicated that the majority of nurses (92.65%) hold positive attitudes toward continuing education (M = 86.32). Nurses' attitudes toward continuing education were related to selected personal and professional characteristics, and hospital policies regarding continuing education. To maintain nurses' positive attitudes and to develop positive attitudes for those who hold negative attitudes, some strategies for continuing education should be considered by nursing administrators.     

The continuing ethical dilemma of the do-not-resuscitate order

The continued use of the do-not-resuscitate (DNR) order remains very confusing to health care workers, especially when surgical intervention is undertaken either by choice or necessity. Although ethics committees can aid in clarification, and the use of advance directives can further define patient wishes, patient and family member education is necessary to ascertain what a surgical patient really desires. As technology advances, perioperative nurses will continue to be bombarded with ethical issues surrounding the DNR order. This article addresses how nurses can be proactive in obtaining answers to these difficult questions and learn how to deal with this dilemma.     

The parent-nurse relationship from the perspective of parents of children with cancer

Research to date has overlooked the specific relationship between parents and nurses, particularly in the context of family-centered care for a hospitalized child with cancer. The purpose of this study was to describe how parents perceive the relationship with the pediatric staff nurse necessitated by the hospitalization of their child with cancer. Using a symbolic interactionist framework and a modified grounded theory methodology, this study explored the parent-nurse relationship when a child with cancer is hospitalized. A purposive, theoretical quota sampling method was used to recruit 16 parents. Both parents' and nurses' care were examined from the parents' perspectives; mothers and fathers were interviewed separately. Analysis of the data led to the development of a substantive theory describing parent care (Making it Better), nursing care (Going Through the Motions, Caring Incompletely and Caring Completely), and the parent-nurse relationship (Working Together). Conditions influencing the care provided by parents and nurses and in turn the parent-nurse relationship were also identified. This research describes strategies nurses use to enhance the family-centered care they provide and reveals the effect nursing care has on parents' hospital experiences. Recommendations are made for nursing research, practice, and education.     

Clinical oncology nurses' perceptions of research

Within the realm of oncology nursing, research has been an integral part in its development as a specialty practice. Yet despite the growing volume of published nursing research studies, little is known about how nurses working in oncology care settings perceive research. Therefore, the purposes of this study were to examine clinical oncology nurses' perceptions of research and to determine factors influencing their perceptions. Two hundred and eighty-three registered nurses providing cancer care to patients in 40 health care agencies across northern Ontario participated in the survey. Data were collected using a questionnaire developed by Alcock and colleagues (1990) which addressed nurses' perceived value of research, their role, interest and experience in research as well as the research climate of the agency. The findings showed that respondents valued nursing research and perceived a research role for staff nurses. However, the respondents did not perceive strong administrative or collegial support for nurses' involvement in research activities. In addition, the study results indicated that the clinical oncology nurses' perceptions of research were influenced by educational preparation.     

Development of an ostomy competency

Staff educators and staff nurses developed an ostomy competency, with the guidance and expertise of the advanced practitioner and enterostomal nurse at a large teaching hospital. The competency improved the quality of care for surgical ostomy patients. Care was standardized and staff nurses' clinical knowledge was enhanced. Following the sessions, staff nurses verbalized increased confidence in working with patients with ostomies and demonstrated increased autonomy and problem-solving abilities. No variances in educational aspects of care were noted on clinical pathways.     

Discharge planning for new mothers. At home everything is different

In the hope of discovering a user friendly resource applicable to the Clinical practice of all nurses, staff at Vancouver General Hospital experiment with the use of nursing protocols. Last year nurses on the neurological unit proposed that effective management of seizure patients could be further facilitated when expected standards of care were properly developed, implemented, utilized and evaluated in the form of a nursing protocol. A two phase study was conducted attempting to compare those patients admitted to the unit one year prior to the use of the protocol, with those admitted for one year following its implementation. The results of this study will be presented in relation to the effectiveness of the protocol on patient outcomes. As well, the unit nurses' response to working with the protocol will be reviewed.     

The Comox Valley Nursing Centre

With today's emphasis on health care reform across Canada, many individuals, groups and governments are seeking new approaches to the delivery of health care. Nursing organizations have argued for approaches that make better use of nurses' experience and expertise. Thus, a project in British Columbia, the Comox Valley Nursing Centre, warrants interest from nurses and policy makers for the way it broadened the nursing role to provide high quality, effective health care in specific community.     

The intersection of technology and care in the ICU

In this article the author describes the paradoxical nature of the relationship between technology and care in the ICU. Although technology enhances care by expanding the repertoire of competent nurses' responses to the patient, it simultaneously alienates nurse and patient, hence inhibiting care. This occurs when nurses and patients have different understandings of technology and when the nurse identifies with the values imposed by technology at the expense of acknowledging her own and the patient's vulnerability.     

A prospective study on the behavior of pediatric intensive care unit nurses, concerning the care given to suicidal children

Pediatric intensive care units use sophisticated medical technology and are staffed by deeply committed nurses who are subjected to significant psychological stress. This stress varies with the type of patient and influences the style and quality of care. With this respect, children and adolescents admitted after a suicidal attempt are considered catalysts. However, there have been no systematic studies of how pediatric intensive care nurses respond emotionally to their interactions with these patients. This epidemiological study conducted in five Parisian Teaching Hospital pediatric intensive care units used a specially designed questionnaire to evaluate nurses' responses on the basis of style of care. Children under 16 years of age admitted after attempted suicide were studied comparatively with same age children admitted for status asthmaticus or encephalopathy with seizures. Results highlighted the differences in nurses' psychological responses to these situations and their difficulties in interacting with patients. This study provides strict methodological guidelines for investigating an issue often discussed emotionally or on the basis of anecdotal data.