The family physician and industrial hygiene

Family physicians are increasingly being called on to become involved in the health care of workers in local industries. Many family physicians are the sole providers of occupational health care in their communities, yet their formal training is usually deficient in some of the more specialized aspects of occupational medicine. Treating work-related injuries and exposures to hazardous substances may require analyses of work sites that many family physicians have neither the time nor the expertise to perform adequately. Industrial hygienists are the consultants who are qualified to assess potential occupational hazards and are trained to perform a comprehensive analysis of the work environment as it relates to worker health. This analysis may include the measurement of potentially hazardous substances, such as ambient air concentrations of particulate matter and toxic gases, and recommendations for prevention of exposures. Two cases are presented to illustrate how valuable a consultation with an industrial hygienist can be to the family physician.     

An occupational analysis of consulting psychology: Results of a national survey.

Surveyed 143 consulting psychologists (aged 31–85 yrs) who are members of the American Psychological Association's Division of Consulting Psychology to obtain an occupational analysis of consulting psychology. Results suggest that consulting psychologists see themselves as primarily serving individual and organization consultees in business/industrial and hospital settings. The skill most important to professional identity is general problem solving. When the graduates of the de facto specialties were examined for consultation education and practice differences, few differences emerged, indicating that no recognized specialty better trains consultants. Results are discussed in light of the need for specific course work, supervised experiences, and professional development in consulting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work Stress, Support, and Mental Health in Construction

Construction professionals are subjected to a plethora of occupational demands that can have a negative effect on their psychological wellbeing. Such demands can have an adverse influence on individual and organizational performance. To investigate the nature of self and social supports and mental health among construction professionals, an exploratory study was undertaken using the Stress and Mental Health Survey. The survey was distributed to construction professionals throughout Australia and 449 responses were received. Analysis revealed that those working for a contracting organization on-site reported higher levels of poor mental health and greater work stress than consultants. Those working on-site also experienced greater levels of self-stress, whereas consultants reported higher levels of self and work support. Work support was a significant predictor of poor mental health for consultants. Good health, however, was predicted by self, situational, and work support, whereas those working for a contractor only self-support predicated good mental health. It is concluded that while supports are essential in the fostering of good mental health, the absence of these supports can have a significant impact on poor mental health.     

A study of self-care among Irish doctors

Little is known about the self care employed by Irish doctors, though studies in other countries suggest this is likely to be less than ideal. In this study 76 doctors; general practitioner trainees, general practitioners and hospital consultants, completed a questionnaire on their self management of illness. High levels of self-prescribing and referral were discovered. The implications for the health of doctors in Ireland and the need for an occupational health service for doctors are discussed.     

Nurse managed occupational health services: a primary care model in practice

1. Managed care focus on delivering health care which values prevention, early intervention, continuity of care, commitment to quality care, and outcomes, as well as client satisfaction. Occupational health nurses routinely integrate these values into their practice. 2. An on-site model of primary health care delivery, incorporating the fundamentals of occupational health nursing, can bring significant savings to the organization in health related costs. 3. Case management may provide the greatest potential for growth in occupational health nursing. It is a method that can be used together with managed care to maximize quality health care services. 4. Viewing health related costs as an investment as opposed to part of a benefit plan, influences employees to make positive choices. It also impacts the delivery of health care services on a systematic, global level, which affects total health care costs.     

Academic occupational safety and health training programs

Occupational safety and health encompasses four core disciplines: industrial hygiene, occupational safety, occupational medicine, and occupational health nursing. This chapter traces the growth of these specialties throughout the 20th century in response to growing demands of the workplace. Graduate and certification programs are described for each of these four areas.     

The clinical application of the nursing process in selected acute care settings: a professional mirage

The nursing process is the problem solving framework purported to be used in a multiplicity of health care settings. Although its use is widespread in educational and clinical settings, some nurse clinicians display negative attitudes towards its use and state that it is incongruent with nursing practice. To date, there has been no study cited that has examined it use within clinical settings to determine the substance of these claims. Using grounded theory methodology, this study examined the clinical application of the nursing process in acute care hospital settings. Data were obtained from semi-structured interviews with predominantly nurse clinicians (n = 27), participant field observations of nurse clinicians, and in-depth audits of patient records. Textual data were managed using NUD-IST and analysed using constant comparative method. Data generation and analysis proceeded simultaneously using open coding, theoretical coding, and selective coding techniques until saturation was achieved. Nurses in this study experienced the basic social problem of being in a state of "Unknowing" that was linked to a number of factors, such as, the existence of a fragmented and inconsistent method of determining and communicating patient care and work conditions of immense change and uncertainty. The findings revealed several problems with the clinical application of the nursing process and illustrated that the espoused theory was unable to be clinically applied.     

Sequence and phylogenetic analysis of the Rhizobium leguminosarum biovar trifolii pyrE gene, overproduction, purification and characterization of orotate phosphoribosyltransferase

Problem solving in clinical nursing practice is the essence of good care delivery. This paper gives an overview of a research study which identified the cognitive problem solving process nurses use while delivering care. The study was conducted in the clinical setting and used a qualitative research methodology of observation, followed by in-depth semi-structured interview. The analysis of the study revealed diagnostic reasoning is the process used by clinicians. Information regarding the differences between novices and experts is offered as topics for discussion throughout the paper, and recommendations for changes to educational processes are made.     

Moving into the information era: does the current nursing paradigm still hold?

The transition into the information era is characterized by society's passage through three crossroads representing a change from: (a) technology to post-technology; (b) rigid jobs and hierarchies to dejobbing and vanishing hierarchies; and (c) limited competition to competition dominating all markets. These transitions have caused dramatic changes in the health care system at large and escalating problems that cannot be solved within the current paradigm of nursing. Among the nursing problems that were identified are those including difficulties in: (a) defining the relative contribution of nursing vis a vis other health professions; (b) the scope and dimensions of nursing authority; (c) implementing all aspects of the nursing intervention; (d) actualizing caring in nursing intervention; and (f) implementing the nursing process as a major thinking process in the profession. The analysis of the state of nursing suggests that the current clinical paradigm fails to consolidate the economic and quality issues into the core of nursing. It is not capable of solving central professional problems and emerging dilemmas. Considering that under the current paradigm, nursing has difficulties in highlighting to clients and the system alike where nursing can make a difference, it is questionable whether such a paradigm can ensure the existence of nursing in the future.     

Long-lived picture priming in normal elderly persons and demented patients

Health care professionals who serve as consultants for insurance companies provide an essential service in reducing health care costs and ensuring access to care for increased numbers of people. The role and function of these consultants is not always appreciated or welcomed by providers, who may view them as intruders to the doctor-patient relationship and feel that treatment plans are being second-guessed. Consultants, on the other hand, may be placed in uncomfortable positions when radiographically visible pathological conditions are not addressed on a treatment plan. Overlooking such conditions in hopes of not embarrassing the treating dentist is not an ethical option. When an isolated omission or error is encountered, it is best for consultants to contact the treating dentist and advise him or her of the disparity between planned treatment and observed pathology. Patients, providers, and the profession will benefit through this collegial exchange of information. When consultants observe continual omissions or errors, the stakes are much greater and the public's health must be protected through implementation of the peer-review system.     

An exploration into occupational stress experienced by HIV health care professionals who work within genitourinary medicine settings.

The present study investigates the occupational stress of health care workers involved with HIV care in genitourinary medicine (GUM) outpatient departments. Sixteen nursing and 14 medical staff completed the P. Gray-Toft and J. G. Anderson (1981) occupational stress inventory. This assesses 7 potential sources of stress (death and dying, uncertainty regarding treatment, inadequate preparation, lack of support, conflict with others, conflict with physicians, and workload). The mean scores obtained revealed a preponderance of low-stress scores for both medical and nursing staff. Analyses of variance and covariance further demonstrated that, in general, levels of stress did not differ within or between the occupational groups. However, sources and characteristics of stress were different between nurses and doctors. In this group of health care professionals, their work with HIV-positive patients within the GUM outpatient setting may be instrumental in limiting levels of stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of body hydration on renal function according to renographic findings in healthy children

The background and tasks of occupational health nurses in North Dakota vary considerably. Those entering the field have little or no previous exposure to occupational health nursing and must develop skill through seminars, corporate training or area associates. In most instances, the nurse represents the occupational safety and health program for the firm and must take on additional roles such as safety director or assistant plant manager. In addition, the occupational health nurse performs numerous in-plant medical services ranging from emergency medical care to counseling and education. The occupational health nurse in North Dakota generally does not record family histories, take throat cultures, take routine x-rays, make hospital or home visits nor perform air sampling or noise level measurements.     

Toward successful compliance with JCAHO standard NC.1

Recommendations resulting from a JCAHO survey can be a true blessing as they force nursing departments to assess critically their professional practice and documentation systems. Systematic preparation, begun at least two years prior to the survey, includes Nursing Administration, a Nursing Documentation Task Force and all staff nurses. Educational consultants assigned to each unit bring nurses up-to-date on nursing process and nursing diagnosis. Mock surveys and cross-training in chart review prepare staff nurses for confident participation in the accreditation process.     

Medical-surgical nursing: a new teaching approach and its evaluation by the student

This issue is about a teaching methodology developed by the Medical-Surgical subject of Nursing on Graduate Course at Universidade Estadual de Londrina. The teachers used the student-centered teaching process based on interpersonal relationship and problem solving method. The aim was to evaluate the last period of nursing students perception about developing of cognitive, affective and psychomotor abilities when compared with others subjects of nursing course since 1985 until 1990. This method of teaching supplied more integration among theory and practice, more ability in developing library search and oral exposition, besides more active student participation on his apprenticeship process.     

Nurse managed occupational health centers: an overview

1. Nurse managed centers provide clients with direct access to professional nursing care. 2. Lillian Wald, Mary Breckenridge, and Margaret Sanger established nurse managed centers at the beginning of this century. 3. Primary, secondary, and tertiary prevention programs and services are based on the mission, outcomes, staffing, and financing of the occupational health center. 4. Essential parameters for comprehensively evaluating an occupational health nurse managed center include, client outcomes, client satisfaction, and cost-benefit.     

Joint hospital management by physicians and nursing administrators

The effectiveness of physician involvement in hospital management may depend on how physicians actually interact with nurses and administrators in management committees and other forums. The study on which this article is based used the theory of cooperative and competitive goal interdependence to analyze problem solving between physicians and nursing administrators.     

Occupational health and the the provision of nursing care for older adults

Providing nursing care to the senior citizen is a rewarding and exciting area of nursing. Care is provided in a vast array of settings from home health and day care to extended residential care sites. These challenges require health care workers to be adaptive and innovative, attentive to detail, compassionate teachers, and promoters of safety for their patients and for themselves. An understanding of the transmission of microorganisms, knowledge of protective mechanisms, and a focus on safety will help ensure good health for the nurse and the elder client. Maintenance of occupational safety and health are combined efforts for the employee and the employer working together to ensure a safe environment for those who need services and those who provide them.     

Managing the occupational environment of managed care

The emergence of managed care has resulted in a practice environment buffeted by rapid and sweeping changes. Shifts in philosophy and approach to payment for health care affect the nature of the service and the method of its delivery. The occupational adaptation frame of reference is used to illustrate the challenges imposed by the physical, social, and cultural components of the changing occupational environment. Perceptions, observations, and concerns of middle level occupational therapy, physical therapy, social work, and nursing managers illustrate the impact of this new environment. Therapists are challenged to understand their own changing work setting and to apply the same effort to mastering its challenges as they would to examining the context of their patient's occupational performance and to designing and implementing an appropriate clinical intervention.