Constancy and difference in the dimensions and elements of nursing practice, 1901-1981 : a thesis presented in partial fulfilment of the requirements for the degree of M.A. (Soc. Sci.) at Massey University

Irregular pagination: pgs 124 & 285 missingThis study presents a selective literature review in which the three components of modern nursing (practice, education and research) are identified. Consideration is given to the dimensions and elements of two of the components - nursing education and nursing practice and the relationship between these two components is investigated using the examination system of nursing education as the connective link. From the literature review presented in the first three chapters, the Nursing Education Examination. Practice Model (N.E.E.P.) has been derived for this project which examines the constancy and differences in the six stated dimensions of nursing practice and their associated elements along a time continuum from 1901 to 1981. The model is used to collect and collate the data elicited from the analysis of the five yearly sample of State Final examination papers and the identification of historical trends in the New Zealand Nursing Journal, relating to the six dimensions of nursing practice and their associated elements. This two pronged approach allowed the author to crosscheck the findings from the two data sources. In addition, changes in the composition of nursing practice are studied in one specific area; the nursing care of patients with accidental trauma. The following propositions were derived from the literature review presented in the first section of this study; 1. That the six dimensions of nursing practice (care, cure, protection, teaching, co-ordination and patient advocacy) will remain constant over time and different practice setings; 2. that the elements of each dimension will vary with time and with practice setting. The findings elicited from the analysis of surgical examination papers revealed that the three dimensions of care, cure and co-ordination occur in all the time periods investigated in this study. The same three dimensions of nursing practice are evident in at least 81% of the time periods in which questions relating to accidental trauma in the examination papers are found. Therefore these three dimensions can be said to form the "heart" of nursing practice over the years. Although fluctuations occur in the importance placed upon the dimensions, from 1961 increasing emphasis is found in all the dimensions except the cure dimension where a declining trend is demonstrated. It was found that constancy in all six dimensions of nursing practice is apparent from this time. An examination of the elements of nursing practice shows that although the three dimensions of nursing practice remain constant over the years, findings relating to the elements making up three dimensions indicate both constancy and differences. The five elements of nursing practice which make up the "core" elements of nursing practice are; general nursing care; reference to specific patients; functional status; treatments; and nurse interactions. References to these elements appear in each of the 17 time periods in the general analysis. Their importance in relation to the nursing of patients with accidental trauma is also evident. At the other extreme are the elements of sleep, blood pressure, and T.P.R. which appear in less than 3 of the 17 time periods. Reference to patient preferences/ interests are never found in the data elicited from the examination papers. Examination of accidental trauma findings reveals similar trends to the general results. From 1961 particularly the journal articles substantiate the findings elicited from the examination analysis. A brief discussion of the implications of the constancy and difference in the dimensions of nursing practice and their associated elements for nursing is included

Unleashing Top-of-License Registered Nurse Practice: An Integrative Review

In light of a well-renowned report, “The Future of Nursing” released by the Institute of Medicine (2010), recommendations were suggested that nurses should practice at, and to, the full extent of their licensure, also referred to as top-of-license nursing practice. Transforming nursing care models coupled with strong leadership support is critical to fostering an environment where top-of-license practice can be fully achieved and sustained. This integrative review provides a compilation and synthesis of the available published evidence regarding the best practices for fostering environments conducive to top-of-license nursing practice. Results of these studies strongly supports the notion of nurses practicing to the full extent of their education and training

Spirituality in nursing practice

Spirituality is an important aspect of holistic care which is frequently overlooked owing to difficulty conceptualising spirituality and confusion about how to integrate it into nursing care. This article seeks to understand what is meant by spirituality and spiritually competent practice, it explores some of the attitudes towards spirituality and describes some of issues affecting integration of spirituality into nursing care

Professional practice attributes within public health nursing : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing at Massey University

Modifiable organisational attributes that reflect a professional nursing practice environment are important determinants of both the experience of people who access health care services and the job satisfaction of nurses who work within health care organisations. Research relating to acute care settings, commonly known as the Magnet phenomenon has made an outstanding contribution to health sector knowledge by identifying features that attract and retain nurses, promote excellence in patient care, and achieve superior patient outcomes. These features have been studied by the Nursing Work Index Revised which measures attributes that reflect a professional nursing practice environment. More recently there has been an interest in the potential applicability of these attributes in the community setting. A recent study surveyed United States home health nurses and New Zealand district nurses to ascertain which of the Nursing Work Index Revised attributes were perceived by them as important to the support of their professional practice. In this study 92% of items previously tested in acute settings were considered important in community settings. This descriptive study extends the previous work by investigating how another group of primary health care nurses in New Zealand (public health nurses) perceive the importance of specific organisational attributes within their practice setting. The Nursing Work Index Revised was utilised and participants were asked to rate their agreement or disagreement with the importance and presence of 48 attributes on the Nursing Work Index Revised against a 4-point Likert scale. The findings of the study validate the use of the Nursing Work Index Revised as a tool in the community setting. The study's findings, implications for nursing practice, future research and the potential use of this tool to support the development of primary health care nursing in the New Zealand health sector is presented

BSE Practice and BSE Self-Efficacy Among Nursing Students in Aceh, Indonesia

Purpose: To survey the level of BSE practice among female nursing students in Aceh, and the degree of self-efficacy in those who did practice it.Method: Seventy-six nursing students from the Public Nursing College, Syiah Kuala University in Aceh who met the inclusion criteria were recruited. Stratified proportionate random sampling was used to determine the required number of first, second, and third year students. BSE self-efficacy of the students was measured by the BSE Self-Efficacy Questionnaire which was modified from an existing tool developed by Khatun (2010). In addition, the students' doing BSE or not was measured by BSE Practice Questionnaire which was developed by the researcher. The data were analyzed by using descriptive statistics.Result: Only 39.5% of the students practiced BSE with more than half of the students saying they did not practice BSE (60.5%). The main factors that influenced the students' performing BSE were not having a family history of breast cancer, single, and no history of breast illness. Among the thirty students who practiced BSE, most of them did not practice it routinely (70%), nor at the correct time (86.7%), and their confidence in performing BSE was at a moderate level overall, with a high level for BSE procedural efficacy and moderate level for barrier management efficacy.Conclusion: A majority of the Acehnese nursing students did not practice BSE, and those who did had only a moderate level of BSE self-efficacy. Therefore, the results of this study suggest emphasizing the need to teach nursing students about BSE in their undergraduate courses, with future follow-up research regarding the success of the educational program

Aligning Evidence-Based Practice With Translational Research: Opportunities for Clinical Practice Research

Magnet(R) and other organizations investing resources in evidence-based practice (EBP) are ideal laboratories for translational nursing research. Translational research, the study of implementation of evidence into practice, provides a unique opportunity to leverage local EBP work for maximum impact. Aligning EBP projects with rigorous translational research can efficiently meet both EBP and research requirements for Magnet designation or redesignation, inform clinical practice, and place organizations at the leading edge of practice-based knowledge development for the nursing discipline

Nurses\u27 Perceptions of Structural Empowerment: A Practice Review Process Pilot

Nurses are professionally and morally obliged to monitor and evaluate nursing practice via active participation in review mechanisms that are designed to promote patient safety and care delivery, thereby improving patient care quality (American Nurses Association [ANA], 1988, 2001, 2004; O\u27Rourke, 2006). The purpose of this Doctor of Nursing Practice (DNP) project was to develop, pilot, and evaluate a nurse practice review process with frontline nurses within Fresno Heart & Surgical Hospital (FHSH), a small specialty hospital, affiliated with Community Medical Centers (CMC) in Fresno, California. A nurse practice algorithm was subsequently developed and structural empowerment was assessed with the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II) (Laschinger, Finegan, Shamian, & Wilk, 2001). While there was a small sample size, the DNP project evaluation demonstrated that frontline nurses want to participate in improvement activities within the facility and believed the nurse practice review algorithm would effectively monitor and evaluate nursing practice

Theory and practice in the induction of five graduate nurses : a reflexive critique : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Education at Massey University

This thesis investigates the induction of comprehensive nurses into a professional culture during their polytechnic nursing education and first year of hospital practice. It combines a critical theory approach with case study method. The ways in which social forces constrain individual and professional action are demonstrated through a critical reflexive analysis of the perceptions of five recently graduated comprehensive nurses. Each graduate was interviewed at regular intervals over a three month period. It is argued that previous studies of professional socialisation of nurses conducted within both empirico-analytic and interpretive epistemologies, have tended to objectify the day-to-day actions that students and new graduates take. While providing descriptions of the socialisation process, previous studies have not explored the reflexivity of understanding and action as well as the structural constraints of nursing education and practice. In this thesis critical social theory provides a framework in which to reveal, through empirical research, the constraining conditions of actions, and, through interpretive forms of enquiry, human perception and understanding. The reflections of the five participants in this study reveal that there are similar structural constraints in education as in hospital based nursing practice. There is, in effect, a continuity of structural constraints and this is contrasted with a disjunction between knowledge and beliefs gained through education and those apparently required in nursing practice. The graduates' perceptions are discussed and interpreted in terms of both the intended and the unintended learning states engendered by their actual experiences in the polytechnic and hospital settings. It is suggested that, at present, nursing education and practice are shaped by forms of technical control which arise from the dominant ideologies already embedded in the education and health care structures. In particular, nursing curricula are dominated by the technical linear paradigm of curri­culum design which contributes to a distorted separation of theory and practice and which obscures the process of reproduction of professional culture. It is argued that a more socially critical approach to the design of nursing curricula might begin to transform some of the structures which presently inhibit and constrain the professional choices and actions of student and graduate nurses

‘The Lighthouse Invites the Storm’ – Professional Regulation of Nursing in England and Wales – Under Threat

This paper explores current issues related to the professional regulation of nursing in England and Wales and considers whether self-regulation is currently under threat. In modern times there have been a significant number of serious incidents and scandals in health and social care and these have attracted adverse publicity in the media and exercised the mind of Government in the direction of public protection. Mental health practice has not escaped the critical gaze and recent homicide inquiries continue to cast a long shadow over the provision of mental health services. Recently, the Government has questioned the effectiveness of the nurses' professional body, the Nursing and Midwifery Council, and has spelt out the pressing need for tighter regulation of nursing practice. Recent policy documents aimed at ‘modernising’ nursing careers may actually circumscribe professional autonomy and subtly control the development of nursing practice and nurse education. On 1st April 2009 a new regulatory body, the Care Quality Commission will come into being and its advent will herald significant changes for health and social care. Lost in the changes will be the Mental Health Act Commission, as a stand alone visiting body