The state of bereavement support in adult intensive care: A systematic review and narrative synthesis

Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions. A systematic review and narrative synthesis. Medline, CINAHL Plus, PsycINFO, Web of Science, EMBASE were searched and inclusion/exclusion criteria were applied. Included studies were appraised using relevant appraisal tools. Fourteen papers formed the review; five of which were international surveys reporting variable bereavement practices and levels of support. A lack of training and resources were identified barriers. Nine papers reported the effectiveness of primarily discrete bereavement support interventions including: a personal memento, a handwritten condolence letter, a post-death meeting; storytelling, research participation, use of an ICU diary. One study evaluated a bereavement follow-up program. Generally, all identified interventions were well accepted by bereaved families. The reviewed evidence was weak, and findings were contextually bound. As such, it is difficult to make recommendations for the most acceptable and effective bereavement support intervention(s). Bereavement support in ICU needs further exploration and clinicians must be adequately trained and supported for the delivery of evidence-informed, culturally competent care. [Abstract copyright: Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Les Effets Potentiels de la Version Française du NCLEX-RN® sur le Choix de la Langue de Formation d\u27Étudiantes Infirmières Francophones en Situation Minoritaire.

Contexte : Un très faible taux de réussite a été remarqué chez les étudiantes infirmières francophones en situation minoritaire ainsi qu’une chute du nombre de candidates qui choisissent de passer en français le nouvel examen d’autorisation, le NCLEX-RN®, qui a été introduit en 2015. Ces données sont préoccupantes s’agissant de la qualité et de la pérennité des services de santé en français dans les régions linguistiques minoritaires au Canada. Objectifs : Le but de cet article est de présenter les résultats concernant les expériences des étudiantes inscrites dans un programme de formation initiale en sciences infirmières en français sur leur prise de décision quant à : 1) la langue du programme auquel elles se sont inscrites, 2) la langue dans laquelle elles ont choisi de passer le NCLEX-RN®, 3) leur intérêt à travailler dans un contexte francophone, 4) leurs connaissances générales relatives au nouvel examen d’autorisation et 5) les sources d’information sur le NCLEX-RN®. Méthodologie : Un devis de recherche mixte séquentiel a été retenu comportant l’utilisation de questionnaires. Des analyses descriptives et des analyses thématiques et de contenu ont été effectuées. Résultats : 51 étudiantes de la cohorte francophone ont participé à cette étude. La majorité des participantes comptaient passer le NCLEX-RN® en anglais; l’intérêt médiatique porté à la version française de l’examen a eu une influence sur leur décision. Quatre grands thèmes ont été mis en évidence à partir des questions à court développement du questionnaire : 1) langue maternelle choisie comme langue de formation, 2) trois principaux facteurs qui influencent le choix de la langue pour le NCLEX-RN®, 3) collègues et médias comme sources d’information sur le NCLEX-RN®, et 4) importance et fierté d\u27étudier en français. Conclusion : Les résultats de ce projet ont mis en évidence les facteurs qui influencent la prise de décision des étudiants francophones quant au choix de la langue de l’examen et les raisons pour lesquelles les finissantes étudieraient à nouveau en français. Abstract Background: Since the introduction of the new entry to practice exam, the NCLEX-RN®, there has been a very low success rate among Francophone nursing students living in minority situations. In addition, there has been a drop in the number of candidates who choose to write the exam in French. These results are of great concern in terms of the quality and sustainability of French language health services in French language minority communities in Canada. Objectives: The purpose of this article is to present the results of a study exploring the experiences of students enrolled in an entry level nursing program in French in terms of their decision-making regarding: 1) the choice of the language of the nursing program in which they were enrolled, 2) the language in which they chose to write the NCLEX-RN®, 3) their interest in working in a Francophone context, 4) their general knowledge of the new entry to practice exam, and 5) information sources on the NCLEX-RN©. Methodology: A sequential mixed methods design using surveys with multiple-choice and open-ended questions was used to conduct this study. Descriptive analyzes, as well thematic and content analysis, were used to analyze the data. Results: 51 students from a francophone graduating cohort participated in this study. The majority of the participants expected to write the NCLEX-RN® in English; the media attention on the French version of the exam influenced their decision. Four main themes were highlighted : 1) Choice of language of student based on their first language, 2) Three main factors that influence the choice of the language in which they write the NCLEX-RN®, 3) Colleagues and media as sources of information on the NCLEX-RN®, and 4) Importance and pride of studying in French. Conclusion: The results of this project shed light on the factors that influence francophone students\u27 decision-making regarding the choice of language for the exam and the reasons why graduating students would choose to study in French again or not

Dead on the table: A theoretical expansion of the vicarious trauma that operating room clinicians experience when their patients die

The practice of operating room (OR) clinicians–nurses, surgeons, and anesthetists–is fundamentally about preserving life. Some patients, however, die in the OR. Clinicians are therefore vulnerable to moral and emotional trauma. In this paper, we discuss three forces that shape clinicians’ moral and emotional experiences in OR care: biomedical values, normative death discourse, and socially (un)sanctioned grief. We suggest how each of these forces increases clinicians’ vulnerability to feel traumatized when their patients die. We hope this discussion will stimulate clinicians and researchers to engage with social and cultural determinants of clinicians’ experiences when patients die

The use of Delphi and Nominal Group Technique in nursing education: A review

Foth T, Efstathiou N, Vanderspank-Wright B, et al. The use of Delphi and Nominal Group Technique in nursing education: A review. International Journal of Nursing Studies. 2016;60:112-120