Not Very Welcoming: A Survey of Internationally Educated Nurses Employed in Canada

Countries around the world are struggling to cope with a shortage of nurses and are increasingly relying on internationally educated nurses to fill the gap. Internationally educated nurses represent 9% of the Canadian nursing workforce, but this is expected to grow as the shortage continues. This study aimed to identify and understand the experiences of internationally educated nurses who came to Canada to seek nursing work. Methods: A cross-sectional survey of a random sample of internationally educated nurses was conducted. Descriptive statistics were used to analyze the survey responses. The survey also included an open-ended question about experience with the move to Canada to work as a nurse. Responses to the open-ended question were content analyzed and triangulated with the survey data. Results: A total of 2,107 internationally educated nurses responded to the study (47% response rate). Most were female (95%) and married (80%), and almost half were from the Philippines (49%). Professional (e.g., salary & benefits, 60%) and personal (e.g., quality of life, 56%) reasons drove migration to Canada, but 76% reported no recruitment incentives, and most (56%) relied on friends and family for information about nursing in Canada. Significant barriers to practicing in Canada included the licensure exam (75%), and obtaining information about different types of practice in Canada (56%). Conclusions: The findings from this study provide important information about internationally educated nurses’ perceptions and experiences of coming to Canada to obtain work in nursing. Improving the means for seeking employment by overseas nurses is a key area that regulatory agencies, health managers and policy leaders need to understand and address. Strategies to improve the barriers nurses face, particularly those related to licensure are important considerations

Nursing heroism in the 21st Century'

Abstract Background The Vivian Bullwinkel Oration honours the life and work of an extraordinary nurse. Given her story and that of her World War II colleagues, the topic of nursing heroism in the 21st century could not be more germane. Discussion Is heroism a legitimate part of nursing, or are nurses simply 'just doing their job' even when facing extreme personal danger? In this paper I explore the place and relevance of heroism in contemporary nursing. I propose that nursing heroism deserves a broader appreciation and that within the term lie many hidden, 'unsung' or 'unrecorded' heroisms. I also challenge the critiques of heroism that would condemn it as part of a 'militarisation' of nursing. Finally, I argue that nursing needs to be more open in celebrating our heroes and the transformative power of nursing achievements. Summary The language of heroism may sound quaint by 21st Century standards but nursing heroism is alive and well in the best of our contemporary nursing ethos and practice.</p

The Nursing Worklife Model: Extending and Refining a New Theory

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75205/1/j.1365-2834.2007.00670.x.pd

Conflicting priorities: observation of medicines administration

Author's accepted version (post-print).This is the peer reviewed version of the following article: Alteren, J., Hermstad, M., White, J. & Jordan, S. (2018). Conflicting priorities: Observation of medicine administration. Journal of Clinical Nursing, 27(19-20), 3613-3621, which has been published in final form at https://doi.org/10.1111/jocn.14518. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Available from 19/05/2019.acceptedVersio

Linking the Practice Environment to Nurses' Job Satisfaction Through Nurse-Physician Communication

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74776/1/j.1547-5069.2005.00063.x.pd

Staffing, skill mix and the model of care

Aims and objectives: The study aimed to explore whether nurse staffing, experience and skill mix influenced the model of nursing care in medical-surgical wards. Background: Methods of allocating nurses to patients are typically divided into four types: primary nursing, patient allocation, task assignment and team nursing. Research findings are varied in regard to the relationship between these models of care and outcomes such as satisfaction and quality. Skill mix has been associated with various models, with implications for collegial support, teamwork and patient outcomes. Design: Secondary analysis of data collected on 80 randomly selected medical-surgical wards in 19 public hospitals in New South Wales, Australia during 2004-2005. Methods: Nurses (n = 2278, 80·9% response rate) were surveyed using The Nursing Care Delivery System and the Nursing Work Index-Revised. Staffing and skill mix was obtained from the ward roster and other data from the patient record. Models of care were examined in relation to these practice environment and organisational variables. Results: The models of nursing care most frequently reported by nurses in medical-surgical wards in this study were patient allocation (91%) and team nursing (80%). Primary nursing and task based models were unlikely to be practised. Skill mix, nurse experience, nursing workload and factors in the ward environment significantly influenced the model of care in use. Wards with a higher ratio of degree qualified, experienced registered nurses, working on their 'usual' ward were more likely to practice patient allocation while wards with greater variability in staffing levels and skill mix were more likely to practice team nursing. Conclusions: Models of care are not prescriptive but are varied according to ward circumstances and staffing levels based on complex clinical decision making skills. Relevance to clinical practice: Variability in the models of care reported by ward nurses indicates that nurses adapt the model of nursing care on a daily or shift basis, according to patients' needs, skill mix and individual ward environments. © 2010 Blackwell Publishing Ltd

Traditions of research into interruptions in healthcare: A conceptual review

Background Researchers from diverse theoretical backgrounds have studied workplace interruptions in healthcare, leading to a complex and conflicting body of literature. Understanding pre-existing viewpoints may advance the field more effectively than attempts to remove bias from investigations. Objective To identify research traditions that have motivated and guided interruptions research, and to note research questions posed, gaps in approach, and possible avenues for future research. Methods A critical review was conducted of research on interruptions in healthcare. Two researchers identified core research communities based on the community’s motivations, philosophical outlook, and methods. Among the characteristics used to categorise papers into research communities were the predominant motivation for studying interruptions, the research questions posed, and key contributions to the body of knowledge on interruptions in healthcare. In cases where a paper approached an equal number of characteristics from two traditions, it was placed in a blended research community. Results A total of 141 papers were identified and categorised; all papers identified were published from 1994 onwards. Four principal research communities emerged: epidemiology, quality improvement, cognitive systems engineering (CSE), and applied cognitive psychology. Blends and areas of mutual influence between the research communities were identified that combine the benefits of individual traditions, but there was a notable lack of blends incorporating quality improvement initiatives. The question most commonly posed by researchers across multiple communities was: what is the impact of interruptions? Impact was measured as a function of task time or risk in the epidemiology tradition, situation awareness in the CSE tradition, or resumption lag (time to resume an interrupted task) in the applied cognitive psychology tradition. No single question about interruptions in healthcare was shared by all four of the core communities. Conclusions Much research on workplace interruptions in healthcare can be described in terms of fundamental values of four distinct research traditions and the communities that bring the values and methods: of those research traditions to their investigations. Blends between communities indicate that mutual influence has occurred as interruptions research has progressed. It is clear from this review that there is no single or privileged perspective to study interruptions. Instead, these findings suggest that researchers investigating interruptions in healthcare would benefit from being more aware of different perspectives from their own, especially when they consider workplace interventions to reduce interruptions

Challenging the holy grail of hospital accreditation: A cross sectional study of inpatient satisfaction in the field of cardiology

Extent: 7p.Background: Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology) the relationship between patient satisfaction (as measured by the recommendation rate) and accreditation status. Methods: Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55%) became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered. Results: The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds) and patient (age, gender) characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI) 63.4 - 67.8%) and hospitals without accreditation (65.8%, 95% CI 63.1 - 68.5%) was not significantly different. Conclusion: Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction.Cornelia Sack, Peter Lütkes, Wolfram Günther, Raimund Erbel, Karl-Heinz Jöckel and Gerald J Holtman

Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak

TOC Summary Line: Healthcare workers in hospitals affected by SARS experience increased psychological stress 1–2 years after the outbreak