What makes a nurse today?:A debate on the nursing professional identity and its need for change

In 2020, due to the Nightingale year and COVID-19 crisis, nursing is in the public eye more than ever. Nurses often are being seen as compassionate helpers. The public image of nursing, however, also consists of stereotypes such as nursing being a 'doing' profession and care being a 'female' characteristic. Next to that, nursing is associated with images from the past, such as 'the lady with the lamp'. Therefore, in the public eye at least, the nursing identity seems a simple and straightforward enough construct, but nothing less is true. Looking at what a professional identity consists of, historic and social developments influence a group identity as a construct. In addition, individual, professional and contemporary societal moralities, including stereotypes, play its role. Nurses themselves reinforce stereotypes in order to fit into what is expected, even when they believe professional behaviour encompasses other features. They may do so individually as well as in a group context. But nursing actually seems to be better off when viewed upon as a diverse, autonomous profession. Moral values such as compassion motivate nurses to enter the profession. Research shows that if such values are addressed in daily practice, nursing could perhaps be saved from nurses leaving the profession because of feeling unfulfilled. Another aspect concerns the huge nursing body of knowledge. If seen as the ground on which nursing behaviour is standing, it would contribute to a different image of nursing than simplified stereotypes, which do not acknowledge the complex nature of the profession. This paper challenges the idea that the nursing identity is unchangeable and the notion that 'a nurse will always be a nurse'. By doing so, the paper contributes to a debate on the supposed 'true' nature of the nursing identity and opens a discussion on the need for it to change

How to educate navigators in a complex world: making a case in higher professional education in The Netherlands

This article focuses on the increased relevance and urgency to pay explicit attention to complexity-informed perspectives on real-world issues in Dutch higher professional education. Moreover, it describes lessons learned from experiments with so-called Embedded Complexity Workshops. These workshops, comprised of activities like network visualization, yield promising results and can serve as a starting point for further development

Compassie in de Verpleegkundige Praktijk: een leidend principe voor goede zorg

Compassie krijgt in toenemende mate aandacht als belangrijke waarde voor goede verpleegkundige zorg. Vooral voor chronisch zieke ouderen is zorg met compassie van belang omdat zij vaak langdurig afhankelijk zijn van verpleegkundige zorg. Chronisch zieke ouderen moeten inleveren als gevolg van hun ziekte, zij lijden verlies op verschillende aspecten in hun leven. Toch is compassie geen expliciete waarde in beroepsprofielen of andere formele omschrijvingen van verpleegkundige zorg. Dit proefschrift laat zien wat compassie is en betekent voor de zorg aan chronisch zieke ouderen. Margreet van der Cingel onderzocht hoe chronisch zieke ouderen en verpleegkundigen compassie ervaren en toepassen in de dagelijkse uitvoer van verpleegkundige zorg. De verpleegkundige kan compassie tonen door mee te leven op basis van zeven dimensies: aandacht, luisteren, leed benoemen, betrokkenheid, helpen, aanwezigheid en begrip. Voor chronisch zieke ouderen betekent zorg met compassie dat er beter met hen wordt samengewerkt. Zorgdoelen worden daadwerkelijk op basis van hun voorkeuren vastgesteld, zoals dat in evidence based practice hoort. Compassie was in de moderne verpleegkunde altijd al een kernwaarde, nu wordt duidelijk dat compassie een expliciete en formele plaats in de verpleegkunde behoort te krijgen. Margreet van der Cingel is verpleegkundige, verplegingswetenschapper en organisatieadviseur. Zij is als senior trainer/docent en onderzoeker verbonden aan de Christelijke Hogeschool Windesheim te Zwolle. Zij werkt in het domein Gezondheid en Welzijn en is gelieerd aan het lectoraat Innoveren in de Ouderenzorg

Service user involvement in pre-registration general nurse education: a systematic review

Aims and objectives: A systematic review of published studies on service user involvement in undergraduate, pre-registration general nursing education (excluding mental health-specific programmes). The objective is to examine how students are exposed to engagement with service users. Background: The requirement of service user involvement in all nurse education is policy expectation of health professional education providers, in response to the increased public and political expectations. Previous literature reviews have focused solely on mental health. Design: Systematic review using the PRISMA guidelines; timeframe 1997-2014; published in English. Methods: Search of CINAHL, Cochrane Review, Education Research Complete, Internurse, MEDLINE, PsychINFO, Scopus, SocINDEX and Web of Science yielded 229 citations; 11 studies met the review eligibility criteria. Results: Seven studies used qualitative methodology, two quantitative and two mixed methods. Studies from the United Kingdom dominated (n=9), the remainder from South Africa and Turkey. The results are described using four themes: benefits and limitations of service user involvement; nursing student selection; education delivery; practice-based learning and assessment. Most studies were small scale; nine had less than 30 participants. Overall the evidence suggests that student, lecturers and service users valued service user involvement in nurse education, to provide an authentic insight into the illness experience. Logistical considerations around support and student cohort size emerged. Conclusions: This is the first systematic review to focus on service user involvement in general nurse education. It reveals that service user involvement commenced later and is more limited in general programmes as compared to equivalent mental health education provision. Most of the evidence focuses on perceptions of the value of involvement. Further research is required to more clearly establish impact on learning and clinical practice. Relevance to clinical practice: service user involvement in nurse education is valued by stakeholders but preparation and support for those involved, including mentors is underestimated

The concept of compassion within UK medial generated discourse: A corpus informed analysis

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in health care. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62,626‐word corpus of data was analysed using Laurence Anthony software “AntCon”, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type “nurse” was used positively. Conclusion: This study adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and communicating should also be addressed by established practitioners to maintain compassionate interactions between professionals as well as nurse–patient relationships. Future research should focus on how compassionate practice is defined by both health professionals and patients. Relevance to clinical practice: To maintain nursing as an attractive profession to join, it is important that nurses are viewed as compassionate. This holds implications for professional morale, associated with the continued retention and recruitment of the future workforce. Existing ideologies within the practice placement, the prior care experience environment, as well as the educational and organisational design, are crucial factors to consider, in terms of their influences on the expression of compassion in practice

Healthcare providers' perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study

Compassion is considered a component of quality healthcare that healthcare providers (HCPs) are increasingly expected to provide. While there have been some studies exploring facets of HCPs' perspectives on the barriers and facilitators to providing compassion, a comprehensive understanding based on direct reports from HCPs is lacking. The aim of this study was to explore HCP perspectives and experiences of perceived barriers and facilitators of compassion. This study used Straussian grounded theory to examine HCP perspectives. Semi-structured focus groups with frontline HCPs and individual interviews with peer-nominated exemplary compassionate care providers were audio-recorded, professionally transcribed, and analyzed. Fifty-seven participants were recruited from 3 healthcare settings within both rural and urban settings in Alberta, Canada, using convenience, snowball, and theoretical sampling. Qualitative analysis of the data generated two categories and associated themes and sub-themes delineating perceived barriers and facilitators to compassion. The first category, challenges to compassion, reflects participants' discomfort associating the notion of barriers to compassion, and contained several themes participants conceptualized as challenges: personal challenges, relational challenges, systemic challenges, and maladaptive responses. The second category, facilitators of compassion, included the themes of: personal facilitators, relational facilitators, systemic facilitators, and adaptive responses of intentional action. Although participants described certain factors such as system and time constraints along with interaction styles of patients and families that can challenge HCP compassion, these challenges were not considered insurmountable. While acknowledging these as challenges, participants identified HCPs themselves, including their responses towards the identified challenges of compassion, as significant factors in this process -a novel finding from this study. This study provides insight into HCPs' perspectives on the notion of barriers and facilitators in the provision of compassion. This article is protected by copyright. All rights reserved. [Abstract copyright: This article is protected by copyright. All rights reserved.

Plastid phylogenomics resolves ambiguous relationships within the orchid family and provides a solid timeframe for biogeography and macroevolution

Recent phylogenomic analyses based on the maternally inherited plastid organelle have enlightened evolutionary relationships between the subfamilies of Orchidaceae and most of the tribes. However, uncertainty remains within several subtribes and genera for which phylogenetic relationships have not ever been tested in a phylogenomic context. To address these knowledge-gaps, we here provide the most extensively sampled analysis of the orchid family to date, based on 78 plastid coding genes representing 264 species, 117 genera, 18 tribes and 28 subtribes. Divergence times are also provided as inferred from strict and relaxed molecular clocks and birth–death tree models. Our taxon sampling includes 51 newly sequenced plastid genomes produced by a genome skimming approach. We focus our sampling efforts on previously unplaced clades within tribes Cymbidieae and Epidendreae. Our results confirmed phylogenetic relationships in Orchidaceae as recovered in previous studies, most of which were recovered with maximum support (209 of the 262 tree branches). We provide for the first time a clear phylogenetic placement for Codonorchideae within subfamily Orchidoideae, and Podochilieae and Collabieae within subfamily Epidendroideae. We also identify relationships that have been persistently problematic across multiple studies, regardless of the different details of sampling and genomic datasets used for phylogenetic reconstructions. Our study provides an expanded, robust temporal phylogenomic framework of the Orchidaceae that paves the way for biogeographical and macroevolutionary studies.Universidad de Costa Rica/[814-B8-257]/UCR/Costa RicaUniversidad de Costa Rica/[814-B6-140]/UCR/Costa RicaIDEA WILD/[]//Estados UnidosSociedad Colombiana de Orquideología/[]/SCO/ColombiaFundação de Amparo à Pesquisa do Estado de São Paulo/[11/08308-9]/FAPESP/BrasilFundação de Amparo à Pesquisa do Estado de São Paulo/[13/19124-1]/FAPESP/BrasilSwiss Orchid Foundation/[]//SuizaRoyal Botanic Gardens, Kew/[]//InglaterraSwedish Research Council/[2019-05191]//SueciaSwedish Foundation for Strategic Research/[FFL15-0196]/SSF/SueciaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Jardín Botánico Lankester (JBL