Caring attributes and preparedness to care: effects of a pre-enrolled nursing certificate programme in Singapore

Background: Caring is a highly complex and abstract concept, and nurturing a caring attribute among individuals for a nursing career is believed to be best introduced at the start of student journey in preparatory courses specifically designed for nursing. However, because of the need to professionalise nursing, pre-enrolled nursing programmes have been discontinued and replaced by generic healthcare programmes in many parts of the world. Aim: This study aims to evaluate the impact of pre-enrolled certificate nursing education on students’ caring attributes and their preparedness to care. Methodology: A mixed methods approach using unstructured questions and the Caring Behaviour Inventory was employed to determine student caring attributes and their preparedness to care. The participants were final year pre-enrolled nursing students in Singapore. Findings: Students demonstrated attributes of caring based on an average CBI score of 4.55 (SD 0.32). Expressions of professional nurse caring were explicit in students’ entire learning journey and these took various forms of approach embedded in both curricular and extracurricular activites. The study also found that nurturing caring attributes was associated with a high expectation of student social behaviour and closely linked to the increasingly good reputation of nursing as a profession in that region. Conclusions: This study indicates the high potential value of pre-enrolled nursing education for developing the caring attributes of individuals. A nursing-oriented programme title and its high status associated with nursing were critical elements for nurturing the caring attributes. The implications for developments in nurse education and research are discussed

Caring behaviours of student nurses: Effects of pre-registration nursing education

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care

Ground Cover Management for Conservation Tillage Burley Tobacco

There are several advantages of using conservation tillage management practices for burley tobacco production. These include reduced soil erosion, soil water conservation, and lower input costs. Inconsistent yields in past research and trials have made tobacco producers hesitant in adopting conservation tillage. This research was conducted near Springfield, Tennessee and Greeneville, Tennessee to investigate no-till and strip-till practices with different ground cover management techniques during winter and spring months in an effort to identify appropriate technologies. The first study evaluated cover management in established sod. Conventional tillage tobacco was compared to tobacco transplanted either no-till or strip-till into the following sod treatments: (a) spring killed sod, (b) fall killed sod without a winter cover crop, (c) fall killed, wheat cover, and (d) fall killed, rye cover. The objectives of the second study were to explore the possibility of using cover crops for winter forage or straw production, harvested prior to the late-spring transplanting of the tobacco crop. In this study, conventional tillage tobacco was compared to tobacco transplanted either no-till or strip-till into the following ground cover treatments: (a) wheat cover, (b) wheat grazed, (c) rye cover, (d) rye grazed, (e) rye straw, and (f) soybean residue. Conventional tillage produced higher tobacco yields than conservation tillage in three out of four tests. Conservation tillage yields in the sod test at Highland Rim were equal to conventional tillage. Treatments implementing strip tillage with low residue cover generally produced the highest tobacco yields of the conservation tillage treatments. This was probably a result of higher soil temperature due to lower residue cover and the tilled strip. Soil temperatures in these treatments were comparable to conventional tillage. Soil penetration resistance was also less in strip-till (ST) than in notill (NT), indicating a less consolidated rooting zone; this may have been another reason that ST yield was higher than NT

Addressing Traumatic Stress in the Acute Traumatically Injured Patient

Psychological injuries after an acute traumatic event are commonly overlooked. Currently within United States, there is no consistently utilized screening process that addresses traumatic stress within the acute trauma population. Roy\u27s Adaptation Model guided this project, focusing on the idea that bedside nurses are at the frontline of providing early identification through nursing assessment. The purpose of this pilot study was to evaluate whether the implementation of the Primary Care-Posttraumatic Stress Disorder (PC-PTSD) screening tool by bedside nurses would result in identifying more patients at risk for traumatic stress after an acute trauma as compared with the use of no screening method. This descriptive survey study took place over a 6-week period at a Midwest Level 1 trauma hospital. The results revealed that the tool did not increase the number of health psychology consults when compared with the same 6-week period a year prior when no tool was used. Nonetheless, use of the PC-PTSD tool did trigger 28% of the patients to receive a health psychology consult. Forty-five percent of patients who received a health psychology consult were recommended outpatient therapy. Utilization of this tool by bedside nurses did not adversely increase a number of inappropriate health psychology consults. These results agree with the literature and further suggest that there are a clinically significant number of acute trauma patients who are at risk for traumatic stress. With this screening tool, nurses accurately assessed patients and connected them with timely psychological treatment

High fidelity full sized human patient simulation manikins: Effects on decision making skills of nursing students

Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p < .005) and active participation in debrief (t = 70.11, p < .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p < .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p < .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students

Lee Barnett and Steven Bryant in a Joint Senior Composition Recital

This is the program for the joint senior composition recital of Lee Barnett and Steven Bryant. This recital took place on April 14, 1994, in the McBeth Recital Hall in the Mabee Fine Arts Center

Variable sediment oxygen uptake in response to dynamic forcing

Seiche-induced turbulence and the vertical distribution of dissolved oxygen above and within the sediment were analyzed to evaluate the sediment oxygen uptake rate (JO2), diffusive boundary layer thickness (δDBL), and sediment oxic zone depth (zmax) in situ. High temporal-resolution microprofiles across the sediment-water interface and current velocity data within the bottom boundary layer in a medium-sized mesotrophic lake were obtained during a 12-h field study. We resolved the dynamic forcing of a full 8-h seiche cycle and evaluated JO2 from both sides of the sediment-water interface. Turbulence (characterized by the energy dissipation rate, ε), the vertical distribution of dissolved oxygen across the sediment-water interface (characterized by δDBL and zmax), JO2, and the sediment oxygen consumption rate (RO2) are all strongly correlated in our freshwater system. Seiche-induced turbulence shifted from relatively active (ε = 1.2 × 10-8 W kg-1) to inactive (ε = 7.8 × 10-12 W kg-1). In response to this dynamic forcing, δDBL increased from 1.0 mm to the point of becoming undefined, zmax decreased from 2.2 to 0.3 mm as oxygen was depleted from the sediment, and JO2 decreased from 7.0 to 1.1 mmol m-2 d-1 over a time span of hours. JO2 and oxygen consumption were found to be almost equivalent (within ~ 5% and thus close to steady state), with RO2 adjusting rapidly to changes in JO2. Our results reveal the transient nature of sediment oxygen uptake and the importance of accurately characterizing turbulence when estimating JO2

A quasi-experiment to evaluate the effects of a blended approach of simulation learning and podcasting on caring behaviours

Background: The need for quality nursing personnel in clinical practice expected nurse teachers to be able to impart instrumental and expressive aspects of caring behaviours to nursing students. Operating in a resource-limited higher educational context, nurse teachers are required to do so in a cost effective way. This study as part of a larger study evaluated the effects of a blended approach to learning of caring behaviours based on ‘modified’ medium-fidelity simulation scenarios and podcasting to repeat debriefs. Methods: This study employed a quasi-experimental, two group pre-test-post-test design. The study included 146 second year nursing students. Participants were divided into ‘intervention’ and ‘control’ groups and were asked to complete a caring behaviour inventory scale at various stages of the research study. Results: Students in the intervention group scored statistically higher, post receiving medium-fidelity simulation learning and higher post podcasting. The exposure to high fidelity simulation learning has resulted in the lower scoring in control group. Conclusions: This study highlights the value of a blended approach based on medium-fidelity simulation learning and podcasting. Successful learning of caring behaviours lies in the heart of a care-oriented teaching approach rather than the use of sophisticated technologies. This study has implications for a better practice in nursing education for developing student caring behaviours, it also has a wider implication for all vocational and non-nursing healthcare education