[Nurses as patients. The view from the bed].
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Biomedical subjects
Publications and source records attributed to D A Child.
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In this qualitative study, pediatric home health nurses described the solitary, ambiguous, and unprogrammed nature of home health nursing. As employees of the family, the nurses in this study found it necessary to negotiate their work tasks and working conditions with family members. In describing the meaning of their work, the nurses emphasized differences between hospital and home health nursing with regard to their authority for care decisions, methods of child discipline, parental control of care, and innovations of nursing routines and interventions. Characteristics of pediatric home nursing are identified in order for these to be communicated to prospective home care nurses, to pediatric nurse educators, and to home health managers. With knowledge of these characteristics, a new home health nurse will be better prepared to negotiate shared patient care responsibilities with the client's family.
Increasingly, hospital nurse administrators are being called upon to organize and implement home care services and to market these services to physicians, patients, and family members. A survey of hospital personnel revealed that both nurses and physicians perceived themselves as the persons primarily responsible for determining the patient's need for postdischarge home care. In listing criteria for selecting a home care agency for patient referral, nurses and physicians rated service dependability and nursing care quality as the most important criteria.
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Two patients are described in whom failure of the Pollard endotracheal tube produced complete respiratory obstruction. Comparisons are made of external diameters, resistance to gas flow and resistance to compression between Pollard tubes and several conventional tubes. It is concluded that the Pollard tube is not satisfactory for microlaryngoscopy.
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Desiring to use videotapes to teach nursing management and failing to find commercially available tapes on needed topics, the authors produced their own tapes on using a decision tree, negotiating a labor contract, leading a quality circle discussion, defending a budget request, conducting an evaluation conference, and leading a brainstorming session. Having identified the underlying principles for each topic, they wrote scripts for 15 minute vignettes dramatizing a nurse manager's use of each technique. They directed nursing and theater students' portrayals of the characters for each vignette. The edited videotapes of managerial interventions proved to be effective models for nurses enrolled in basic management courses. The scriptwriter, director, camera operator, and student actors all acquired an in-depth understanding of the videotaped managerial interventions through their research and prerehearsal conferences.
Funding from a Division of Nursing training grant supported the management education of 35 first- and middle-level nurse managers from a variety of hospitals, clinics, and home health agencies. Nurse administrators and scholars introduced nurse management approaches and techniques to the program participants in three workshops that featured lectures, group exercises, group discussions, and videotapes. Project staff provided ongoing counseling and support to participants by means of teleconferences and telephone coaching, with the result that participants applied many of their newly learned concepts and skills on the job.