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PubMedDate not supplied

Improving critical thinking in nursing practice.

Nurse educators and practicing nurses agree that the complexity of health care demands critical thinking skills. In this article, the author describes critical thinking and its development both as knowledge based and practice bound. Included are strategies nurses can use to further develop critical thinking skills. Case scenarios are presented for educators to consider in promoting nurses' reflection and clinical reasoning skills in their practice settings.

Clinical Competence↗
PubMed2002

Nursing on paper: therapeutic letters in nursing practice.

Nursing on paper: therapeutic letters in nursing practice This paper offers a selected piece of interpretive research extracted from the context of a larger research study. The hermeneutic research inquiry described in this paper involved the examination of the nursing and family therapy intervention of therapeutic letters. It incorporated the textual interpretation of 11 therapeutic letters, clinical sessions with three families, clinical team discussions, and research interviews with four family members and three nurse clinicians who participated in the writing of the letters. This particular paper extracts segments of the research related to the letters received by two participants, as well as some general findings, with a focus on the possibilities and influences of therapeutic letters in nursing practice. The findings of this research offer suggestions, not as a template, but as an inspiration and evocation to write therapeutic letters that address the obligation of meeting people experiencing illness at the point of their suffering, with words and questions that invite relationship, reflection, and are large enough to sustain a meeting.

Alberta↗
PubMed2003

Nursing informatics: the key to unlocking contemporary nursing practice.

Nursing informatics is a relatively new nursing specialty. Recognized by the American Nurses' Association in 1992, this field within nursing has grown exponentially. Once the purview of highly specialized individuals, nursing informatics has now crept into all dimensions of nursing, from domain of advanced nurse practitioners to prominence in critical care nursing. Nowhere is the management and processing of health-related information more important than in the care of the critically ill patient. Fast-paced environments, split-second decision making, wireless communications, monitoring systems run with computerized backbones, and computerized ordering and documentation, all things unimaginable just a decade ago, are now fundamental to nursing practice. Each requires a baseline understanding of informatics for true mastery. The domain of nursing informatics continues to grow as nursing incorporates expanded roles and new technology into practice. Education for nurse informaticians includes preparation from the baccalaureate level through the doctorate level and national board certification. Areas of practice are expansive, including hospitals, industry, education, policy-making, research, administration, and international settings. Although informaticians work with computers, computing technology is not the heart of the domain. Computers are simply tools that are used. Examples of informatics tools include handheld devices, point-of-care documentation, computerized provider order entry, and bar code medication administration. Nursing informatics plays an essential role in the future directions of healthcare by defining the relationship between nurses and information technology as well as the knowledge that can be gained when these domains work together.

Biomedical Technology↗
PubMed1989

The impact of nurse managed care on the cost of nurse practice and nurse satisfaction.

How are costs of nursing care effected when professional nurses practice nursing based on patient's needs as opposed to institutional policy? The author discusses a different nursing care delivery system that builds on primary nursing but frees the nurse from institutional constraints. The results were a 20 percent decrease in nursing costs and increased satisfaction among the nursing staff participants.

Connecticut↗
PubMedDate not supplied

The devil is in the details: body fluid testing regulation and the erosion of nursing practice.

Nurses have long performed tests on simple body fluids (e.g., chem strip, urine Dip Stix, guaiac of stool, urine specific gravity). As a result of the interpretation of JCAHO regulations by hospital administrators, nurses no longer have access to the supplies necessary to perform these tests. This article discusses the background surrounding the issues of body fluid regulation and how the current JCAHO laboratory regulations erode the scope of nursing practice. The author makes specific suggestions for nurses to retain their practice in this area.

Body Fluids↗
PubMed1993

The job satisfaction of health visitors, district nurses and practice nurses working in areas served by four trusts: year 1.

This paper reports the results of the first of three annual surveys of the job satisfaction of health visitors, district nurses and practice nurses working in communities served by four trusts. Analysis of variance illustrates differences in the level of Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Training and Satisfaction with Pay and Prospects. Practice nurses appear to be the most satisfied group; the level of satisfaction for health visitors is significantly lower. Qualitative analysis of the additional comments made by approximately one-third of respondents illustrates the gulf in perceived values between staff and management and the feelings of uncertainty experienced by community nurses in the wake of major legislative change. Possible reasons for differences in level of staff satisfaction between the four trusts are discussed.

Adult↗
PubMed2006

Human becoming-guided patient-centered care: A new model transforms nursing practice.

Nurses working on an orthopedic surgery and rheumatology unit in a large teaching hospital in Canada participated in a 24-month research project to evaluate what happens when nurses are provided 20% of their time for the purpose of learning and self-development. Half of the teaching-learning was aligned with the commitment of the organization to advance patient-centered care, and in particular patient-centered care guided by the nursing theory, human becoming. The other half was self-directed by nurse participants according to their learning interests and self-development priorities. The purpose of this column is to describe the teaching-learning and mentoring processes in which the nurses were engaged and to highlight the subsequent changes in nursing practice that have happened on the unit from the perspectives of nurse participants.

Adult↗
PubMed1992

The career development internship program. Pathway to enhanced nursing practice.

Nurse administrators can enhance nursing practice and improve patient care by providing clinical nurses with ways to develop and share their expertise in areas such as education, management, quality assurance, advanced clinical practice, and research. The authors describe the Career Development Internship Program that grew out of the Management Internship Program. This creative program allows for professional growth in specific fields while also developing leadership capability.

Career Mobility↗
PubMedDate not supplied

Continuing professional education: does it make a difference in perceived nursing practice?

Nursing professional development educators, nurses, and their employers want assurances that continuing professional education (CPE) programs have quality and positively influence nursing practice behaviors and subsequent patient outcomes. The goal of this prospective study was to evaluate a model for measuring perceived changes in expertise and perceived utility and applicability of concepts gained from attendance at three types of CPE generally offered at the American Nurses Association's (ANA) 2000 convention. Perceived nursing expertise was measured at before, after, and 6 months following CPE program attendance. Advantages and limitations for use of this CPE evaluation model are described.

Adult↗
PubMedDate not supplied

Clinical supervision and practice nurses.

practice nurses need clinical supervision to help them keep abreast of their expanding primary care role. Ali Farquharson, Gail Trotter and Sheila Nimmo report on a project that set out to provide a support model.

Clinical Competence↗
PubMed1983

Ethical dimensions of nursing practice.

Nurses are often called upon to participate in ethical decision-making. As the dimensions of nursing care increase, this role will also increase. This article has provided some strategies by which the nurse can come to an independent, personal decision; understand why the stance was chosen; and articulate the rationale for the choice to others. Obviously, this article is not meant to provide the sole groundwork for ethical decision-making, but rather an impetus for the practicing nurse to seek more information on ethics and the ethical dimensions of her own practice. Resolving ethical dilemmas will never be easy; however, by utilizing the theories and models presented here, the nurse can contribute to a responsible ethical decision. The Blackfoot Indian tribe has a philosophy regarding ethical choice that seems appropriate: "Everything is neither right nor wrong. The right or wrong is in the choosing, the keeping, the losing. All paths are light and shadow, and every path is a different thing to each man. The right and the wrong, the good and the evil lie not upon the silent pathway, but in the man that walks it..."

Decision Making↗
PubMedDate not supplied

Clinical supervision for the development of nursing practice.

Nursing practice demands a range of problem-solving skills and abilities, and preregistration courses may only provide limited preparation. Clinicians need to draw on the skills and expertise of experienced colleagues in order most effectively to use their time and energies in a new role or clinical area. Experienced staff may enhance both their clinical expertise and their support of colleagues through the role of clinical supervisor. Clinical supervision has benefits for the supervisor in terms of professional development and for the supervisee as regards identifying and addressing clinical problems. According to the position statement on clinical supervision for nurses and health visitors published by the UKCC (UKCC, 1996) clinical supervision aims to identify solutions to problems, improve practice and increase understanding of professional issues. This article examines roles and responsibilities in clinical supervision and discusses the benefits for individuals and for health services.

Clinical Competence↗
PubMed1990

A model for differentiated nursing practice.

Nurse administrators continually search for a nursing care delivery system that has a positive effect on nurse retention, as well as on patient and fiscal outcomes. The authors describe a transitional model of differentiated nursing practice that is having a beneficial effect on outcomes.

California↗
PubMed1986

Applying family stress theory to nursing practice.

Nursing research is increasing its use of theories derived from family sociology and family social science. A number of these theories are helpful in explaining health phenomena and guiding nursing practice in clinical settings wherein the family is an integral part of the intervention. The use of family stress theory in clinical practice is especially relevant in promoting health during normal family transitions, and in assessing family changes during a family member's acute or chronic illness.

Adaptation, Psychological↗
PubMed1993

Woman abuse: educational strategies to change nursing practice.

Nurses and other health care providers are ideal persons to intervene with women who are experiencing violence and abuse in their intimate relationships. All women are not assessed for this health care problem because of lack of education on the part of their health care providers. This article presents principles and methods for the provision of education about women abuse to practicing nurses and students in graduate and undergraduate nursing programs. By redressing this lack of knowledge and skills, nurses will be empowered to provide clinical intervention and leadership in addressing this major health and social problems. Sample outlines and objectives are provided.

Adult↗
PubMedDate not supplied

An analysis of wisdom: an experience in nursing practice.

Nurses have demonstrated an interest in the nurse-patient relationship as both as a process and as the meaning derived from this relationship. Consequently the elements of the nurse-patient relationship have been explored within a variety of contextual experiences. To date, there has been no articulation of the experience of wisdom within the context of the nurse-patient relationship. This exploratory hermeneutic study examines the lived experience of wisdom in nursing practice. Three self-identified individuals from a northeast metropolitan area, ranging in age from 40 to 50 years, participated in multiple non-structured interviews. All participants spoke and understood English. Transcripts were analyzed using Gadamerian methodology. The findings suggest two constitutive patterns in participants' experience of wisdom: "Transformation as a Moment in Time" and "Transformation as Unfolding/Evolving Moments in Time."

Adult↗