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Differences in professional activities, perceptions of professional problems, and practice patterns between men and women graduates of Jefferson Medical College.

Differences between men and women graduates of one medical school in practice patterns, professional activities, and problems were investigated. A questionnaire was mailed in 1986 to 600 physicians, randomly selected from 1,102 who had graduated from Jefferson Medical College of Thomas Jefferson University between 1977 and 1981. Four hundred fifty (364 men and 86 women) responded (75%). The women were less likely than the men to be employed full-time; however, proportionately more women than men held full-time academic appointments, treated patients from low-income families, and served in underserved areas in inner cities. The women reported working fewer hours per week and having fewer patients than did the men. The women published scientific articles as often as did the men but were less likely to serve on professional committees, receive professional awards, or develop medical procedures. The women were less concerned about the oversupply of physicians and malpractice litigation. Implications of the findings for health manpower planning and practice pattern expectations are discussed.

Adult↗

Effective methods for disseminating research findings to nurses in practice.

Professionals in all disciplines are challenged by the proliferation of new knowledge. Nurses, too, must find cost-effective ways of ensuring that their patients are benefiting from the most current knowledge about health and illness. The methods of research dissemination to clinicians described in this article are presumed to be effective because of anecdotal reports, conference evaluations, or clinician surveys. The profession needs more sophisticated evaluations of the effectiveness of various dissemination methods. In the meantime, whether you are a researcher, an administrator, an educator, or a clinician, you have a role to play in improving research dissemination. Implement just one strategy from this article and evaluate the results. Each contribution moves nursing toward research-based practice.

Congresses as Topic↗

Radiologists in the United States: demographic, professional, and practice characteristics.

OBJECTIVE: The purpose of this report is to present a statistical portrait of radiologists in the United States based on the 1990 American College of Radiology Manpower Survey. Unlike previous surveys, this survey included radiologists who were not members of the College and was thus more representative of all radiologists. (Approximately three quarters of radiologists are College members.) We examined how the demographic, professional, and practice characteristics of radiologists vary among major groups within the profession. MATERIALS AND METHODS: A stratified random sample of 2804 radiologists and nuclear medicine specialists was drawn from the American Medical Association Physician Masterfile, which is the most complete and extensive single source of information on physicians in the United States. Because the total numbers of female radiologists, nuclear medicine specialists, and radiologists less than 35 years old are relatively small, these groups were deliberately "oversampled" (hence the term stratified random sample) to ensure sufficient numbers of responses in these categories for meaningful analysis. A total of 1845 completed questionnaires were received, which yields a response rate of 68% if the questionnaires sent to invalid addresses are excluded. Responses were weighted to make the data representative of all radiologists, despite differences in sampling rates. RESULTS: Findings for professionally active radiologists who completed their training included the following: 94% were certified by the American Board of Radiology, 13% were women, 47% were less than 45 years old, fees for service were the primary remuneration for 62%, and 72% are in practices owned by physician members of the practice. By major activity in radiology, 69% were diagnostic radiology generalists; 11% were radiation oncologists; 18% were diagnostic radiology subspecialists; and 2% were nuclear medicine specialists. A breakdown by age indicated that the age group of radiologists less than 45 years old included more women, diagnostic subspecialists, and persons who had fellowship training than other age groups did. Percentages of diagnostic radiology generalists and solo practitioners were lower among younger radiologists. Radiation oncologists, compared with all others, were the most likely to practice solo or in small groups of two to four members. The subfields with the highest percentages (60% or more) of diagnostic radiologists reporting expertise or proficiency were CT, mammography, and sonography. Among radiologists who were retired, half had retired by the time they were 65 years old. However, a majority of radiologists 65-69 years old were still working, as were 40% of those 70-74 years old. CONCLUSION: The profession of radiology is changing, with more women, subspecialists, and fellowship-trained radiologists in younger age groups and fewer solo practitioners. Only a small percentage of radiologists are not board certified. Radiologists typically remain professionally active into their late 60s or even beyond.

Adult↗

[Evidence-based medicine--method, critical appraisal and usefulness for professionalized business practice in medical].

The concept of evidence-based medicine (EBM) describes 5 steps that lead to a scientifically based solution of clinical problems. EBM is often reduced to the search for the best evidence (randomised controlled trials, meta-analyses) or the introduction of guidelines. This causes criticism and may have consequences for medicine. But EBM also emphasizes the so-called clinical expertise of the doctor, which is important for reference to the individual patient. This point of EBM is being developed further. Connected with the theory of professionalization by U. Oevermann, stressing the importance of hermeneutical competence, EBM turns out to be a sophisticated model of professional medical practice.

Clinical Trials as Topic↗

The development of a postanesthesia record incorporating the nursing process.

The professional practice of nursing is a comprehensive discipline involving assessment, planning, implementation, and evaluation in its approach to both daily practice and problem solving. An integral part of this process is the development of nursing diagnoses, setting of goals, and evaluation of progress towards meeting those goals. In order to further professional practice in the PACU, the PACU staff at St Francis Hospital in Greenville, SC, developed a new record that incorporates nursing diagnosis, goal setting, and evaluation along with the documentation of appropriate nursing interventions to meet stated goals. The staff believed that such a record would advance their professional practice, meet the ASPAN standards of nursing practice, and meet the Joint Commission for Accreditation of Healthcare Organizations requirements that documentation in the PACU show a nursing plan of care. The need for such a record was shown in the literature search and the record was developed, tested over a 30-day period, and implemented in September 1988. Staff response to the record has been very positive with nurses indicating that the record not only improved documentation, but also increased individual accountability for initiating nursing measures to meet stated goals.

Evaluation Studies as Topic↗

Education for professional nursing practice: looking backward into the future.

The publication of the 1965 ANA position paper calling for the baccalaureate degree as the minimum requirement for entry into professional nursing practice initiated an impassioned debate which continues to frustrate and divide nursing. An examination of the entry into practice debate from an educational perspective reveals some interesting similarities in the social and political pressures felt by nursing in 1965 and the challenges that exist today. In looking back at the course of nursing education during the past thirty-seven years, some useful insights emerge which can help to set direction for the future. The author argues that it is time to leave the old debate behind and agree on the importance of developing a better educated profession.

Australia↗

Organizational climate and intensive care unit nurses' intention to leave.

OBJECTIVE: The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. DESIGN: Cross-sectional design. SETTING: Hospitals and critical care units. SUBJECTS: Registered nurses (RNs) employed in adult intensive care units. INTERVENTIONS: Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey. MEASUREMENTS AND MAIN RESULTS: Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers. RESULTS: A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05). CONCLUSIONS: Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.

Adult↗

Contemporary breast-feeding policy and practice: implications for midwives.

In this paper, the authors draw upon recent Australian research to provide a critical commentary on the current policies and professional practices surrounding breast feeding. These studies, conducted by the first and second authors, explored aspects of the breast-feeding experience, with the findings highlighting areas for concern in relation to the promotion and support of breast feeding in western societies. Of particular concern to the authors was the number of women in these studies who equated breastfeeding with being a 'good' mother. This perception meant that some women maintained a strong commitment to breast feeding despite enormous difficulties. In this paper we firstly, overview the findings of these studies and use women's stories to illustrate their perseverance and their intense commitment to breast feeding. In the second part of the paper, we consider the consequences of the strong public rhetoric surrounding breast feeding in Australia and challenge some of the assumptions underlying policies and professional practices related to breast feeding. We examine the consequences of 'professionalising' breast feeding, and make suggestions for a way forward in the promotion of breast feeding that encompasses the range of perspectives held by women. In conclusion, the authors highlight the complexity of establishing appropriate breast-feeding policies that guide professional practices in a flexible manner, allowing for diversity in individual breast-feeding experiences.

Attitude to Health↗

Radiology nursing: legal issues surrounding the expanded role.

The annual conference for the Royal College of Nursing's Forum of Nurses in Radiology and Cardiology took place in Birmingham last year. Participants were asked to consider the ways in which their professional practice could develop within The Scope of Professional Practice (UKCC, 1992a) guidelines and the possible problems they feared could arise. The legal issues which arose from their answers were then analysed. The aim of this article is to examine, in the light of the legal issues, the chosen areas of expansion within the nurse's role and the concerns felt by the participants in order to draw up lessons for nursing generally.

Humans↗