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Using a Holter electrocardiograph (ECG), we recorded the heart rates of ward nurses by working hours and nursing activity. Energy expenditure was calculated from the heart rate data and nurse work lord was evaluated. The following results were obtained. 1) Average heart rates were 77 (beats/min) for day-shift nurse in surgical ward, 76 for evening-shift nurse in mixed, ward, and 74 for night-shift nurse in mixed ward. 2) The energy expenditures per day were calculated to be 3,474 kcal for day-shift nurse in surgical ward, 3,060 kcal for evening-shift nurse in mixed ward, and 3,238 kcal for night-shift nurse in mixed ward. 3) The energy expenditures during working hours were 2,110 kcal/510 min for day-shift nurse in surgical ward, 1,805 kcal/495 min for evening shift nurse, and 2,014 kcal/570 min for night-shift nurse in mixed ward. 4) The highest energy expenditures of nurse engaged in direct nursing care were 834 kcal (39.5%) for day-shift nurse in surgical ward, 632 kcal (34.9%) for evening-shift nurse in mixed ward, and 790 kcal (39.2%) for night-shift nurse in mixed ward. 5) The longest working hours were 174 min (34.1%) in assisting with medical examinations and treatment by day-shift nurse, 155 min (31.3%) in direct care by evening-shift nurse, and 222 min (39.0%) by night-shift nurse. The results indicate that the energy expenditure calculated from the average heart rate of ward nurses in higher than that of other types of workers. The reason for this difference is discussed in this report. Also, this study showed that the energy expenditure determined by this method does not necessarily increase in proportion to working hours.
Nursing education in Sweden has undergone quite a few changes during the last decade. The aim has been to make nursing more holistic, individualised and health-oriented. Social competence, systematic problem solving and research have also been emphasised. These changes in nursing education have led to new demands on nurse teachers. Nurse teachers, directors of nursing education at three nursing schools and a few nurses were interviewed about the problems they experienced in relation to the new demands. The main problems reported were: 1) students inadequately prepared for nursing education, 2) students' attitudes to the social and health-oriented content of the first course at nursing school, 3) integration of research and nursing, 4) resistance to a more theory-based and nurse teacher-dominated nursing education, 5) integration of nursing theory and nursing practice and 6) incompatible demands on the clinical nurse teacher.
The organization of nursing department significantly effects the hospital management. Especially, the head nurse is one of the most important position because head nurse is a first-line manager in the hospital level, a middle manager in nursing service organizations level and the top manager in each nursing unit level. This study was attempted to show the ideal model and rule by compare head nurses' role perception with staff nurses' role expectation according to two types of hospital. The survey was conducted among 94 head nurses and 233 staff nurses who are working at 5 different University Hospitals over 600 beds and 93 head nurses and 218 staff nurses who are working at 12 different General Hospitals between 100-300 beds in Seoul. The data was collected in a period from 8th September to 13th October in 1989 and the instrument used for this study was based on Han's one and referred back to many literary sources and revised. The collected data was analysed by computer using S.P.S.S. program as a Mean, Percentage, Cronbach's alpha, Chi-Square, t-test and ANOVA. 1. The study was compared to the difference of the two subject group's general characteristics according to a type of hospital. As a result, there were significant differences in age, educational background and career. 2. This Study was compared to the difference of the two subject group's role perception and role expectation about each question according to a type of hospital. The result of this comparisons as follows: First, These were the most important issue between both groups: "Head nurse has to know about her staff's events and problems and then help them to solve that promptly" Second, These were the least important issue between both groups: "Head nurse has an interview with patient's family and visitors", "Head nurse is interested in her staff's privacy". 3. This study was compared to the differences of each role areas according to a type of hospital. As a result, there were no significant differences both two subject groups except nursing manager role in staff nurses' group (t = -2.893, df = 449.0, p = 0.004). 4. This study was tested to the difference of the two subject groups according to general characteristics. As a result, All of that there were no significant differences.
The use of nursing diagnosis by staff nurses in a 225-bed metropolitan hospital was examined. The sample consisted of 82 newly hired nurses who had participated in a mandated staff development program on nursing process theory and use of nursing diagnosis, with an emphasis on transfer of knowledge to practice. The data collected included demographic information, attitudes concerning nursing diagnosis, pretest and posttest scores, and percent completed on the audits of chart documentation. A cross-tabulation by clinical arena was performed on the forms used to document utilization of nursing diagnosis. Analysis of the data indicated that a greater proportion of the charts for the nurses in the maternal/child clinical arena evidenced use of nursing diagnosis as a component of practice. The nurses in the critical care arena scored slightly lower. The nurses in the medical/surgical arena had the lowest compliance of both completion and utilization of nursing diagnosis. This study demonstrated that nurses can be taught to use nursing diagnosis in the clinical setting.
This study was designed to clarify how nurses and nursing students perceive their clients' needs for spiritual nursing care, it's practices, and problems. The purpose was to suggest directions for the development of spiritual nursing practice. The major findings are as follows: Respondents primarily perceived spiritual nursing as nursing care designed to help terminally ill patients accept death. Many of the respondents showed a high level of awareness of spiritual nursing care and its necessity. Few of them, however, bad actual experience in spiritual care. Those with experience in spiritual nursing care tend of take either a religious approach or perceived it as the therapeutic use of the self. The greatest problem related to the practice of spiritual care was found to be lack of time. Most of nurses and nursing students were found to be well aware of the needs for spiritual nursing care but were hindered from practising it because of the lack of time. To resolve the problem it was recommended that the scope of nursing practice be readjusted and that pre- and in-service programs should be developed to further heighten nursing students' interest in spiritual nursing care.
The activities of the three dimensions of nursing does not occur in isolation. Nursing practice, the field of study of nursing science, has characteristics which influence the scientific practice of nursing. Nursing practice is constituted by the nurse practitioner as a result of the fact that the pre-scientific interpretations of the nurse give form (gestalte) to nursing interactions. From a functional perception in nursing science, the scientific practitioner must take cognisance of the pre-scientific interpretations. Besides the empirical reality, specific values and assumptions form an integral part of this practice of science in Nursing. The third dimension, the philosophy of nursing brings greater clarity in that the activities of the first two dimensions can be organised, analysed and evaluated.
The development, implementation, and evaluation of a program that incorporates a registered nurse and licensed vocational nurse partnership model into the critical care practice setting is described. This model can be used by nurse executives to alleviate some of the immediate consequences of the nursing shortage and potentially to achieve a longer-range solution by expanding the pool of registered nurses. Evaluation of the program revealed statistically significant increases in nurse job satisfaction; perceptions of reduced workload and stress; a perception by registered nurses and physicians of increased nursing care quality; decreased registered nurse turnover and sick time; and a positive perception of the role of the licensed vocational nurse in the critical care unit.
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The purpose of this study was to develop and validate the Nursing Severity Index, a new method used to measure the admission severity of illness of hospital patients using nursing diagnoses, which categorize biologic, functional, cognitive, and psychosocial abnormalities. This retrospective cohort study with independent development and testing phases was conducted at a U.S. academic medical center. In the development phase, data regarding 14,183 adult medical-surgical patients admitted to the medical center in 1985 and 1986 was used. In the testing phase, data regarding 7,302 patients admitted in 1987 and 1988 was used. Primary nurses prospectively recorded the presence or absence of 61 nursing diagnoses on admission. Demographic and clinical data were obtained from hospital data bases. In the development phase, the number of admission nursing diagnoses was highly related (P < 0.001) to in-hospital mortality. Using multiple logistic regression, 34 nursing diagnoses were identified as independent predictors of mortality; the Nursing Severity Index equals the number of these 34 diagnoses. In the testing phase of 7,302 patients, the Nursing Severity Index was related (P < 0.001) to mortality rates, which were 0.5%, 1%, 2%, 6%, 13%, 22%, and 31% in seven hierarchical strata defined by the Index. The Index was as accurate in predicting mortality as MedisGroups (receiver-operating-characteristic curve areas, 0.814 +/- 0.016 vs. 0.845 +/- 0.015, respectively, P = 0.12). Furthermore, the Nursing Severity Index and MedisGroups together (receiver operating characteristic curve area 0.880 +/- 0.014), were more accurate (P < 0.01) than either measure alone. The Nursing Severity Index assesses multiple dimensions of illness, can be easily measured during routine patient care, accurately predicts the risk of in-hospital death, and has similar prognostic accuracy as MedisGroups. Its usefulness in outcomes assessment, quality assurance, and case management merits further study.
This study surveyed pulmonary clinical nurse specialists, oncology clinical nurse specialists, critical care nurses, and medical-surgical nurses to assess smoking prevalence, attitudes toward the educator and exemplar role, and reasons for smoking. Of the 120 questionnaires distributed, 114 (95%) were returned. Of the oncology clinical nurse specialists, 23.1% were former smokers and none reported currently smoking. Prevalence of smoking among the remaining groups was 28.5% for pulmonary clinical nurse specialists, 30% for medical-surgical nurses, and 46.7% for critical care nurses. More than 70% of respondents agreed with statements about the nurse as educator and exemplar (role model) in smoking cessation. This study provides evidence of a lower prevalence of cigarette smoking among nurses prepared as oncology clinical specialists and greater support for the educator and exemplar role than previously reported.
This study was undertaken to compare the attitudes of nurses and nursing students toward computer use in nursing practice and to clarify factors that influence these attitudes. Three factors within the student sample were examined: changes over time, prior experience with computers, and attitudes toward technology in general. Second, the attitudes of the nursing students were compared with those of a sample of practicing nurses. Finally, the multidimensional structure of Stronge's attitude scale was analyzed. A total of 353 sophomore nursing students and 358 staff nurses participated in the study. The analysis produced a refined 17-item attitude scale composed of three identifiable subscales: computers and patient care, computers and personal security, and general attitude. It was found that students had less experience with computers than the investigators had anticipated, and there was little change over three successive cohorts of students. However, in general, students' attitudes toward computer use in nursing were positive, and the more computer experience students had, the more positive their attitudes. The attitudes of the practicing nurses also were generally positive, but differences between students and nurses were observed.
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