It has become clear that nursing is a high-risk occupation with regards to stress-related diseases. In this study, we were interested in nurses' experiences of stress and the emotions arising from stress at work. Results showed that nurses experienced negative stress which was apparently related to the social environment in which they worked. Four nurses were interviewed. The method used was grounded theory. Analysis of the interviews singled out absence of response as the core category. Recurring stressful situations obviously caused problems for the nurses in their daily work. Not only did they lack responses from their supervisors, they also experienced emotions of frustration, powerlessness, hopelessness and inadequacy, which increased the general stress experienced at work. Our conclusion is that the experience of absence of response leads to negative stress in nurses.
BACKGROUND: This paper describes a study that explores the experiences of internationally educated nurses (IENs) in their efforts to gain entry to practice as Registered Nurses (RNs) in the province of Ontario, Canada. AIM: The aim was to uncover, in part, the issues related to professional nursing credentialling. METHODS: This study was guided by a biographical narrative (qualitative) research methodology. A convenience sample of 12 IEN students volunteered for this study representing the Philippines, Mainland China, Korea, Ukraine and India. FINDINGS: The findings were that the IENs progress through a three-phase journey in their quest for licensure in Ontario. These phases include: (1) hope - wanting the Canadian dream of becoming an RN in Ontario; (2) disillusionment - discovering that their home-country nursing qualifications do not meet Ontario RN entry to practice; and (3) navigating disillusionment - living the redefined Canadian dream by returning to nursing school to upgrade their nursing qualifications. CONCLUSIONS: Professional regulatory nursing bodies and nursing educators, as well as practising nurses, must be aware of the potentially confusing and unpleasant processes IENs go through as they qualify for the privilege of practising nursing in Ontario.
This paper aims to present a theoretical account of professional nursing challenges involved in providing care to patients suffering from chronic obstructive pulmonary disease. The study objectives are patients' and nurses' expectations, goals and approaches to assisted personal body care.
The provision of help with body care may have therapeutic qualities but there is only limited knowledge about the particularities and variations in specific groups of patients and the nurse-patient interactions required to facilitate patient functioning and well-being. For patients with severe chronic obstructive pulmonary disease, breathlessness represents a particular challenge in the performance of body care sessions.
We investigated nurse-patient interactions during assisted personal body care, using grounded theory with a symbolic interaction perspective and a constant comparative method.
Twelve cases of nurse-patient interactions were analysed. Data were based on participant observation, individual interviews with patients and nurses and a standardized questionnaire on patients' breathlessness.
Nurses and patients seemed to put effort into the interaction and wanted to find an appropriate way of conducting the body care session according to the patients' specific needs. Achieving therapeutic clarity in nurse-patient interactions appeared to be an important concern, mainly depending on interactions characterized by: (i) reaching a common understanding of the patient's current conditions and stage of illness trajectory, (ii) negotiating a common scope and structuring body care sessions and (iii) clarifying roles.
It cannot be taken for granted that therapeutic qualities are achieved when nurses provide assistance with body care. If body care should have healing strength, the actual body care activities and the achievement of therapeutic clarity in nurses' interaction with patients' appear to be crucial.
The paper proposes that patients' integrity and comfort in the body care session should be given first priority and raises attention to details that nurses should take into account when assisting severely ill patients.
Trauma affects children from all ethnicities, nationalities and socioeconomic backgrounds. However, indigenous children may experience trauma differently than their majority population peers due to traumatic histories of colonization and marginalization. This article reports on an exploratory qualitative study of how service providers in Western Montana and Northern Norway conceptualize Native American and Sámi children's experiences of trauma today. Findings reveal that participants relate current trauma experiences of indigenous youth to historical and intergenerational traumas.
Fear can be problematic for children who come into contact with medical care. This study aimed to illuminate the meaning of being afraid when in contact with medical care, as narrated by children 7-11 years old. Nine children participated in the study, which applied a phenomenological hermeneutic analysis methodology. The children experienced medical care as "being threatened by a monster," but the possibility of breaking this spell of fear was also mediated. The findings indicate the important role of being emotionally hurt in a child's fear to create, together with the child, an alternate narrative of overcoming this fear.
Theories exist to challenge current practice, create new approaches to practice and remodel the structure of rules and principles. One question is whether nurses could find in psychosocial theories of ageing a theoretical foundation on which to base support of older people in their ageing process.
The aim of the present paper was to analyse five psychosocial theories of ageing and to discover what they could mean for gerontological nursing in Sweden.
A literature search was conducted to find original works. Research questions inspired by Fawcett's framework guided the analysis.
Psychosocial theories of ageing cover different aspects of the ageing process, but do not address crucial issues regarding the attitudes and structure of good nursing care. These theories provide no clear guidance on how to care for older people and how to support them in their ageing process. However, the analysis did show that the theories contain underlying values that influence society and staff as regards their views on the ageing process and how care of older people should be carried out. Nursing interventions to support ageing will be quite different depending on the theoretical perspective taken by nurses.
There is a need to translate the ageing theories into guidelines, so that staff in gerontological care will have tools to use in practice irrespective of which theoretical perspective they choose to use in care. This could also promote care that is tailored to each individual older person.
The needs of parents of hospitalized children have received some attention in the health literature, but few studies have compared parents' perceptions of needs with staff's ideas about parents' needs. The aim of this study was to examine differences between the perceptions of the needs of parents of hospitalized children held by staff - nurses, doctors and allied health staff, and parents in a 150-bed paediatric hospital in Sweden. The convenience sample comprised 132 staff - nurses, doctors and allied health staff and 115 parents of children admitted to all the wards except intensive care. Kristjánsdóttir's "needs of parents of hospitalized children" questionnaire (NPQ) was the instrument of choice and was modified slightly for use with staff. Results indicated significant differences in perceptions of the importance of different needs of parents, of how well they were being met in the hospital and how much help the parents needed to have them filled. Differences between parents' and staff's perceptions of the importance of parental needs were found in areas relating to psychosocial needs, but in general, in that hospital, the needs were being adequately met. The main differences between staff's and parents' results were in the degree of independence shown by parents in requiring help to have their needs met. This demonstrates either that parents are much more independent than appraised by staff, or, that parents are sometimes unaware of the level of assistance available.
This study explored various factors and income sources that registered nurses believe are important in retirement planning.
In many countries worldwide, many registered nurses are approaching retirement age. This raises concerns related to the level of preparedness of retiring nurses.
A mail-out questionnaire was sent to 200 randomly selected nurses aged 45 and older. SPSS descriptors were used to outline the data. Multiple t-tests were conducted to test for significant differences between selected responses by staff nurses and a group of nurse managers, educators and researchers.
Of 124 respondents, 71% planned to retire by age 60. Only 24% had done a large amount of planning. The top four planning strategies identified were related to keeping healthy and active, both physically and mentally; a major financial planning strategy ranked fifth. Work pensions, a government pension and a personal savings plan were ranked as the top three retirement income sources. No significant differences were found between the staff nurse and manager groups on any of the items. IMPLICATIONS FOR NURSING MANAGERS/CONCLUSIONS: The results of this study suggest that managers' preparation for retirement is no different from that of staff nurses. All nurses may need to focus more on financial preparation, and begin the process early in their careers if they are to have a comfortable and healthy retirement. Nurse managers are in a position to advocate with senior management for early and comprehensive pre-retirement education for all nurses and to promote educational sessions among their staff. Managers may find the content of this paper helpful as they work with nurses to help them better prepare for retirement. This exploratory study adds to the limited amount of research available on the topic.
To explore nursing home patients' oral hygiene and their nurses' assessments of barriers to improvement.
In nursing homes, nurses are responsible for patients' oral hygiene.
This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study.
More than 40% of patients had unacceptable oral hygiene. 'More than 10 teeth' gave OR = 2, 1 (p = 0.013) and 'resist being helped' OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients' teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning.
Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses' education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.