Nursing care of families continues to be a challenge within complex and demanding health-care systems. Educational strategies to bridge the theory-practice gap, connecting classroom learning with clinical experiences in undergraduate nursing education, enable students to develop the skills required to form meaningful partnerships with families. This article describes how undergraduate nursing students complete a 15-Minute Family Interview in a clinical practice setting, and document the interview process in a reflective major paper. Students integrate research and theory and identify ways to improve the care of families in the clinical setting while building communication skills and confidence in interacting with families in everyday practice. The implementation of the assignment and the evaluation of the process, including quotes from 10 student papers and 2 clinical faculty members, are discussed. Implications for education and ongoing research are offered.
In a previous study the knowledge and views of nursing students on how they thought nurses, both in their professional role and as private persons, should act at a disaster site were evaluated. In the present study the practical functional role and experiences of nurses (n = 16) in two major disaster situations (one 'load and go' and one 'stay and play' type of emergency situation) were assessed from personal interviews along a standardized questionnaire. Nurses more routinely involved in emergency care and nurses with no or limited previous practical experience of disaster nursing were included in the study. Leadership-type actions, i.e. a systematic way of attempting to survey and to comprehend the situation, what has happened, and how many injured there may be at the site of the accident, were reported by most of the experienced nurses, while inexperienced nurses were involved mainly in the immediate care of injured according to directions given by more experienced members of the emergency team. Readiness for action, reflected by having a feeling of being prepared for work at the disaster site, was experienced more often by nurses with considerable previous experience of disaster nursing than by nurses with limited experience. Negative experiences, such as feelings of being insufficient, of unreality, mental strain, and problems in understanding the organization, were commonly mentioned by the inexperienced nurses. The present study stresses the importance, for all types of nurses, of more systematic training in disaster nursing.
GENESIS (General Ethnographic and Nursing Evaluation Studies In the State) is a tested and proven community analysis strategy that integrates ethnographic and epidemiologic data to arrive at a comprehensive, holistic description of the health of a community and its residents. Communities analyzed in most project GENESIS studies have been rural or semirural. ACTION (Assessing Communities Together in the Identification Of Needs) is an extension of the GENESIS community analysis model that was developed to meet the unique needs of community-level research and analysis in an urban, multicultural setting. Significant differences in the context in which the ACTION projects took place necessitated extensions in specific components of the GENESIS model. Application of the GENESIS model by the ACTION team is described. Based on the experiences with ACTION, recommendations are offered for future urban, multicultural community analysis projects.
Although most long-term care facilities cannot always evaluate and treat their residents during acute, intercurrent illnesses, it is possible to design systems that allow for effective care without transfer.
International agencies are required to adapt, pilot and then evaluate the effectiveness of the Nurse-Family Partnership (NFP) prior to broad implementation of this public health intervention. The objectives of this qualitative case study were to: 1) determine whether the NFP can be implemented in Canada with fidelity to the US model, and 2) identify the adaptations required to increase the acceptability of the intervention for service providers and families.
108 low-income, first-time mothers in Hamilton, Ontario, received the NFP intervention. In-depth interviews were conducted with NFP clients (n=38), family members (n=14) and community professionals (n=24).
Hamilton, Ontario.INTERVENTION AND DATA COLLECTION: An intensive nurse home visitation program delivered to women starting early in pregnancy and continuing until the child was two years old. Processes to adapt and implement the NFP were explored across seven focus groups with public health nurses and managers. Eighty documents were reviewed to identify implementation challenges. Data were analyzed using directed content analysis.
The NFP model elements are acceptable to Canadian health care providers, public health nurses and families receiving the intervention. The primary adaptation required was to reduce nurse caseloads from 25 to 20 active clients. Recommendations for adapting and implementing all model elements are described.
The NFP model requires minor adaptations to increase the acceptability of the intervention to Canadian stakeholders. A consistent approach to adapting the NFP program in Canada is necessary as provincial jurisdictions commit themselves to supporting an experimental evaluation of the effectiveness of the NFP.
The experiences and adaptation of 8 women who were heterosexually infected with the HIV were examined. An interview schedule consisting of open-ended questions was used to elicit a full range of responses. Roy's (1984) adaptation model, focusing on physiological needs, self-concept, role-function, and interdependence provided the structure for analysis of each transcript. The interviews indicated that the women who had strong social and family support were coping better with their situation than were women who had little support. The interview responses also showed a lack of professional comportment among health care professionals in their contact with women who are HIV positive, indicating a need for further investigation of health care workers' knowledge and understanding of the needs of HIV-positive women. To plan effective programs, health care professionals need to identify the specific needs of each woman from a holistic perspective.
This article is a study of the experiences of community based nurses; specifically, their ratings of the adequacy of time they had to complete treatment and prevention activities. Perception of adequacy of time to complete job functions is important because of its links to job satisfaction and job stress. The largest predictor of a sense of inadequate time was visit characteristics. Specifically, it was the mental health speciality team which was most likely to experience inadequate time to deliver treatment and prevention activities. Possible explanations include the time required to deliver care to this patient population, and/or the greater travelling distances and coordination activities linked to provision of services to this patient population. Nurse characteristics were also important in the analysis. Nurses with an RN designation were less likely to report stress with the time they had to complete their activities. Years of community nursing experience was also an important predictor; individuals with greater community experience were less likely to report inadequate time for their duties.
Data were collected by telephone interviews with 178 mothers of full-term patients in a NICU (neonatal intensive care unit) concerning advice on facilitation of the initiation of breastfeeding. The main advice to the first author as a nurse in the NICU concerned the environment, advice on breastfeeding, distance between units, work organization and nurse behaviour. The advice to other mothers of patients centred on persistence, physical contact with the infant, and not to let nurses take over maternal role functions. The data were structured into themes and categories, classified by one author and two research assistants according to Roy's adaptation theory, and analysed for degree of interrater agreement. The overall agreement of classification was high, reaching 92.5%. It was easily applied by nurses after a brief introduction and proved useful for structuring interview data. It also contributed to clarification of nurse behaviour and division of roles between nurses and mothers. As the four adaptation modes showed considerable overlap, this kind of classification seems inadvisable for application to the assessment of patient/parent situations in the nursing process. For use in a clinical setting, the theory needs the addition of the interactive aspect of nurse and patient/family role functions, and may then be used as a framework for the development of assessment tools.
Preparing future nurses to care for dying patients and their families represents a challenge for nursing education. Affective learning, essential to nurture a caring perspective in end-of-life care, can elicit strong emotional reactions in students, to which nurse educators must remain keenly sensitive. This article presents the experience of nurse educators and students with experiential and reflective activities addressing the affective domain of learning, within an intensive 4-week undergraduate course on end-of-life care, developed with a competency-based approach. It stressed the importance of strategic teaching for developing interpersonal competencies in end-of-life care, but revealed difficulties for both nurse educators and students in assessing outcomes derived from affective learning.