Abstract
Aim
This article aims to contest misrepresentations and distortions of sociological writings on the nursing profession.
Background
During the latest ICN congress in Montreal, it has been ...suggested that professions, and the nursing profession for that matter, are thought of by sociologists in a similar way as organised crime, meaning that it is like a ‘money sponge’ sucking resources out of society, without however giving anything in return. Allegedly, there would be a distinct branch of sociology depicting the professions in this light.
Discussion
By sketching out relevant sociological ideas, including the sociology of nursing, I explain that there is no tradition portraying the professions as mafias. I demonstrate that while both the professions and organised crime are socially organised, they are radically different in legitimacy. The caring professions are themselves different in ethos from the classic professions, all the more so from criminal organisations. A distinct stream of research in sociology has been devoted to nursing, without however suggesting such an analogy.
Conclusion
I lament that attendees to the ICN congress were indeed given an inaccurate representation of sociological thinking. Sociologists addressing nursing as a profession tend to highlight processes of emancipation, autonomy, vindication and social justice, as care work is essential to the broader socioeconomic order.
Implications for Nursing Policy
While nursing as a profession is socially organised, the power devices and tactics it deploys in the sociopolitical arena are characterised by their legitimacy. Unlike organised crime, nursing policymaking is situated within a framework of lawfulness, fairness and transparency.
Biological considerations suggest that renin-angiotensin system inhibitors might influence the severity of COVID-19. We aimed to evaluate whether continuing versus discontinuing renin-angiotensin ...system inhibitors (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) affects outcomes in patients admitted to hospital with COVID-19.
The REPLACE COVID trial was a prospective, randomised, open-label trial done at 20 large referral hospitals in seven countries worldwide. Eligible participants were aged 18 years and older who were admitted to hospital with COVID-19 and were receiving a renin-angiotensin system inhibitor before admission. Individuals with contraindications to continuation or discontinuation of renin-angiotensin system inhibitor therapy were excluded. Participants were randomly assigned (1:1) to continuation or discontinuation of their renin-angiotensin system inhibitor using permuted block randomisation, with allocation concealed using a secure web-based randomisation system. The primary outcome was a global rank score in which participants were ranked across four hierarchical tiers incorporating time to death, duration of mechanical ventilation, time on renal replacement or vasopressor therapy, and multiorgan dysfunction during the hospitalisation. Primary analyses were done in the intention-to-treat population. The REPLACE COVID trial is registered with ClinicalTrials.gov, NCT04338009.
Between March 31 and Aug 20, 2020, 152 participants were enrolled and randomly assigned to either continue or discontinue renin-angiotensin system inhibitor therapy (continuation group n=75; discontinuation group n=77). Mean age of participants was 62 years (SD 12), 68 (45%) were female, mean body-mass index was 33 kg/m
(SD 8), and 79 (52%) had diabetes. Compared with discontinuation of renin-angiotensin system inhibitors, continuation had no effect on the global rank score (median rank 73 IQR 40-110 for continuation vs 81 38-117 for discontinuation; β-coefficient 8 95% CI -13 to 29). There were 16 (21%) of 75 participants in the continuation arm versus 14 (18%) of 77 in the discontinuation arm who required intensive care unit admission or invasive mechanical ventilation, and 11 (15%) of 75 participants in the continuation group versus ten (13%) of 77 in the discontinuation group died. 29 (39%) participants in the continuation group and 28 (36%) participants in the discontinuation group had at least one adverse event (χ
test of adverse events between treatment groups p=0·77). There was no difference in blood pressure, serum potassium, or creatinine during follow-up across the two groups.
Consistent with international society recommendations, renin-angiotensin system inhibitors can be safely continued in patients admitted to hospital with COVID-19.
REPLACE COVID Investigators, REPLACE COVID Trial Social Fundraising Campaign, and FastGrants.
The usefulness of literature review in qualitative research and the humanities needs no elaboration for the readership of this journal. Yet, I would like to contribute to the discussion on ...‘systematic review’ started by Dr. Sally Thorne with her editorial published recently in Nursing Inquiry (Thorne, 2018). I thank Dr. Thorne for sharing her concerns and suggestions, as she foregrounds an important case regarding the status of superior scholarship attributed (erroneously) to that type of work. It also invites us to question the spurious hierarchy of reviews (systematic over narrative) and avoid possible misunderstandings related to the particular contribution that each can make.
Stigma constitutes a threat for professionals who work in mental health care, through their association with mental illness as a discrediting attribute. Together with nurses’ unclear self-perception, ...recent insights suggest that stigma may inform the apparent identity crisis within the mental health nursing profession.
This article explores how stigma may give meaning to mental health nursing identities. The nursing role is built upon official labels, a prime trigger of stigma. Therefore, due to nurses’ ambiguous relation with the psychiatric/medical care and their own stigma experiences due to their association with mental health problems, they can be considered as a stigmatizing, de-stigmatizing and stigmatized group. Dynamics which inform this intricate relation between stigma and mental health nursing identity are the focus of this article. Accordingly, this article points to the importance of including stigma in the overall study of mental health nursing identity.
This research uses a qualitative case-study design. Ethnographic data were gathered from 33 nurses in 4 wards in two psychiatric hospitals in the region of Ghent (Belgium).
Participant observation and semi-structured interviews were combined to access the meaning of being a mental health nurse in these specific care contexts and its possible interference with mental health stigma.
The findings suggest that tackling stigma is a particularly important personal motive for nurses to work in mental health care. The meaning of stigma is closely entangled with nurses’ troublesome relationship with the medical model of care. Variations between hospitals regarding the extent to which stigma informs the professional role constructs and identity of nurses are found to be related to the degree of formalization of the nursing roles in these different hospitals.
The present study points to the relevance of the integration of stigma in mental health nursing identity research. Furthermore, the focus on stigma may offer an opportunity to link contexts of illness and care, and nurses’ identity constructs.
La etnografía sociológica ha ganado mayor aceptación entre los sociólogos debido a su capacidad para comprender la vida cotidiana a un nivel microsocial. El pensamiento inductivo desempeña un papel ...crucial en la formulación teórica, ya que la recopilación de datos conduce al surgimiento de hipótesis y destaca conexiones con patrones universales. Sin embargo, la literatura etnográfica tiende a centrarse más en técnicas de observación y descuida otros métodos de campo. Para abordar esta laguna, este artículo analiza el uso de métodos visuales, como sociogramas y dibujos hechos por participantes, en un estudio de caso. Estas herramientas mejoraron la profundidad del significado en el proceso de investigación etnográfica.
El artículo pone en contexto las estadísticas de veinte años desde la despenalización de la eutanasia en Bélgica. En esta reconstrucción se analizan los aspectos centrales de la política, tales como ...su carácter democrático y la protección de la objeción de conciencia. A menudo discutido de forma aislada, este artículo plantea el fin de vida voluntario como parte de un programa paliativo que, a su vez, integra una visión más amplia, como se refleja en el paquete de regulaciones del año 2002. Además de delinear ciertas consecuencias deontológicas, entre otras, el artículo subraya el carácter excepcional de la eutanasia, limitándose a casos debidamente calificados de sufrimiento físico o psíquico, pero que de manera significativa reivindica el respecto de la autonomía de la persona. Con todo, el artículo invita a considerar códigos morales múltiples de cara a uno de los pocos eventos de los que tenemos certeza: la muerte.
For over 20 years, the notion of 'management of care' has been foregrounded as key in the jurisdiction of the nursing profession, with the aim of detaching itself from the wider medical umbrella. A ...number of voices have advocated such centrality. These include juridical, academic and occupational perspectives. Critical stances, although peripheral, have also been voiced. These have been received, at best, with a 'polite silence' in mainstream circles.By looking at the arguments surrounding the 'management of care' circulated in these two decades, this article reports the various forms of discursive practice that participate in the political process of autonomy building. Particularly, we focus on the validity of the arguments as well as the cohesion
arguments within the knowledge system. In doing so, we evaluate its main premises and foundations, the reach of the conceptualisation and its disjointed, differing and incomplete bases. Similarly, we used an inferential technique for the reconstruction of omitted and unexpressed assertions.The article introduces an approach of the humanities that is seldom seen in healthcare. It also proposes a research agenda in regard to management of care for the upcoming decades.
Sexual signaling is an important reproductive barrier known to evolve early during the formation of new species, but the genetic mechanisms that facilitate the divergence of sexual signals remain ...elusive. Here we isolate a gene linked to the rapid evolution of a signaling trait in a pair of nascent neotropical orchid bee lineages, Euglossa dilemma and E. viridissima. Male orchid bees acquire chemical compounds from their environment to concoct species-specific perfumes to later expose during courtship. We find that the two lineages acquire chemically distinct perfumes and are reproductively isolated despite low levels of genome-wide differentiation. Remarkably, variation in perfume chemistry coincides with rapid divergence in few odorant receptor (OR) genes. Using functional assays, we demonstrate that the derived variant of Or41 in E. dilemma is specific towards its species-specific major perfume compound, whereas the ancestral variant in E. viridissima is broadly tuned to multiple odorants. Our results show that OR evolution likely played a role in the divergence of sexual communication in natural populations.
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