In the United States and throughout the industrialized world, just as the population of older and sicker patients is about to explode, we have a major shortage of nurses. Why are so many RNs dropping ...out of health care's largest profession? How will the lack of skilled, experienced caregivers affect patients? These are some of the questions addressed by Suzanne Gordon's definitive account of the world's nursing crisis. InNursing against the Odds, one of North America's leading health care journalists draws on in-depth interviews, research studies, and extensive firsthand reporting to help readers better understand the myriad causes of and possible solutions to the current crisis.
Gordon examines how health care cost cutting and hospital restructuring undermine the working conditions necessary for quality care. She shows how the historically troubled workplace relationships between RNs and physicians become even more dysfunctional in modern hospitals. In Gordon's view, the public image of nurses continues to suffer from negative media stereotyping in medical shows on television and from shoddy press coverage of the important role RNs play in the delivery of health care.
Gordon also identifies the class and status divisions within the profession that hinder a much-needed defense of bedside nursing. She explains why some policy panaceas-hiring more temporary workers, importing RNs from less-developed countries-fail to address the forces that drive nurses out of their workplaces. To promote better care, Gordon calls for a broad agenda that includes safer staffing, improved scheduling, and other policy changes that would give nurses a greater voice at work. She explores how doctors and nurses can collaborate more effectively and what medical and nursing education must do to foster such cooperation. Finally, Gordon outlines ways in which RNs can successfully take their case to the public while campaigning for health care system reform that actually funds necessary nursing care.
Aims and objectives
To examine and present the success rate in relation to nurse‐led elective DCCV service in AF patients.
Background
As the incidence of AF increases healthcare settings will ...continue to face challenges in providing appropriate timely intervention. The provision of DCCV has primarily been medical‐led. Due to the increasing requirement of hospital beds, cost restriction and medical team stress the roles of nurse specialists have been driven to include elective DCCV.
Design
A systematic review with a narrative synthesis was undertaken.
Methods
The databases searched include the following: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, Clinical Key, Web of Science, Cochrane Library and HSE library website. A total of 187 articles were identified, and seven studies were included for synthesis. The EBL checklist was used to assess validity. The PRISMA checklist was used for transparency.
Results
The results of this review show an acceptable complication rate, no negative patient outcomes and a high rhythm conversion success rate. A disparity was identified due to the lack of distinction between registered nurse (RGN), advanced nurse practitioner (ANP), advanced practice provider (APP) and nurse practitioner (NP) roles. These results support the belief that a highly skilled nurse in this specific background working in a supportive organisational framework can make a valuable contribution to such practices.
Conclusion
A structured nurse‐led elective DCCV service appears safe, effective and has a high success rate in restoration to sinus rhythm in AF. However, the need for further research in order to advance knowledge and support changes in nurse‐led DCCV practice is evident.
Relevance to clinical practice
This review demonstrates that a nurse‐led elective DCCV service appears safe and successful in restoring sinus rhythm. It has promising potential effects in terms of waiting time, cost saving and achieving patient satisfaction.
This award-winning text guides nursing graduate students in developing the key skills they need to fulfill emerging leadership roles as our health care system experiences profound change and ...increasing complexity. The book provides a wealth of critical information, practical tools, creative vision, and inspiration that will help to facilitate leadership at the highest level of clinical practice. This second edition is expanded and updated to incorporate leadership challenges resulting from health care reform, changes in the current vision of health care, and innovations that foster leadership development. Two completely new chapters address transformational leadership regarding changing health care perspectives and emerging contexts for health care.
The text helps graduate students to master the skills they need to work effectively with interdisciplinary colleagues, address challenges within the confines of budget constraints, and resolve health care disparities and improve outcomes in all settings. With contributions from expert scholars and clinicians in the humanities, natural and social sciences, organizational studies, business, nursing, and other health care sciences, this inspirational text fulfills the DNP core competencies as described in the American Association of Colleges of Nursing (AACN) Essentials of DNP EducationThis award-winning text guides nursing graduate students in developing the key skills they need to fulfill emerging leadership roles as our health care system experiences profound change and increasing complexity. The book provides a wealth of critical information, practical tools, creative vision, and inspiration that will help to facilitate leadership at the highest level of clinical practice. This second edition is expanded and updated to incorporate leadership challenges resulting from health care reform, changes in the current vision of health care, and innovations that foster leadership development. Two completely new chapters address transformational leadership regarding changing health care perspectives and emerging contexts for health care. The text helps graduate students to master the skills they need to work effectively with interdisciplinary colleagues, address challenges within the confines of budget constraints, and resolve health care disparities and improve outcomes in all settings. With contributions from expert scholars and clinicians in the humanities, natural and social sciences, organizational studies, business, nursing, and other health care sciences, this inspirational text fulfills the DNP core competencies as described in the American Association of Colleges of Nursing (AACN) Essentials of DNP Education
Nursing is about growth, yet it spends so much time focusing on disease and entropy. While the nursing role is expanding into advanced practice roles, and twenty-first century nursing is almost ...unrecognisable compared to its nineteenth century roots, at the heart of nursing is growth. Sometimes called "caring", growth requires nurturing, and, while it is difficult to define, without it nurses are merely medical technicians. In the context of nursing, health is about change, change from a less healthy state to a more healthy state and the nurse's role is to promote that change whenever possible. However, change is difficult; we are creatures of habit, afraid of change, and preferring the illusion of safety with the "devil we know rather than the devil we don't know". However, when someone is ready to change, they have already grown.This book combines the author's twenty-five years of experience in Solution Focused Interactions and empirical evidence derived from his PhD research to argue that Solution Focused Interactions provide a means for nurses, in all domains of nursing and midwifery, to provide care that promotes growth and change in the people they work with, while restoring and maintaining their enthusiasm for practice. This book serves as an eminently practical introduction to how Solution Focused Interactions can be used across nursing practice, making use of transcripts and case studies to illustrate the ways in which nurses can help their patients to grow and change, while also growing and changing themselves.
The organizational environment can foster or impede full deployment of advance practice registered nurses (APRNs), affecting the quality of care and patient outcomes. Given the critical role APRNs ...play in health care, it is important to understand organizational factors that promote or hinder APRN practice to maximize the potential of this workforce in health care systems.
The aim of this study was to synthesize evidence about APRN practice environments, identify organizational facilitators and barriers, and make recommendations for better APRN utilization.
A literature search was conducted in CINAHL, PubMed, and PsychInfo, yielding 366 studies. No time or geographic limitations were applied. Study quality was appraised using the National Institutes of Health National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Studies.
Thirty studies conducted in the United States, Canada, and the Netherlands met inclusion criteria. The majority of the studies involved nurse practitioners. Facilitators to optimal practice environment were autonomy/independent practice and positive physician/APRN relations. Barriers included policy restrictions on practice, poor physician relations, poor administrator relations, and others' lack of understanding of the APRN role. Barriers correlate with job dissatisfaction and increased intent to leave job.
The review highlights the importance of physician and administration relations, organizational-level policies, and colleagues' understanding of the APRN role in promoting effective practice environments. Organizations should align policy reform efforts with factors that foster positive APRN practice environments to efficiently and effectively utilize this increasingly vital workforce. Future research is warranted.
This is the only professional issues-oriented Doctor of Nursing Practice (DNP) text to fully integrate all eight American Association of Colleges of Nursing DNP competencies into one volume. It ...defines practice scholarship for the DNP role and facilitates the sound development of key leadership skills that enable DNP graduates to effectively influence politics and health care policy in order to improve patient and population health care outcomes. The text focuses on the educational requirements of DNPs engaged in the arenas of leadership, health care policy, and information technology. It covers the growth and development of the DNP role, particularly in the context of contemporary health care challenges. With a focus on the Capstone Project, the text addresses the relationship of the DNP role to ongoing scholarship. It covers three important essentials of the DNP curriculumóevidence-based practice, health information technology, and outcomes measurementóand how they can be used to transform health care in the 21st century. The text's challenging and thought-provoking content is of particular value not only to students, but also to professors who will welcome the clarity it offers to the highly complex DNP curriculum.
To identify newly qualified nurses’ experiences during transition to professional practice, and explore their and other key stakeholders’ perceptions of nursing transition programmes.
Scoping review ...using the Arksey and O'Malley framework.
Several electronic databases were searched for relevant articles, which were supplemented by hand-searching and internet searches for grey literature. 1823 potentially relevant articles published between 1974 and 2019 were retrieved from the initial search, and an additional ten articles were obtained from the supplemental search. Each article was independently reviewed, leaving 60 articles eligible for inclusion in the review.
Two overarching themes emerged: 1) the transition experience; 2) the perceived benefits of nursing transition programmes. Evidence that nursing transition programmes positively impact the transition experience is inconclusive. Some studies suggest a positive impact on newly qualified nurses’ competency, level of confidence and attrition rates; others reported no impact. There was a general consensus that newly qualified nurses still encounter difficulties when transitioning into professional practice. Most articles found were quantitative in nature, focusing on measurable outcomes of nursing transition programmes. Few investigated the experiences and perceptions of newly qualified nurses, preceptors, and managers regarding the transition to professional practice.
Literature mapping suggests that newly qualified nurses frequently struggle to successfully complete the transition into professional practice, and that this transition is complex and multifaceted. There is limited evidence to justify the widespread implementation of nursing transition programmes. Additional research focusing on experiences and perceptions of newly qualified nurses and their transitory process is warranted.
Tweetable abstract: Are newly qualified nurses receiving sufficient transition support (e.g. #nursing residency programs or #preceptorship)? #Nurse #Nurses #nursing_intern
Aim
This study examined the influence of toxic and transformational leadership practices on nurses' job satisfaction, psychological distress, absenteeism and intent to leave the organisation or the ...nursing profession.
Background
Transformational leadership is attributed to favourable nurse consequences; however, the nursing literature is silent regarding the causal association between toxic leadership and nurses' job outcomes.
Methods
This is a cross‐sectional study involving 770 registered nurses from 15 hospitals in Central Philippines. Data were collected using seven self‐report scales during the months of December 2019 to February 2020.
Results
The composite scores for the transformational leadership scale and toxic leadership scale were 4.22 and 1.59, respectively. Toxic leadership predicted job satisfaction, absenteeism, psychological distress and intention to leave the profession. Transformational leadership predicted job satisfaction and intent to leave the profession.
Conclusion
Results suggest that nurses working with a transformational leader report higher job contentment and lower intent to leave the nursing profession. Nurses who work for a manager exhibiting toxic leadership behaviours demonstrated lower job contentment, higher stress levels, frequent absenteeism and higher intent to leave the nursing profession.
Implication for Nursing Management
Nurse retention strategies should include measures to foster transformational leadership and derail toxic leadership practices in nurse managers through evidence‐based education, training and professional development.
Aims
The aim of this study was to describe the nurse–patient relationships and to study how caring behaviours were described. The review question was: What factors influence the caring relationship ...between a nurse and patient?
Background
There is a growing perception that nurses fail to provide compassionate and competent care. Policy documents prescribe compassion as an essential aspect of care; however, the evidence drawn on remains unclear and without clear applications to practice.
Design
Umbrella review methodology, informed by the Joanna Briggs Institute guidelines, was employed and adapted to enable the inclusion of systematic reviews that were of sufficient methodological quality.
Data sources
An extensive PsychInfo, Pubmed, CINAHL, Scopus, WoS and Embase search was conducted for literature published from January 2000 ‐ March 2014. Key words included ‘nurse’, ‘patient’ and ‘relationship’ in combination with index terms to find literature published from 2000 onward.
Review methods
Critical appraisal, data extraction and synthesis were carried out according to existing guidelines for undertaking umbrella reviews.
Results
Twelve reviews (representing over 290 studies) were included following critical appraisal. Forty‐seven findings were extracted, resulting in 14 categories and six synthesized findings; ‘Expectations of the relationships’ ‘Values’, ‘Knowledge and skills’, ‘Communication’, ‘Context and environment’ and ‘The impact of the relationship’.
Conclusions
A substantial body of evidence demonstrates that both patients and nurses have expectations about the nature and importance of the caring relationship. Nurses should be mindful that their behaviours and attitudes need to align with what patients value about the relationship. Context shapes the relationship in positive and negative ways.
A single comprehensive reference for nursing leaders, leadership organizations, nursing clinicians, and educators, Nursing Leadership is the only compendium of nursing terminology in existence. ...Written by eminent nursing professionals, it provides descriptions of prominent individuals in nursing, information regarding nine leadership-related topics, and current trends in nurse leadership. This second edition has been expanded to encompass 80 new entries and revisions or updates to all original entries. It provides an extensive overview of current leadership issues including theories, characteristics, and skills required of nurse leaders in today's complex health care system. Highly respected contributors include Claire Fagan, Beverly Malone (NLN CEO), Polly Bednash (AACN CEO), Patricia Benner, and many others. For ease of use this new edition contains both alphabetic and thematic indexes, extensive cross-referencing, and print and web references for each entry.
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