"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' ...Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions."-from the Introduction
In a series of provocative essays,The Complexities of Carerejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.
The authors undertook a descriptive analysis review to gain a better understanding of the various approaches to and outcomes of team training initiatives in prelicensure curricula since 2000.
In July ...and August 2014, the authors searched the MEDLINE, PsycINFO, Embase, Business Source Premier, and CINAHL databases to identify evaluative studies of team training programs' effects on the team knowledge, communication, and skills of prelicensure students published from 2000 to August 2014. The authors identified 2,568 articles, with 17 studies meeting the selection criteria for full text review.
The most common study designs were single-group, pre/posttest studies (n = 7), followed by randomized controlled or comparison trials (n = 6). The Situation, Background, Assessment, Recommendation communication tool (n = 5); crisis resource management principles (n = 6); and high-fidelity simulation (n = 4) were the most common curriculum bases used. Over half of the studies (n = 9) performed training with students from more than one health professions program. All but three used team performance assessments, with most (n = 8) using observed behavior checklists created for that specific study. The majority of studies (n = 16) found improvements in team knowledge, communication, and skills.
Team training appears effective in improving team knowledge, communication, and skills in prelicensure learners. Continued exploration of the best method of team training is necessary to determine the most effective way to move forward in prelicensure interprofessional team education.
The full participation of women as healthcare providers is recognized globally as critical to favorable outcomes at all levels, including the healthcare system, to achieving universal health coverage ...and sustainable development goals (SDGs) by 2030. However, systemic challenges, gender biases, and inequities exist for women in the global healthcare workforce. Fragile and conflict-affected states/countries (FCASs) experience additional pressures that require specific attention to overcome challenges and disparities for sustainable development. FCASs account for 42% of global deaths due to communicable, maternal, perinatal, and nutritional conditions, requiring an appropriate health workforce. Consequently, there is a need to understand the impact of gender on workforce participation, particularly women in FCASs. This scoping review examined the extent and nature of existing literature, as well as identified factors affecting women's participation in the health workforce in FCASs. Following Arksey and O'Malley's scoping review methodology framework, a systematic search was conducted of published literature in five health sciences databases and grey literature. Two reviewers independently screened the title and abstract, followed by a full-text review for shortlisted sources against set criteria. Of 4284, 34 sources were reviewed for full text, including 18 primary studies, five review papers, and 11 grey literature sources. In most FCASs, women predominate in the health workforce, concentrated in nursing and midwifery professions; medicine, and the decision-making and leadership positions, however, are occupied by men. The review identified several constraints for women, related to professional hierarchies, gendered socio-cultural norms, and security conditions. Several sources highlight the post-conflict period as a window of opportunity to break down gender biases and stereotypes, while others highlight drawbacks, including influences by consultants, donors, and non-governmental organizations. Consultants and donors focus narrowly on programs and interventions solely serving women's reproductive health rather than taking a comprehensive approach to gender mainstreaming in planning human resources during the healthcare system's restructuring. The review identified multiple challenges and constraints facing efforts to create gender equity in the health workforce of FCASs. However, without equal participation of women in the health workforce, it will be difficult for FCASs to make progress towards achieving the SDG on gender equality.
Technology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional ...regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited. To examine the impact of technology and digitalization on regulation, we conducted an exploratory case study of the regulatory bodies for nursing, law, and social work in Ontario, Canada. Data were collected over two phases. First, we collected documents from the regulators' websites and regulatory consortiums. Second, we conducted key informant interviews with two representatives from each regulator. Data were thematically analyzed to explore the impact of technological change on regulatory activities and policies and to compare how regulatory structure and field shape this impact. Five themes were identified in our analysis: balancing efficiency potential with risks of certain technological advances; the potential for improving regulation through data analytics; considering how to regulate a technologically competent workforce; recalibrating pandemic emergency measures involving technology; and contemplating the future of technology on regulatory policy and practice. Regulators face ongoing challenges with providing equity-based approaches to regulating virtual practice, ensuring practitioners are technologically competent, and leveraging regulatory data to inform decision-making. Policymakers and regulators across Canada and internationally should prioritize risk-balanced policies, guidelines, and practice standards to support professional practice in the digital era.
Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense ...pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry-to-practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care.
This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions.
Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation.
This protocol is registered with the Open Science Framework ( https://doi.org/10.17605/OSF.IO/BD2ZX ).
ABSTRACT Objectives: to analyze theoretical conceptions of Eliot Freidson’s Sociology of Professions scoped on health and nursing professions. Methods: Eight nurses were interviewed, all involved in ...the development of the professional Council on the timeframe from 1975 to 1986. Documental resources were Laws, Ordinances, Resolutions, Reports, Meeting Minutes and Public Deeds. Information was organized as from literature and Eliot Freidson’s conceptions, and thematic content analysis was carried out. Results: the concepts authored by Eliot Freidson allowed for the development of a concept chart that portrays the nursing profession and that may be expanded for the other occupations in the health field, in consonance with professional organization in the country. Final Considerations: Eliot Freidson’s framework, in interpretation for nursing, consolidates the profession with relative autonomy, expertise by Nursing Care Systematization and credentialism by professional normalizations.
RESUMEN Objetivos: analizar las concepciones teóricas de la Sociología de las Profesiones de Eliot Freidson para el alcance de las profesiones de salud y enfermería. Métodos: estudio sociohistórico cualitativo, con fuentes orales y documentales. Se entrevistó a ocho enfermeras involucradas en el desarrollo del Consejo Profesional en el período de 1975 a 1986. Los documentales fueron Leyes, ordenanzas, resoluciones, informes, actas de reuniones y escrituras públicas. La información se organizó a partir de la literatura y las concepciones de Eliot Freidson, y se realizó un análisis de contenido temático. Resultados: los conceptos emitidos por Eliot Freidson permitieron la creación de un marco conceptual que represente a la profesión de enfermería, que podría ampliarse a otras profesiones de la salud, en línea con la organización profesional del país. Consideraciones Finales: el marco de Eliot Freidson, en interpretación de enfermería, consolida la profesión con relativa autonomía, experiencia en Sistematización de la Atención de Enfermería y credencialismo en los estándares profesionales.
RESUMO Objetivos: analisar as concepções teóricas da Sociologia das Profissões de Eliot Freidson para o âmbito das Profissões da Saúde e da Enfermagem. Métodos: estudo qualitativo sócio-histórico, com fontes orais e documentais. Foram entrevistados oito enfermeiros envolvidos no desenvolvimento do Conselho profissional no recorte temporal de 1975 a 1986. As documentais foram Leis, Portarias, Resoluções, Relatórios, Atas de Reuniões e Escrituras Públicas. As informações foram organizadas a partir da literatura e concepções de Eliot Freidson, e realizada análise de conteúdo temática. Resultados: os conceitos emitidos por Eliot Freidson permitiram a criação de um Quadro conceitual que representa a Profissão Enfermagem, podendo ser ampliado para as demais profissões da área da Saúde, em consonância com a organização profissional no país. Considerações Finais: o referencial de Eliot Freidson, em interpretação para a Enfermagem, consolida a profissão com autonomia relativa, expertise pela Sistematização da Assistência de Enfermagem e credencialismo pelas normalizações profissionais.
Technology is transforming service delivery in many health professions, particularly with the rapid shift to virtual care during the COVID-19 pandemic. Health profession regulators must navigate ...legal and ethical complexities to facilitate virtual care while upholding their mandate to protect the public interest. The objectives of this scoping review were to examine how the public interest is protected when regulating health professionals who provide virtual care, discuss policy and practice implications of virtual care, and make recommendations for future research. We searched six multidisciplinary databases for academic literature published in English between January 2015 and May 2021. We also searched specific databases and websites for relevant grey literature. After screening, 59 academic articles and 18 grey literature sources were included for analysis. We identified five key findings: the public interest when regulating health professionals providing virtual care was only implicitly considered in most of the literature; when the public interest was discussed, the dimension of access was emphasized; criticism in the literature focused on social ideologies driving regulation that may inhibit more widespread use of virtual care; subnational licensure was viewed as a barrier; and the demand for virtual care during COVID-19 catalyzed licensure and scope of practice changes. Overall, virtual care introduces new areas of risk, potential harm, and inequity that health profession regulators need to address as technology continues to evolve. Regulators have an essential role in providing clear standards and guidelines around virtual care, including what is required for competent practice. There are indications that the public interest concept is evolving in relation to virtual care as regulators continue to balance public safety, equitable access to services, and economic competitiveness.
In the nineteenth century, more than a third of American hospitals were established and run by women with religious vocations. InSay Little, Do Much, Sioban Nelson casts light on the work of these ...women's religious communities. According to Nelson, the popular view that nursing invented itself in the second half of the nineteenth century is historically inaccurate and dismissive of the major advances in the care of the sick as a serious and skilled activity, an activity that originated in seventeenth-century France with Vincent de Paul's Daughters of Charity. In this comparative, contextual, and critical work, Nelson demonstrates how modern nursing developed from the complex interplay of the Catholic emancipation in Britain and Ireland, the resurgence of the Irish Church, the Irish diaspora, and the mass migrations of the German, Italian, and Polish Catholic communities to the previously Protestant strongholds of North America and mainland Britain. In particular, Nelson follows the nursing Daughters of Charity through the French Revolution and the Second Empire, documenting the relationship that developed between the French nursing orders and the Irish Catholic Church during this period. This relationship, she argues, was to have major significance for the development of nursing in the English-speaking world.
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