International Journal of Nursing Practice, Dec 1, 2006
The nurse-patient interaction is central to providing nursing care. This qualitative study explor... more The nurse-patient interaction is central to providing nursing care. This qualitative study explores nurses' and culturally diverse patients' experiences within nurse-patient relationships in acute care wards. Eight nurses and their respective patients volunteered to join the study and were interviewed. The three themes identified in relationships between nurses and culturally diverse patients were shared tension, perceived difference and held awareness. It is concluded from the study that relationships between nurses and culturally diverse patients in acute care wards during short episodes of hospitalization are not easy for nurses and need to receive deeper consideration as to how they can be developed more effectively. It is recommended that educational support be provided to develop more effective interactions between nurses and patients with research being carried out to investigate factors that can strengthen culturally diverse patient-nurse interactions in acute care settings.
Identification of nurses' experiences of caring for culturally di... more Identification of nurses' experiences of caring for culturally diverse patients in acute care settings contributes to transcultural nursing knowledge. This qualitative study aims to describe nurses' experiences of caring for culturally diverse adult patients on medical and surgical wards in an acute care setting. These experiences identify current practice and associated issues for nurses caring for culturally diverse clients. A purposive sample of ten registered nurses was interviewed and transcripts analysed. Main findings were acquiring cultural knowledge, committing to and engaging with culturally diverse patients. Strategies for change developed from these findings focus on increasing cultural competency of nurses by: implementing a formal education program; developing partnerships with patients and their families to increase cultural comfort; and increasing organisational accommodation of the culturally diverse with policy review and extension of resources. Further research to explore issues for bilingual nurses and to describe the experiences of culturally diverse patients and their families in general acute care settings is recommended.
To the nurse managers who volunteered to participate in this study. To Miss Jacqueline Britton an... more To the nurse managers who volunteered to participate in this study. To Miss Jacqueline Britton and Ms Brenda Hayman for their support with transcription and encoding in NVivo and Dr Joanne Cummings for editorial assistance. ABSTRACT Objective This study aimed to explore and describe nurse managers' experiences with a team‑based approach to nursing care in hospital settings. Design A qualitative descriptive study using interviews to explore managers' experiences of team nursing. Setting Medical and surgical wards in an acute care setting Participants Five nurse managers (four female and one male) who volunteered to participate following calls for 'expressions of interest' in three acute care hospitals Findings The team nursing experiences of nurse managers are described using three main categories: adapting to team nursing, gains with team nursing and concerns with team nursing. Conclusions Nurse managers considered gains for staff and patients were made with the implementation of a team‑based approach to nursing care. This team‑based approach to care was regarded by managers to enable nursing staff of varying experience and skill to provide care more safely as direct supervision by more experienced staff was possible. However the role of team leader necessitated staff development and support to enhance clinical leadership skills involved in this new role.
Objective: To describe the experiences of culturally diverse family members who make the decision... more Objective: To describe the experiences of culturally diverse family members who make the decision to stay with their relatives in acute care wards. Design: A qualitative descriptive study. Setting: Medical and surgical wards in an acute care hospital with a 70% non-English speaking background patient population. Subjects: Eight culturally diverse family members who stayed with their hospitalised relatives for at least four shifts or the equivalent hours. Method: In-depth interviews of approximately 45 minutes. Findings: Three main categories described the experience of family members. These categories were carrying out in-hospital roles, adhering to ward rules, and facing concerns. Conclusions: Findings indicate nurses and family members could benefit from negotiating active partnerships; family friendly ward environments need to be fostered, supported by appropriate policies; and further research is needed into culturally diverse family members' partnerships with nurses in acute care settings.
Journal of Midwifery & Women's Health, Jan 2, 2009
From recalled childbirth cases, a series of cues and related factors were previously identified t... more From recalled childbirth cases, a series of cues and related factors were previously identified that were used by midwives when making decisions to suture or not suture perineal and associated trauma incurred during spontaneous vaginal delivery. This study aimed to determine the validity of these cues and related factors. A panel of 18 experienced midwives evaluated their content validity using the criteria of "necessity" and "sufficiency." The two main cue categories-"bleeding" and "birth trauma"-were considered by 18 (100%) of the panel members to be necessary to assess. At least 16 (89%) panel members considered the following specific cues necessary to assess: in the bleeding category-type, flow, amount, and effect of application of pressure or ice; in the birth trauma category-trauma sites, trauma types, dimensions of trauma, types of tissue, alignment of tissue, edema, and bruising. Seventeen (94%) panel members considered seven woman-centred related factors that were necessary to assess and 14 (78%) considered the combination of all cues in bleeding, birth trauma, and related factors sufficient for making the decision to suture or not. The availability of these validated cues and related factors has the potential to guide a comprehensive assessment on which the decision to suture or not suture depends. This addition to the domain of midwifery knowledge enables educational preparation of midwives who will have the capacity to more adequately support women in childbirth.
Nurses’ experiences of making decisions to call emergency assistance to their patients Patient su... more Nurses’ experiences of making decisions to call emergency assistance to their patients Patient survival often depends on decisions by nurses to call emergency assistance. The experiences of nurses calling emergency assistance have not been described. This descriptive study explored the experiences of registered nurses (n=32) using unstructured interviews. The main findings were that nurses questioned whether they were doing the ‘right thing’ calling the emergency team, sometimes collaborated with others prior to calling and most felt nervous and anxious. They recognized patient deterioration from feelings they had that something was wrong. However, they were not able ‘to put their finger on it’. Knowing the patient and past experiences were involved in the recognition of deterioration. This association indicates the importance of experience in the development of clinical decision‐making skills. Further, nurses calling emergency assistance need to be provided with the opportunity to debrief after calling. Their heavy reliance on subjective data before searching for objective data as outlined in the emergency calling criteria suggests that it is essential that nurses do not devalue or ignore concerns they may have about patients.
International Journal of Nursing Practice, Dec 1, 2006
The nurse-patient interaction is central to providing nursing care. This qualitative study explor... more The nurse-patient interaction is central to providing nursing care. This qualitative study explores nurses' and culturally diverse patients' experiences within nurse-patient relationships in acute care wards. Eight nurses and their respective patients volunteered to join the study and were interviewed. The three themes identified in relationships between nurses and culturally diverse patients were shared tension, perceived difference and held awareness. It is concluded from the study that relationships between nurses and culturally diverse patients in acute care wards during short episodes of hospitalization are not easy for nurses and need to receive deeper consideration as to how they can be developed more effectively. It is recommended that educational support be provided to develop more effective interactions between nurses and patients with research being carried out to investigate factors that can strengthen culturally diverse patient-nurse interactions in acute care settings.
Identification of nurses' experiences of caring for culturally di... more Identification of nurses' experiences of caring for culturally diverse patients in acute care settings contributes to transcultural nursing knowledge. This qualitative study aims to describe nurses' experiences of caring for culturally diverse adult patients on medical and surgical wards in an acute care setting. These experiences identify current practice and associated issues for nurses caring for culturally diverse clients. A purposive sample of ten registered nurses was interviewed and transcripts analysed. Main findings were acquiring cultural knowledge, committing to and engaging with culturally diverse patients. Strategies for change developed from these findings focus on increasing cultural competency of nurses by: implementing a formal education program; developing partnerships with patients and their families to increase cultural comfort; and increasing organisational accommodation of the culturally diverse with policy review and extension of resources. Further research to explore issues for bilingual nurses and to describe the experiences of culturally diverse patients and their families in general acute care settings is recommended.
To the nurse managers who volunteered to participate in this study. To Miss Jacqueline Britton an... more To the nurse managers who volunteered to participate in this study. To Miss Jacqueline Britton and Ms Brenda Hayman for their support with transcription and encoding in NVivo and Dr Joanne Cummings for editorial assistance. ABSTRACT Objective This study aimed to explore and describe nurse managers' experiences with a team‑based approach to nursing care in hospital settings. Design A qualitative descriptive study using interviews to explore managers' experiences of team nursing. Setting Medical and surgical wards in an acute care setting Participants Five nurse managers (four female and one male) who volunteered to participate following calls for 'expressions of interest' in three acute care hospitals Findings The team nursing experiences of nurse managers are described using three main categories: adapting to team nursing, gains with team nursing and concerns with team nursing. Conclusions Nurse managers considered gains for staff and patients were made with the implementation of a team‑based approach to nursing care. This team‑based approach to care was regarded by managers to enable nursing staff of varying experience and skill to provide care more safely as direct supervision by more experienced staff was possible. However the role of team leader necessitated staff development and support to enhance clinical leadership skills involved in this new role.
Objective: To describe the experiences of culturally diverse family members who make the decision... more Objective: To describe the experiences of culturally diverse family members who make the decision to stay with their relatives in acute care wards. Design: A qualitative descriptive study. Setting: Medical and surgical wards in an acute care hospital with a 70% non-English speaking background patient population. Subjects: Eight culturally diverse family members who stayed with their hospitalised relatives for at least four shifts or the equivalent hours. Method: In-depth interviews of approximately 45 minutes. Findings: Three main categories described the experience of family members. These categories were carrying out in-hospital roles, adhering to ward rules, and facing concerns. Conclusions: Findings indicate nurses and family members could benefit from negotiating active partnerships; family friendly ward environments need to be fostered, supported by appropriate policies; and further research is needed into culturally diverse family members' partnerships with nurses in acute care settings.
Journal of Midwifery & Women's Health, Jan 2, 2009
From recalled childbirth cases, a series of cues and related factors were previously identified t... more From recalled childbirth cases, a series of cues and related factors were previously identified that were used by midwives when making decisions to suture or not suture perineal and associated trauma incurred during spontaneous vaginal delivery. This study aimed to determine the validity of these cues and related factors. A panel of 18 experienced midwives evaluated their content validity using the criteria of "necessity" and "sufficiency." The two main cue categories-"bleeding" and "birth trauma"-were considered by 18 (100%) of the panel members to be necessary to assess. At least 16 (89%) panel members considered the following specific cues necessary to assess: in the bleeding category-type, flow, amount, and effect of application of pressure or ice; in the birth trauma category-trauma sites, trauma types, dimensions of trauma, types of tissue, alignment of tissue, edema, and bruising. Seventeen (94%) panel members considered seven woman-centred related factors that were necessary to assess and 14 (78%) considered the combination of all cues in bleeding, birth trauma, and related factors sufficient for making the decision to suture or not. The availability of these validated cues and related factors has the potential to guide a comprehensive assessment on which the decision to suture or not suture depends. This addition to the domain of midwifery knowledge enables educational preparation of midwives who will have the capacity to more adequately support women in childbirth.
Nurses’ experiences of making decisions to call emergency assistance to their patients Patient su... more Nurses’ experiences of making decisions to call emergency assistance to their patients Patient survival often depends on decisions by nurses to call emergency assistance. The experiences of nurses calling emergency assistance have not been described. This descriptive study explored the experiences of registered nurses (n=32) using unstructured interviews. The main findings were that nurses questioned whether they were doing the ‘right thing’ calling the emergency team, sometimes collaborated with others prior to calling and most felt nervous and anxious. They recognized patient deterioration from feelings they had that something was wrong. However, they were not able ‘to put their finger on it’. Knowing the patient and past experiences were involved in the recognition of deterioration. This association indicates the importance of experience in the development of clinical decision‐making skills. Further, nurses calling emergency assistance need to be provided with the opportunity to debrief after calling. Their heavy reliance on subjective data before searching for objective data as outlined in the emergency calling criteria suggests that it is essential that nurses do not devalue or ignore concerns they may have about patients.
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