Journal of advanced nursing
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This is the second of two linked papers exploring decision making in nursing. The first paper, 'Classifying clinical decision making: a unifying approach' investigated difficulties with applying a range of decision-making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks. ⋯ This is particularly important as nurses' roles continue to expand to embrace elements of managerial, medical and therapeutic work. Analysing nurses' decisions as classification behaviour will also enhance clinical effectiveness, and assist in making nurses' expertise more visible. In addition, the classification framework explodes the myth that intuition, traditionally associated with nurses' decision making, is less rational and scientific than other approaches.
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This is the first of two linked papers exploring decision making in nursing which integrate research evidence from different clinical and academic disciplines. Currently there are many decision-making theories, each with their own distinctive concepts and terminology, and there is a tendency for separate disciplines to view their own decision-making processes as unique. Identifying good nursing decisions and where improvements can be made is therefore problematic, and this can undermine clinical and organizational effectiveness, as well as nurses' professional status. ⋯ An alternative approach based on a general model of classification is then presented in detail to introduce its terminology and the unifying framework for interpreting all types of decisions. The classification model is used to provide the context for relating alternative philosophical approaches and to define decision-making activities common to all clinical domains. This may benefit nurses by improving multidisciplinary collaboration and weakening clinical elitism.
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Grade mix within the district nursing team in the United Kingdom has changed markedly over the last 10 years but the relationship between grade mix and skill mix has received only intermittent research attention. This study adopted an ethnographic approach and aimed to explore the way in which grade and skill are taken into account in the delegation of nursing care. ⋯ The developing role of nursing auxiliaries is discussed in relation to the role of the G grade sister, resource constraints and the standards of patient care. The paper concludes by arguing that the supervision and leadership role provided by the G grade sister should be fully recognized and safeguarded.
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Comparative Study
English nursing and medical students' attitudes towards organ donation.
The purpose of the study reported in this paper was to examine nursing and medical students' attitudes towards organ and corneal donation. A sample of 72 nursing and medical degree students from a British University, completed a 61-item self-administered quantitative questionnaire, adapted by Kent and Owens (1995) from an original tool devised by Parisi and Katz (1986). The findings revealed that all but one of the respondents had an overall positive attitude towards organ donation; a significant relationship was found to exist between the extent of this positive attitude held by each student and their personal willingness to donate organs. ⋯ Overall, the study revealed that although this group of student nurses seem to be in favour of organ donation, with many willing to sign a donor card, doubts still exist in the medical student group. Further work is required to understand this phenomena. A comparison of the data with an earlier study completed by Kent and Owens (1995) indicate that student nurses may have a more positive orientation to donation than qualified staff.