International journal of nursing practice
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This article aims to assist nursing services to use the Ottawa Charter as a framework for nursing practice. Incorporation of the Ottawa Charter for Health Promotion into a nursing structure constitutes an innovation in nursing practice that was evaluated as a quality improvement exercise in a health-care organization responsible for providing services in the area of alcohol and other drugs. The evaluation consisted of two stages and sought to identify the degree to which the framework was effective in practice. ⋯ The data collected was both informative and enlightening and revealed a range of pertinent issues such as staff understanding and interpretation of the Ottawa Charter, expansion of the nurse's role and suggestions for organizational change. The Ottawa Charter strategies are discussed in relation to their relevance to the organization under evaluation and also expanded into recommendations to assist those contemplating using the Ottawa Charter as a framework for nursing practice. There was considerable agreement among the respondents that the Ottawa Charter provided a useful framework for nursing practice but was on occasions problematic.
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I begin this paper by setting out the importance of the Two Cultures debate, given that many nurse authors would agree with Closs's position that the art versus science debate should be closed finally. I suggest that issues are every bit as present and urgent in our current era as they were in the past. ⋯ I then focus on nursing's current understanding of science and art and attempt to defend science from some of the accusations levelled at it, while also questioning some of the claims made on behalf of the arts. In the latter sections of the paper, I make a case for the development of 'nursing humanities' and argue the vital importance of overcoming the Two Cultures divide for the everyday practices of nurses and midwives.
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Burnout is a major contributor to shortages of experienced nurses. The research literature shows a correlation between moral distress and burnout in critical care nurses. This paper reports on part of an interpretive interactionist study concerning nurses' experiences of moral distress which prompted attempts to advocate for vulnerable patients. ⋯ When attempts at advocacy were unsuccessful, the nurses experienced intensified moral distress, frustration and anger. Being an unsuccessful advocate resulted in nurses being relocated within the hospital, nurses being scapegoated and/or burning out. The theoretical links which this paper makes between advocacy, moral distress and burnout are supported by empirical data from the study.
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In a study using unstructured interviews to explore nurses' understanding and interpretations of caring in nursing, one of the major themes emerging from the data is that through caring for patients, nurses discover the meaning and nature of nursing and what it means for them to be nurses. In the process of caring for patients, nurses further develop and understand the knowledge and skill of caring which constitutes the knowledge base of nursing. The data also show that nurses, in their practice, continue to define, develop and shape the meaning and knowledge of caring in nursing. From the evidence of this study, this paper argues that caring can be considered as the ontological and epistemological foundations of nursing.