Canadian journal of nursing administration
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In a qualitative, retrospective case study to identify, describe, and develop a theoretical analysis of perceived group process among female nursing educators/administrators, the term "conflict," as traditionally defined in discussions of "conflict management strategies," was rejected. The term did not readily fit with the management styles of the 27 female nurse educators and administrators. ⋯ In fact, conflict rejection was a specific administrative process identified as part of the successful working of the group over the three-year period studied. This finding indicates a break with traditional male-oriented literature and therefore may have implications for future research into conflict management strategies, especially into successful management strategies used by women and health care professionals.
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During the last two decades, knowledge has increased significantly regarding the treatment of acute pain. One of these advances has been the implementation of multidisciplinary Acute Pain Services in the hospital setting to take on accountability for acute pain management. Acute Pain Services are expanding rapidly in the Canadian health care system. ⋯ The purpose of this study was to examine the effectiveness of, and staff satisfaction with, one Canadian Acute Pain Service. Results of the study indicated that staff were generally satisfied with the Acute Pain Service and felt that the program had made a significant impact on the treatment of acute pain within the hospital; although improvements in pain outcomes were not noted. Adequate communication mechanisms and resources to allow for appropriate workload, education and clinical support are critical to the development and success of an Acute Pain Service.
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Randomized Controlled Trial Clinical Trial
Systematic implementation of an advance health care directive in the community.
In Canada, advance directives have been developed to ensure individual's decisions about health care are known in the event of mental incapacity. This randomized control trial examined the proportion of chronically ill elders receiving Victorian Order of Nurses (VON) services in the home who would complete an advance directive, factors associated with directive completion, treatment choices, and satisfaction with care. The participants consisted of 163 elders with a chronic illness residing within the Hamilton-Wentworth and Haldimand-Norfolk regions in South Central Ontario. ⋯ Younger patients (p = 0.01) and patients with particular nurses (p = 0.04) were more likely to complete a directive. Psychosocial variables such as mood, depression, and uncertainty in illness did not influence directive completion. Satisfaction with involvement in health care decisions was not changed by this intervention (p = 0.576).
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Nurses continue to struggle with the knowledge that practice within a conceptual context is imperative, yet operationalizing theory-based practice has been fraught with challenges and frustrations. It is timely, given the current environment, for nurses to reflect personally and collectively on the processes and meanings of nursing. Caring theories have been examined with increasing frequency recently, as nurse leaders and theorists explore the profession using alternative frames of reference. ⋯ Assumptions integral to the purpose of the project have been validated by staff response. Concepts and their relationships appear to achieve acceptance and be congruent with this nursing group's values and the way in which they practice. Observations to date indicate that collective development of a practice model is providing the means for growth and change in the institution's nursing practice.
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There is a belief in society that nursing is a profession and therefore that nurses are professional. There is also a belief that nurses care, that is, they care for their patients and consequently are a caring profession. ⋯ Where this is the case, can they still be considered individually a professional, and collectively a profession? Is there a connection between caring and profession? Can a nurse be one without the other? The assertion of this paper, is that to be a professional nurse, a nurse must care. "Caring" and "profession" are defined and the components for a model of a professional relationship proposed. Nurses are challenged to find ways in which to reclaim their professional status by recapturing their commitment to caring.