scholarly journals Rural nurse to nurse practitioner: an ad hoc process

2011 ◽  
Vol 3 (1) ◽  
pp. 23 ◽  
Author(s):  
Jenny Carryer ◽  
Julie Boddy ◽  
Claire Budge
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Policy Development ◽  
Ad Hoc ◽  
Demographic Data ◽  
Unmet Need ◽  
Rural Location ◽  
History Of ◽  
Rural Nurse ◽  
Descriptive Survey

INTRODUCTION: Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rural nurse to NP in NZ. METHOD: A qualitative descriptive survey was sent to all NZ nurses with a rural address. Ninety-two questionnaires were returned, of which 21 respondents were working in a rural location and aiming to become an NP. Data analysis included description of demographic data and thematic analysis of open-ended question responses. FINDINGS: Four themes encompassed the experiences of the 21 potential NP candidates: uncertainty about opportunities for employment as an NP and legislative and funding barriers for NP practice; support or resistance from GPs and nurse colleagues, self-doubt, and the importance of mentoring; difficulties with the NP authorisation process; and meeting the NP competencies within the challenges imposed by rural location. CONCLUSION: At the systems level of workforce design, stronger linkages between policy development, investment, employment creation, funding streams, professional regulation and overall communication require attention. KEYWORDS: Rural health; nurse practitioners; workforce; health policy

The Development of Nurse Practitioner Preparation beyond the Master's Level: What is the Debate About?

2010 ◽  
Vol 7 (1) ◽  
Author(s):  
Kelly Brar ◽  
Geertje Boschma ◽  
Fairleth McCuaig
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
The United States ◽  
Master's Level ◽  
Close Attention ◽  
Doctor Of Nursing Practice ◽  
History Of ◽  
Doctor Of Philosophy ◽  
Career Options ◽  
Practice Doctorate

The nursing discipline in the United States (US) has a history of creating various doctorates. One such degree, the Doctor of Nursing Practice (DNP), serves as an alternative to the traditional Doctor of Philosophy (PhD) degree for Nurse Practitioners (NPs) exploring career options. The availability of the DNP has sparked a debate within the profession: close attention to the issues is warranted for any school considering the development of a DNP program. However, some of these issues are not applicable, or apply differently to other contexts including Canada, where the highest level of education for an NP is a PhD. This article will review the history of doctoral education in both countries, compare the practice-focused and research-focused doctorates, discuss the issues of debate, and explore implications for NP practice. To fully inform the decision of the NP, we recommend further research to explore the need for a practice doctorate.

scholarly journals The status of Australian nurse practitioners: the second national census

2011 ◽  
Vol 35 (4) ◽  
pp. 448 ◽  
Author(s):  
Sandy Middleton ◽  
Anne Gardner ◽  
Glenn Gardner ◽  
Phillip R. Della
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Demographic Data ◽  
Healthcare Delivery ◽  
Political Support ◽  
Clinical Protocols ◽  
Clinical Role ◽  
Census Methods ◽  
The Status ◽  
Health Legislation

Objectives. To profile Australian nurse practitioners and their practice in 2009 and compare results with a similar 2007 census. Methods. Self-administered questionnaire. Results. A total of 293 nurse practitioners responded (response rate 76.3%). The majority were female (n = 229, 81.2%); mean age was 47.3 years (s.d. = 8.1). As in 2007, emergency nurse practitioners represented the largest clinical specialty (n = 63, 30.3%). A majority practiced in a metropolitan area (n = 133, 64.3%); a decrease from 2007. Consistent with 2007, only 71.5% (n = 208) were employed as a nurse practitioner and 22.8% (n = 46) were awaiting approval for some or all of their clinical protocols. Demographic data, allocations of tasks, and patterns of practice remained consistent with 2007 results. ‘No Medicare provider number’ (n = 182, 91.0%), ‘no authority to prescribe using the Pharmaceutical Benefits Scheme’ (n = 182, 89.6%) and ‘lack of organisational support’ (n = 105, 52.2%) were reported as ‘limiting’ or ‘extremely limiting’ to practice. Conclusions. Our results demonstrate less than satisfactory uptake of the nurse practitioner role despite authorisation. Barriers constraining nurse practitioner practice reduced but remained unacceptably high. Adequate professional and political support is necessary to ensure the efficacy and sustainability of this clinical role. What is known about the topic? The nurse practitioner is a developing new model of healthcare delivery that performs an advanced clinical role and is becoming increasingly important in the overburdened Australian healthcare system. Our census conducted in 2007 indicated that nurse practitioners perceived many barriers to their practice and were underutilised in the Australian healthcare workforce, specifically because of their inability to prescribe medications. What does this paper add? This paper provides a second census of Australian nurse practitioners in 2009. Similar to the results in 2007, the study indicates that nurse practitioners remain underutilised, with many unable to perform roles within their defined scope of practice because of limitations, such as inability to prescribe medications, lack of a Medicare provider number and awaiting approval for clinical protocols. Lack of support from within healthcare organisations and the nursing profession also were found. What are the implications for practitioners? Nurse practitioners are not being utilised to their maximum clinical capacity despite increasing pressures on the health system. Many of the barriers to nurse practitioner practice that were flagged in 2007 remained issues in 2009. It is hoped the current legislative reform through the Health Legislation Amendment (Midwives and Nurse Practitioners) Act 2010 (Cth) will adequately address these issues.

Perceived barriers to rural nurse practitioner practice

2001 ◽  
Vol 5 (4) ◽  
pp. 218-221 ◽  
Author(s):  
Linda L. Lindeke ◽  
Theresa R. Bly ◽  
Rachel A. Wilcox
Keyword(s):  
Nurse Practitioner ◽  
Perceived Barriers ◽  
Rural Nurse

Small talk as work talk: Enacting the patient-centered approach in nurse-practitioner-patient visits

2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Visit ◽  
Patient Centered ◽  
Small Talk ◽  
Medical Visits ◽  
Relational Work ◽  
The Us ◽  
The Individual ◽  
Patient Relationships

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.

Efficacy of Thiol disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy

2020 ◽  
Vol 23 ◽  
Author(s):  
Gökhan Akkurt ◽  
Burcu Akkurt ◽  
Emel Alptekın ◽  
Birkan Birben ◽  
Mehmet Keşkek ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Demographic Data ◽  
Previous History ◽  
Significant Negative Correlation ◽  
White Blood Count ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Duration Of Surgery ◽  
History Of

Aim: The aim of this study is to investigate the efficacy of thiol disulfide homeostasis and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be encountered during laparoscopic cholecystectomy. Materials and Methods: The study included 65 patients who underwent laparoscopic cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT), amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gallbladder, duration on hospital stay, duration of operation, thiol disulfide and IMA values were evaluated. Results: Native thiol and total thiol averages were higher in patients without a history of cholecystitis, on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate, native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis. While there was a statistically significant negative correlation between native and total thiol values and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of intraoperative pericholecystic adhesion increased. Conclusion: We believe that the evaluation of thiol disulfide homeostasis and IMA parameters prior to laparoscopic cholecystectomy can be used as an effective method for predicting intraoperative difficulties.

Writing and Ritual in Deuteronomy 28

2017 ◽  
Author(s):  
Laura Quick
Keyword(s):  
Ad Hoc ◽  
Comparative Method ◽  
Literary Texts ◽  
History Of ◽  
Important Means ◽  
Written Word ◽  
Ritual Process ◽  
Different Cultures ◽  
Ritual Context

This chapter argue that ritual behaviours might be just as good a source as literary texts for the diffusion of traditional cursing and treaty material across different cultures in the ancient Near East. In particular, the role of ad hoc oral Targum in the ritual process could have been an important means by which traditions were shared between different language communities. Recognition of the ritual context of this material also provides insights for the comparative method, the dating and authorship of Deuteronomy 28, and the subversive impetus thought to have stood behind its composition. Ultimately, the function of the written word in a largely oral world is shown to be fundamental to understanding the composition, function and the early history of the curses in the book of Deuteronomy.

scholarly journals National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer

2017 ◽  
Vol 35 (34) ◽  
pp. 3800-3806 ◽  
Author(s):  
Christopher P. Childers ◽  
Kimberly K. Childers ◽  
Melinda Maggard-Gibbons ◽  
James Macinko
Keyword(s):  
Ovarian Cancer ◽  
Genetic Testing ◽  
Unmet Need ◽  
Cancer Control ◽  
The United States ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Age Of Diagnosis ◽  
History Of ◽  
Interview Survey

Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.

The Relevance of Old World Archaeology to the First Entry of Man into New Worlds: Colonization Seen from the Antipodes

1977 ◽  
Vol 8 (1) ◽  
pp. 128-148 ◽  
Author(s):  
Sylvia J. Hallam
Keyword(s):  
Demographic Data ◽  
Ecological Zones ◽  
The North ◽  
Technological Potential ◽  
The Pacific ◽  
Peopling Of The Americas ◽  
Rapid Spread ◽  
History Of ◽  
Economic Innovation ◽  
Considerable Complexity

Following several discussions in recent numbers of Quaternary Research on the peopling of the Americas, this paper suggests that movements into the New World should be viewed in the wider context of subsistence, technology, and movement around the western littorals of the Pacific, resulting in the colonization not of one but of two new continents by men out of Asia. Specific points which have been raised by these recent papers are reviewed in the light of Australian, Wallacian, and East Asian data.(1) The earliness of watercraft is evidenced by chronology of the human diaspora through Wallacia and Greater Australia.(2) The simplistic nomenclature of chopper-flake traditions masks considerable complexity and technological potential, revealed in detailed Antipodean studies.(3) These traditions also have great potential for adapting to differing ecological zones, evidenced within Greater Australia; and for technological and economic innovation there, through Southeast Asia, and to Japan and the north Asian littoral.(4) The history of discovery and the nature of the evidence from Australia cannot validly be used to controvert early dates in the Americas.(5) Demographic data from Australia suggest that total commitment to a rapid-spread “bowwave” model for the peopling of new continents may be unwise.

scholarly journals Factors Related to Intentions to Commit Dating Violence among Taiwanese University Students: Application of the Extended Theory of Planned Behavior

2021 ◽  
Vol 18 (4) ◽  
pp. 1956
Author(s):  
Chung-Ying Lin ◽  
Ying-Hua Tseng ◽  
Mei-Ling Lin ◽  
Wen-Li Hou
Keyword(s):  
Theory Of Planned Behavior ◽  
University Students ◽  
Family Violence ◽  
Planned Behavior ◽  
Dating Violence ◽  
Safety Issue ◽  
Demographic Data ◽  
Subjective Norms ◽  
Gender Stereotyping ◽  
History Of

Dating violence (DV) constitutes a major public health and safety issue worldwide; however, only limited research into this important subject has been conducted in Taiwan. This study examined university students’ intention to commit DV, based on the expanded theory of planned behavior (TPB), with a history of family violence and gender stereotyping also included as further factors in the original TPB model. A total random sample consisting of 450 university students from four universities in four regions in Taiwan, namely, the northern, southern, central, and eastern regions, participated. Of these participants, 365 (81.1%) completed all of the parts of the questionnaires, which included a survey of demographic data, such as any history of family violence; a gender stereotyping questionnaire; and a DV behavioral intention questionnaire. The results showed that the three main variables of the TPB—that is, subjective norms, attitudes, and perceived behavioral control—significantly related to university students’ intentions to commit DV. More specifically, university students’ attitudes and subjective norms emerged as significant related factors of their intention to commit DV behaviors. Overall, the expanded TPB explained 30.4% of the variance in DV intentions, and attitude was the most significant factors after controlling the background variables. These findings can hopefully be used to help design and implement programs for the prevention of DV behaviors among university students.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

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