Remaining in the nursing profession: The relevance of strong evaluations

2016 ◽  
Vol 25 (7) ◽  
pp. 928-938
Author(s):  
Margareth Kristoffersen ◽  
Febe Friberg
Keyword(s):  
Empirical Study ◽  
Research Question ◽  
Qualitative Interviews ◽  
Charles Taylor ◽  
Nursing Profession ◽  
Science Data ◽  
Data Services ◽  
Research Context ◽  
Complex Question

Background: Why nurses remain in the profession is a complex question. However, strong values can be grounds for their remaining, meaning nurses evaluate the qualitative worth of different desires and distinguish between senses of what is a good life. Research question: The overall aim is to explore and argue the relevance of strong evaluations for remaining in the nursing profession. Research design: This theoretical article based on a hermeneutical approach introduces the concept strong evaluations as described by the Canadian philosopher Charles Taylor and provides examples of nurses’ experiences in everyday nursing care drawn from a Norwegian empirical study. Participants and research context: Data collected in the original study consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses. The research context was the primary and secondary somatic and psychiatric health service, inside as well as outside institutions. Ethical consideration: The article uses data from an original empirical study approved by the Norwegian Social Science Data Services. Information was given and consent obtained from the participants. Findings: Remaining in the nursing profession can be understood as revolving around being a strong evaluator. This has been concretized in issues of being aware of different incidents in life and having capacities as a nurse. Discussion: Why nurses remain is discussed in relation to how nurses have shaped themselves by reflecting on what is of significance in their life. However, being a strong evaluator cannot be seen as the casual condition for remaining. Conclusion: Remaining in the nursing profession is obviously not a contingent matter, rather it is a matter concerned with the qualitative worth of different desires and values. Nurses’ awareness of a life choice impacts on whether they remain or not. Consequently, nurses may need to articulate and reflect on their priorities for remaining.

Relationship-based nursing care and destructive demands

2016 ◽  
Vol 24 (6) ◽  
pp. 663-674 ◽  
Author(s):  
Margareth Kristoffersen ◽  
Febe Friberg
Keyword(s):  
Empirical Study ◽  
Research Design ◽  
Nursing Care ◽  
Work Experience ◽  
Research Question ◽  
Qualitative Interviews ◽  
Human Beings ◽  
Science Data ◽  
Data Services ◽  
The Relationship

Background: The relationship between the nurse and the patient is understood as fundamental in nursing care. However, numerous challenges can be related to the provision of relationship-based nursing care. Challenges exist when nurses do not respond adequately to the patient’s appeal for help. Moreover, challenges arising in the nurse–patient relationship can be understood as more destructive demands from the patient to the nurse, thus begging inquiry into such a relationship. Research question: The overall aim is to explore and argue the relevance of problematizing destructive demands evident within relationship-based nursing care. Research design: This theoretical article explores destructive demands based on the phenomenological philosophy of the Danish theologian and philosopher Knud E. Løgstrup and provides examples of nurses’ experiences in everyday nursing care. The examples are drawn from a Norwegian empirical study based on a hermeneutical research design. Participants and research context: Data consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses with varying work experience within the primary and secondary somatic and psychiatric health service, from inside as well as outside institutions. Ethical consideration: The original empirical study was approved by the Norwegian Social Science Data Services. Information was given and consent was obtained from the participants. Findings: Two themes are described: strong impressions formed in meetings with patients and persistent concern over the burden of work and ability to endure. Discussion: Destructive demands related to relationship-based nursing care are discussed along two lines, first, by further elucidating nurses’ everyday experiences connected to destructive demands and, second, by highlighting the significance of including destructive demands within the relationship-based nursing care. Conclusion: Including destructive demands related to relationship-based nursing care is of particular significance in enabling the proposition that radical, one-sided demands are based on relationality, reciprocity and thereby expectations of life. In short, both the nurse and the patient are human beings in need of love and goodness.

Undergraduate nursing students’ ability to empathize: A qualitative study

2016 ◽  
Vol 25 (6) ◽  
pp. 786-795 ◽  
Author(s):  
Anne Kari Tolo Heggestad ◽  
Per Nortvedt ◽  
Bjørg Christiansen ◽  
Anne-Sophie Konow-Lund
Keyword(s):  
Nursing Home ◽  
Nursing Students ◽  
Qualitative Interviews ◽  
Well Being ◽  
Cognitive Empathy ◽  
Affective Empathy ◽  
Science Data ◽  
Undergraduate Nursing Students ◽  
Data Services ◽  
Undergraduate Nursing

Background: Empathy is of great importance in nursing, as it helps us to see and meet the needs of patients and hence to care for patients in an appropriate way. Therefore, it is of great importance that nursing students and nurses develop their ability to empathize. Objective: The study aimed at gaining knowledge on what characterizes undergraduate nursing students’ ability to empathize with patients during their first practice in a nursing home. In addition, the aim of the study was to investigate what nursing students think is important with regard to upholding their ability to empathize with patients in a professional way. Research design: This research has a phenomenological and hermeneutic design, based on qualitative interviews. Participants and research context: A total of 11 undergraduate nursing students participated in interviews during or right after their first practice in a nursing home. Ethical considerations: Norwegian Social Science Data Services approved the study. Participants were informed that their participation was voluntary. The participants were also assured confidentiality, and they were informed that they could withdraw from the study at any time, without providing any reasons. Findings: What the findings show is that affective empathy is strong among undergraduate nursing students in their first practice. They think the emotions are important to be able to empathize, and they are afraid of becoming indifferent. At the same time, they are afraid that the feelings will hinder them from acting in a professional manner. Discussion: The findings are discussed in light of previous theories on empathy, and especially perspectives on empathy, emotions, and morality. Conclusion: Affective empathy seems to be strong among nursing students, and this may be of great importance to be sensitive to patients’ well-being. However, affective and cognitive empathy should be balanced if nurses will have to meet patients in a professional way.

Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands

2019 ◽  
Vol 27 (5) ◽  
pp. 1315-1326 ◽  
Author(s):  
Trine-Lise Jansen ◽  
Marit Helene Hem ◽  
Lars Johan Dambolt ◽  
Ingrid Hanssen
Keyword(s):  
Psychiatric Care ◽  
Moral Distress ◽  
Quality Care ◽  
Moral Dilemmas ◽  
Ethical Awareness ◽  
Science Data ◽  
Data Services ◽  
Definition Of ◽  
Acute Psychiatric Care

Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.

Ethics support in community care makes a difference for practice

2016 ◽  
Vol 25 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Morten Magelssen ◽  
Elisabeth Gjerberg ◽  
Lillian Lillemoen ◽  
Reidun Førde ◽  
Reidar Pedersen
Keyword(s):  
Large Scale ◽  
Response Rate ◽  
Ethical Challenges ◽  
Next Of Kin ◽  
Science Data ◽  
Data Services ◽  
Care Services ◽  
Ethics Support ◽  
Community Sector

Background: Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities. Objectives: To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities. Research design: Two online questionnaires about the municipal ethics activities. Participants and research context: A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to the second survey (33% response rate). Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services. Findings: Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision. Discussion: This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators. Conclusion: It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors.

scholarly journals Reading Dickens’s characters: Employing psycholinguistic methods to investigate the cognitive reality of patterns in texts

2014 ◽  
Vol 23 (4) ◽  
pp. 369-388 ◽  
Author(s):  
Michaela Mahlberg ◽  
Kathy Conklin ◽  
Marie-Josée Bisson
Keyword(s):  
Empirical Study ◽  
Eye Tracking ◽  
Charles Dickens ◽  
Corpus Linguistics ◽  
Body Language ◽  
The Body ◽  
Research Context ◽  
Corpus Data ◽  
The Brain

This article reports the findings of an empirical study that uses eye-tracking and follow-up interviews as methods to investigate how participants read body language clusters in novels by Charles Dickens. The study builds on previous corpus stylistic work that has identified patterns of body language presentation as techniques of characterisation in Dickens (Mahlberg, 2013). The article focuses on the reading of ‘clusters’, that is, repeated sequences of words. It is set in a research context that brings together observations from both corpus linguistics and psycholinguistics on the processing of repeated patterns. The results show that the body language clusters are read significantly faster than the overall sample extracts which suggests that the clusters are stored as units in the brain. This finding is complemented by the results of the follow-up questions which indicate that readers do not seem to refer to the clusters when talking about character information, although they are able to refer to clusters when biased prompts are used to elicit information. Beyond the specific results of the study, this article makes a contribution to the development of complementary methods in literary stylistics and it points to directions for further subclassifications of clusters that could not be achieved on the basis of corpus data alone.

The Influence of the Established Links between University Courses on the Quality of Teaching

2018 ◽  
Vol 8 (2) ◽  
pp. 35-48
Author(s):  
Jiří Rybička ◽  
Petra Čačková
Keyword(s):  
Higher Education ◽  
Empirical Study ◽  
The Other ◽  
Coherent System ◽  
University Courses ◽  
Quality Of Teaching ◽  
Education Courses ◽  
Initial Knowledge

One of the tools to determine the recommended order of the courses to be taught is to set the prerequisites, that is, the conditions that have to be fulfilled before commencing the study of the course. The recommended sequence of courses is to follow logical links between their logical units, as the basic aim is to provide students with a coherent system according to the Comenius' principle of continuity. Declared continuity may, on the other hand, create organizational complications when passing through the study, as failure to complete one course may result in a whole sequence of forced deviations from the recommended curriculum and ultimately in the extension of the study period. This empirical study deals with the quantitative evaluation of the influence of the level of initial knowledge given by the previous study on the overall results in a certain follow-up course. In this evaluation, data were obtained that may slightly change the approach to determining prerequisites for higher education courses.

Remote Follow-up of Self-isolating COVID-19 Patients with a Patient Portal: Protocol for a Mixed-method Pilot Study (The Opal-COVID Study) (Preprint)

2021 ◽  
Author(s):  
David Lessard ◽  
Kim Engler ◽  
Yuanchao Ma ◽  
Adriana Rodriguez Cruz ◽  
Serge Vicente ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Mixed Method ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Sociodemographic Characteristics ◽  
Patient Portal ◽  
Implementation Outcomes ◽  
Service Outcomes ◽  
Qualitative Analyses

BACKGROUND Individuals diagnosed with COVID-19 are instructed to self-isolate at home. However, during self-isolation, they may experience anxiety and insufficient care. Some patient portals can allow patients to self-monitor and share their health status with healthcare professionals for remote follow-up, but little data is available on the feasibility of their use. OBJECTIVE This manuscript presents the protocol of the Opal-COVID Study which has four objectives: 1) assess the implementation of using the Opal patient portal for distance monitoring of COVID-19 patients self-isolating at home; 2) identify influences on the intervention’s implementation; and describe 3) service and 4) patient outcomes of this intervention. METHODS This mixed-method pilot study aims to recruit 50 COVID-19 patient participants tested at the McGill University Health Centre (MUHC, Montreal, Canada) for 14 days of remote follow-up. With access to questionnaires through the Opal patient portal smartphone app, configured for this study, patients will complete a daily self-assessment of symptoms, vital signs, and mental health, monitored by a nurse, and receive subsequent teleconsultations, as needed. Study questionnaires will be administered to collect data on sociodemographic characteristics, medical background, implementation outcomes (acceptability, usability, and respondent burden) and patient satisfaction. Coordinator logbook entries will inform on feasibility outcomes, namely, recruitment/retention rates and fidelity, as well as on the frequency and nature of contacts with healthcare professionals via Opal. The statistical analyses for Objectives 1 (implementation outcomes), 3 (service outcomes), and 4 (patient outcomes) will evaluate the effects of time and sociodemographic characteristics on the outcomes. For Objectives 1 (implementation outcomes) and 4 (patient outcomes), the statistical analyses will also examine the attainment of predefined success thresholds. As to the qualitative analyses, for Objective 2 (influences on implementation), semi-structured qualitative interviews will be conducted with four groups of stakeholders (i.e., patient participants, healthcare professionals, technology developers and study administrators) and submitted to content analysis, guided by the Consolidated Framework for Implementation Research to help identify barriers and facilitators of implementation. For Objective 3 (service outcomes), reasons for contacting healthcare professionals through Opal will also be submitted to content analysis. RESULTS Between December 2020 and March 2021, 51 patient-participants were recruited. Qualitative interviews were conducted with 39 involved stakeholders, from April to September 2021. Delays in the study process were experienced due to implemented measures at the MUHC to address COVID-19 but the quantitative and qualitative analyses are currently underway. CONCLUSIONS This protocol is designed to generate multidisciplinary knowledge on the implementation of a patient portal-based COVID-19 care intervention and will lead to a comprehensive understanding of feasibility, stakeholder experience, and influences on implementation that may prove useful for scaling up similar interventions. CLINICALTRIAL ClinicalTrials.gov identifier NCT04978233.

The Persistence of Presentism

2009 ◽  
Vol 111 (11) ◽  
pp. 2505-2534 ◽  
Author(s):  
Andy Hargreaves ◽  
Dennis Shirley
Keyword(s):  
Focus Groups ◽  
Intervention Program ◽  
Research Question ◽  
Qualitative Interviews ◽  
Secondary Analysis ◽  
Performance Data ◽  
Low Performing Schools ◽  
Capacity Enhancement ◽  
Quantitative Performance ◽  
Strategies For Change

Background/Context This study draws on the voluminous research on teachers’ workplace orientations and especially on Dan Lortie's documentation of conservatism, individualism, and presentism among teachers. Purpose/Objective/Research Question/Focus of Study This study investigated a school reform network of over 300 secondary schools entitled Raising Achievement Transforming Learning (RATL) to explore the role of the network's interventions in increasing or diminishing presentism. Setting England. Population/Participants/Subjects Quantitative performance data were analyzed for all 300 schools. Site visits were made to 10 RATL schools in which educational administrators and teachers were interviewed individually and in focus groups. Additional phone interviews were conducted with administrators in 14 RATL schools. Intervention/Program/Practice RATL provided a combination of interventions and supports for schools in the network, including data analysis and capacity enhancement; partnering mentor schools with low-performing schools; regional conferences; a Web portal for schools in the project; and a menu of short-, medium-, and long-term strategies for change. Research Design Qualitative interviews and focus groups of educators in RATL schools, along with secondary analysis of pupil performance data. Conclusions/Recommendations In Dan Lortie's seminal research on teachers’ workplace orientations, he identified “presentism,” or short-term thinking, with conservatism and individualism. This research indicates that in the RATL project, individualism among teachers diminished, but this did not diminish either conservatism or presentism. The research identifies three kinds of presentism—endemic, adaptive, and addictive—that have amplified educational conservatism while altering its nature to fit the current culture and political economy of fast capitalism.

Solitary confinement and institutional harm

Incarceration ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 263266632110656
Author(s):  
Bruce Western ◽  
Jessica T. Simes ◽  
Kendra Bradner
Keyword(s):  
Psychological Distress ◽  
Social Isolation ◽  
Qualitative Interviews ◽  
Empirical Support ◽  
Longitudinal Survey ◽  
Material Deprivation ◽  
Solitary Confinement ◽  
Three Dimensions ◽  
Legal Arguments

In a given year, one in five people incarcerated in the U.S. prisons is locked in solitary confinement. We study solitary confinement along three dimensions of penal harm: (1) material deprivation, (2) social isolation, and (3) psychological distress. Data from a longitudinal survey of incarcerated men who are interviewed at baseline in solitary confinement are used to contrast the most extreme form of penal custody with general prison conditions observed at a follow-up interview. Solitary confinement is associated with extreme material deprivation and social isolation that accompanies psychological distress. Distress is greatest for those with histories of mental illness. Inactivity and feelings of dehumanization revealed in qualitative interviews help explain the distress of extreme isolation, lending empirical support to legal arguments that solitary confinement threatens human dignity.

Hindrances to achieve professional confidence: The nurse’s participation in ethical decision-making

2017 ◽  
Vol 26 (3) ◽  
pp. 715-727 ◽  
Author(s):  
Anne Storaker ◽  
Dagfinn Nåden ◽  
Berit Sæteren
Keyword(s):  
Decision Making ◽  
Data Storage ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Research Question ◽  
Daily Practice ◽  
Clinical Work ◽  
Ethical Guidelines ◽  
Science Data ◽  
Written Information

Background: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient’s dignity in their clinical work. Objectives: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice. The chosen research question is “How do nurses participate in ethical decision-making for the patient?” Design and method: We use Gadamer’s philosophical hermeneutics as well as Kvale and Brinkmann’s three levels of understanding in interpreting the data material. Nine registered nurses were interviewed. Ethical considerations: The Ombudsman of Norwegian Social Science Data and the head of the hospital approved the investigation. The participants received both oral and written information about the study and they gave their consent. We informed the participants that the participation was voluntary and that they were free to withdraw at any point in the course of the study. The requirement of anonymity and proper data storage was in accordance with the World Medical Association Declaration of Helsinki (1964). The participants were assured that privacy, and confidentiality would be duly protected. Results: Four key themes emerged: (1) confusion in relation to professional and operational expectations of role, (2) ideal somnolence, (3) inadequate argumentation skills, and (4) compound pressure. Conclusion: Ethical ideals appear to be latent in the mindset of the participants; however, the main finding of this investigation is that nurses need to activate the ideals and apply them into practice. Furthermore, management needs to initiate professional reasoning and interdisciplinary discussions leading to common goals for patients.

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