A Proposal: Nurse-Sensitive Environmental Indicators

2019 ◽  
Vol 38 (1) ◽  
pp. 265-274
Author(s):  
Sarah Johnson ◽  
Elizabeth Schenk

Healthcare contributes significant pollution to the natural environment. Nurses are obligated by professional commitment, to avoid causing harm in their care processes and decisions, including environmental harm. Nurse awareness of healthcare-generated pollution is growing but nurses may lack an understanding of how nursing contributes specifically to this pollution and what nurses can do within their scope and span to address it. This chapter introduces the concept “Nurse-Sensitive Environmental Indicators” as a proposal to identify, measure, and reduce the unintended harm of nursing practice that contributes to healthcare-generated pollution. It discusses the environmental problem, environmental health, and healthcare. The chapter explains what environmental stewardship has to do with nursing and describes nurse sensitive indicators. As has been the case with other quality outcomes measures, identifying agreed-upon environmental outcomes measures may give the nursing profession tools to measure and then address environmental impacts arising from nursing practice.

1995 ◽  
Vol 2 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Nan Gaylord ◽  
Pamela Grace

Advocacy is an important concept in nursing practice; it is frequently used to describe th nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Such ambiguity was evidenced recently in criticisms levelled at the nursing profession by hospital ethicist Ellen Bernal. She reproached nursing for using 'patient rights advocate' as a viable role for nurses. We maintain that, for nursing, patient advocacy may encompass, but is not limited to, patient rights advocacy. Patient advocacy is not merely the defence of infringements of patient rights. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice. La défense des malades joue un grand rôle dans la pratique des infirmiers/ères. Le terme est souvent utilisé pour définir les rapports entre malades et soignants. Le mot 'defénse' pourtant, peut être mal compris. Une ambiguïté était évidente récemment dans la critique de la profession infirmière faite par la philosophe éthique Ellen Bernal. Elle reproche à la profession d'utiliser le terme 'avocat des droits des malades' pour désigner le rôle primordial des infirmiers/ères. Nous croyons que pour les soignants, la défense des malades peut comprendre le rôle 'd'avocat des droits des malades' mais elle ne s'y borne pas. La défense n'est pas limitée à la défense des infractions des droits des malades. La défense dans la profession infirmière est basée sur une philosophie où la pratique infirmière est le soutien des malades dans leur quête de promouvoir leur propre bien-être. Die Fürsprache spielt eine wichtige Rolle in der Krankenpflege. Sie wird oft als kennzeichnend für die Beziehung zwischen Patient und Pflegepersonal beschrieben. Der Ausdruck 'Fürsprache' kann aber auch mehrdeutig interpretiert werden. Das wurde letzthin in der Kritik der Ethikerin Ellen Bernal an der Krankenpflege sichtbar. Sie machte den Pflegenden den Vorwurf, dass sie sich die Rolle des 'Rechts-Advokat des Patienten' aneignen. Wir sind der Meinung, dass es die Aufgabe des Pflegepersonals ist, auch die Rechte der Patienten zu vertreten, aber dass das nur ein Teil der Fürsprache ist. Sie ist nicht nur Verteidignung von verletzten Patientenrechten. Die Fürsprache in der Krankenpflege stammt von einer Philosophie, deren Ausübung die Unterstützung der Patienten für ihr Wohlergehen zum Ziel hat, so wie die Patienten selbst ihr Wohlergehen verstehen. Sie ist eine Ethik der Tat.


Author(s):  
Marsha Fowler

American nursing has an extraordinary body of nursing ethics literature from the 1880s to the mid-1960s. This literature developed prior to the rise of the field of medical ethics (later termed biomedical ethics, then bioethics) in the mid-1960s, and bears little resemblance to its later counterparts. Early nursing ethics was nurse-centric; relationally based; addressed nurses’ ethical comportment in all roles; advanced the social ethics of nursing (especially in response to health disparities); and set forth ethical expectations for the profession as a whole. This first wave of nursing ethics is distinctive and differs significantly from contemporary bioethics, yet it remains grossly under-researched. It offers nurses a wise, comprehensive, generous, and learned ethics that deserves to be reclaimed for today’s nursing practice. This article will offer an author backdrop and an historical review of early nursing ethics literature; consider the nursing profession as a calling; discuss the pivot to bioethics and the Code of Ethics as anomaly.


2010 ◽  
Vol 17 (5) ◽  
pp. 590-602 ◽  
Author(s):  
Mary Deane Lagerwey

The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing’s past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as ‘other’. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession’s past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today


2017 ◽  
Vol 30 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Shelly Ann Fischer

Transformational leadership is a trending style and competency that has been embraced by many industries and nursing practice settings. Similar positive influence on follower engagement, teamwork, and solidarity might be experienced if transformational leadership is employed by administration and faculty as a guiding framework for nursing education. The impact of embedding a teamwork culture in basic nursing education could be significant on students and ultimately on the nursing profession. Further research is needed to develop and test application of the transformational leadership framework in nursing education.


Author(s):  
Helle Max Martin

This article is about improvisation, which is a term that nurses in Uganda employ to describe how they overcome the practical difficulties of working in an institutional setting, which lacks the necessary equipment, drugs and staff. On the basis of data from Tororo Hospital in Eastern Uganda, the article explores the meanings of the term improvisation, how it relates to a general discourse about the nursing profession, and how the nurses handle and make sense of a complex and contradictory work situation. Improvisation is a term that both makes customary nursing practice legitimate and supports a professional identity under pressure. It also articulates a nostalgic longing for better times – located both in the past, the golden age of nursing, and in the future since the term improvisation constructs current practice as an interim phenomenon. Thus, “improvisation” offers a way for the nurses to domesticate the contradictory forces, which play a prominent part in nursing in Uganda today.  


2015 ◽  
Vol 24 (4) ◽  
pp. 452-461 ◽  
Author(s):  
Camille King ◽  
Ann McCue

The authors examine the nursing practice of disposing unaltered controlled substances into public water systems as an issue for nurses concerned with the environmental harm it can cause. A summary of the history of controlled substance management reveals inconsistencies in the interpretation of current regulations that have led to disposal policies that vary by institution, according to a benchmarking survey of regional hospitals. Much attention has been given to the phenomenon of conscientious objection in the context of patient care that conflicts with a nurse’s moral integrity. Nurses who are compelled to dispose narcotics down drains may also face this struggle. The authors submit that this disposal method is based on a type of double effect logic where preventing diversion is viewed as a good effect of flushing unused controlled substances that outweighs any harm it may cause, though there is little evidence to support this conclusion. Consequently, the topic deserves further study so that nurse managers and administrators can support and offer alternatives to nurses who object to flushing drugs down the drain.


2020 ◽  
pp. 105984052094683
Author(s):  
Beth E. Jameson ◽  
Lori S. Anderson ◽  
Patricia Endsley

Many school districts rely on caseload or student to school nurse ratios that are not grounded in evidence-based research. There is a need for a comprehensive workload instrument to describe the work of school nurses that incorporates the complexities of the role and includes acuity, care processes, and social determinants of health. The purpose of this qualitative study was to identify workload activities from a previous Delphi study that can be empirically measured as items for a workload instrument. A nationally representative sample of 27 school nurses participated in four focus groups, describing activities important to the measurement of workload. Focus group input resulted in identification and confirmation of workload activities that impact school nurse workload. Use of the National Association of School Nurses’ Framework for 21st Century School Nursing Practice™ was integral in capturing gaps and important workload activities for a potential workload instrument.


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