Practical and nursing aspects of endocrine conditions

Endocrinology nursing is an ever-evolving specialty. This chapter provides expert and innovative practice-based nursing information. It provides nursing care for thyroid surgery and disorders, facilitating investigation and education about pituitary function and specialist nurse management of different conditions. Education on visual field deficits and minimum driving standards are covered. The full roles of the nurse in pituitary surgery is explained, from pre-op to post-op care. Diabetes insipidus is covered. Responsibilities and possible pathways for managing male fertility, testosterone replacement, and gender dysphoria are all described. Finally, role development and nurse led clinics are examined.

The Role, Development and Opportunities of Spice Commodities for International Relations Between Indonesia and Other Countries in The International Market

Indonesia as a spice producer has the opportunity to become a world spice exporter that can contribute to the Indonesian economy. On the other hand, Indonesia has challenges to be able to improve the performance of Indonesian spices commodities. In this research, an overview of the condition of Indonesian spices will be seen so that the development and opportunities of Indonesian spices can be identified. Therefore the objectives of this study are (1) to determine the development of the area, production and productivity of Indonesian spices, (2) to determine the development and performance of international trade in Indonesian spices, (3) the demand for world and Indonesian spices. in the international market, and (4) the development of world and Indonesian spices prices in the international market. This research uses the basic analytical descriptive method, which is a research method that focuses on solving actual problems in the present. The results showed that in general the acreage and production of spices commodities tended to increase from year to year, but the productivity of pepper, nutmeg and vanilla decreased. When viewed from the balance of the Indonesian spices trade in each period it fluctuates but tends to increase. Meanwhile, the demand for spices in the international and Indonesian markets fluctuates every year but tends to increase and the development of international and domestic spice commodity prices has fluctuated each period.

Role of Dutch internal policy advisors in a hospital quality improvement programme and their influence on nurses’ role development: a qualitative study

ObjectiveNurses are vital in providing and improving quality of care. To enhance the quality improvement (QI) competencies of nurses, hospitals in the Netherlands run developmental programmes generally led by internal policy advisors (IPAs). In this study, we identify the roles IPAs play during these programmes to enhance the development of nurses’ QI competencies and studied how these roles influenced nurses and management.DesignAn exploratory ethnographical study comprising observations, informal conversations, semistructured interviews, focus groups and a strategy evaluation meeting.SettingA teaching hospital in an urban region in the Netherlands.ParticipantsIPAs (n=7) in collaboration with four teams of nurses (n=131), team managers (n=4), senior managers (n=4) and the hospital director (n=1).ResultsWe identified five distinct advisory roles that IPAs perform in the hospital programme: gatekeeper, connector, converter, reflector and implementer. In describing these roles, we provide insights into how IPAs help nurses to develop QI competencies. The IPA’s professional background was a driving force for nurses’ QI role development. However, QI development was threatened if IPAs lost sight of different stakeholders’ interests and consequently lost their credibility. QI role development among nurses was also threatened if the IPA took on all responsibility instead of delegating it timely to managers and nurses.ConclusionsWe have shown how IPAs’ professional background and advisory knowledge connect organisational, managerial and professional aims and interests to enhance professionalisation of nurses.

Nurses in the lead: a qualitative study on the development of distinct nursing roles in daily nursing practice

Background Transitions in healthcare delivery, such as the rapidly growing numbers of older people and increasing social and healthcare needs, combined with nursing shortages has sparked renewed interest in differentiations in nursing staff and skill mix. Policy attempts to implement new competency frameworks and job profiles often fails for not serving existing nursing practices. This study is aimed to understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice. Methods A qualitative study was conducted in four wards (neurology, oncology, pneumatology and surgery) of a Dutch teaching hospital. Various ethnographic methods were used: shadowing nurses in daily practice (65h), observations and participation in relevant meetings (n=56), informal conversations (up to 15 h), 22 semi-structured interviews and member-checking with four focus groups (19 nurses in total). Data was analyzed using thematic analysis. Results Hospital nurses developed new role distinctions in a series of small-change experiments, based on action and appraisal. Our findings show that: (1) this developmental approach incorporated the nurses’ invisible work; (2) nurses’ roles evolved through the accumulation of small changes that included embedding the new routines in organizational structures; (3) the experimental approach supported the professionalization of nurses, enabling them to translate national legislation into hospital policies and supporting the nurses’ (bottom-up) evolution of practices. The new roles required the special knowledge and skills of Bachelor-trained nurses to support healthcare quality improvement and connect the patients’ needs to organizational capacity. Conclusions Conducting small-change experiments, anchored by action and appraisal rather than by design, clarified the distinctions between vocational and Bachelor-trained nurses. The process stimulated personal leadership and boosted the responsibility nurses feel for their own development and the nursing profession in general. This study indicates that experimental nursing role development provides opportunities for nursing professionalization and gives nurses, managers and policymakers the opportunity of a ‘two-way-window’ in nursing role development, aligning policy initiatives with daily nursing practices.

The Reflection, Feedback, and Restructuring Model for Role Development in Nursing Education

An integral component of transitioning to the nursing practice setting is in assimilating and sometimes reformulating and reconceptualizing the knowledge gained in the classroom with what is seen and experienced in practice. An inability to do so may inhibit role development and result in difficult transitions to practice. A constructivist approach was utilized in the development of a new model that describes the process of learning and role development in the clinical and simulation setting. This approach involved reviewing the literature, reanalyzing themes, development of multiple schematics, continual review, personal observations of students in the clinical and simulation settings, and feedback from peer educators. The resulting reflection, feedback, and restructuring model describes an inductive, iterative process strongly influenced by feedback. This conceptual model may be a useful tool to guide nurse educators in facilitating role development and the transition from the classroom to the clinical setting for the nursing student.