...Making patients better: a qualitative descriptive study of registered nurses’ reasons for working in surgical areas Carolyn Mackintosh BA, MSc, RGN, Pg Dip, PhD Senior Lecturer, Division of Nursing, University of Bradford, Unity Building, Trinity Road, Bradford, UK Submitted for publication: 13 May 2005 Accepted for publication: 16 December 2005 Correspondence: Carolyn Mackintosh Division of Nursing University of Bradford Unity Building Trinity Road Bradford BD5 0BB UK Telephone: þ44 1274 236546 E-mail: c.mackintosh@bradford.ac.uk M A C K I N T O S H C ( 2 0 0 7 ) Journal of Clinical Nursing 16, 1134–1140 Making patients better: a qualitative descriptive study of registered nurses’ reasons for working in surgical areas Aims. To explore the reasons and motivation identified by qualified nurses for working within the surgical area. Background. Little is known about the career decisions qualified nurses make, although it is clear that some areas of practice are more popular than others. This qualitative descriptive study considers one common area, surgery, and explores the motivation for decisions made by Registered Nurses (RNs) to work in this area. Method. A sample of 16 RNs working within surgical areas participated in semistructured interviews, using a thematic interview schedule. Findings were analysed using the framework suggested by Morse and Field. Results. Analysis of findings indicates that all participants actively chose to work within...
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...Business Case Analysis - Nursing Second Shift Staffing Business Case Analysis - Second Shift Staffing Monarch General Hospital has recently experienced short staffing of the nursing workforce for the second shift (15:30 to 23:30). This report was commissioned to examine options for the Healthcare Chief Officers involved, which will provide valuable guidance toward a reliable business solution based on currently available evidence. Background Monarch is currently experiencing a deficit in the supply of nurses. In particular, the deficit is on the second shift. But, overall, the actual problem to address is a less than optimal supply of nurses. The plan to remedy the problem for the actual shift involved will be addressed in the strategy and implementation. This deficit of nurses will cause delayed delivery of care to patients and/or adverse events. This will likely lead to patient dissatisfaction, lawsuits and the hospital absorbing unnecessary and unplanned for costs. These factors will ultimately lead to a reduced number of hospital admissions. Monarch must achieve the ability to control the shortage instead of surrendering to it. This report will examine two of the four currently considered options. The first option is hiring additional permanent personnel and the second is hiring short-term, temporary personnel to be used on an as needed basis. Business and Operational Impacts The factors leading to a reduced numbers of hospital admissions will affect...
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...online 2013 December 9. Perceptions of Organizational Justice Among Nurses Working in University Hospitals of Shiraz: A Comparison Between General and Specialty Settings Research Article Nahid Hatam , Mozhgan Fardid , Zahra Kavosi 1,* 1,2 1 1Department of Health Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran 2Student Research Committee, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran *Corresponding author: Nahid Hatam, Department of Health Management, School of Management and Medical Information Sciences, Diamond Building, Shiraz University of Medical Sciences, 9th alley of Ghasroddasht, Shiraz, IR Iran. Tel.: +98-7112340781, Fax: +98-7112340039, E-mail: hatamn@sums.ac.ir. Received: February 9, 2013; Revised: April 26, 2013; Accepted: July 26, 2013 Background: Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. Objectives: The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. Materials and Methods: In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item...
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...FACTORS THAT INFLUENCE NURSE ATTRITION: AN ANALYSIS OF THE RELATIONSHIP BETWEEN SUPERVISOR LEADERSHIP STYLE AND SUBORDINATE JOB SATISFACTION by James D. Long A Dissertation Presented in Partial Fulfillment Of the Requirements for the Degree Doctor of Philosophy Capella University October 2004 UMI Number: 3147190 UMI Microform 3147190 Copyright 2005 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, MI 48106-1346 © James Long, 2004 Abstract Within the healthcare industry, there is an issue of major significance that may result in inadequate levels of staffing to meet patient demand. It has been estimated that at the current rate, hospitals will be forced to function with a nursing vacancy rate of 20 % in the not-toodistant future. The purpose of this study is to determine the effect that leadership style has on the job satisfaction level of nurses. It has been indicated that job satisfaction levels negatively correlate with employee attrition rates (Vandenberghe, Stordeur, & D'hoore, 2002). Using the Multifactor Leadership Questionnaire (MLQ) 5X Short (revised) and the Abridged Job Descriptive Index/Abridged Job in General (AJDI/AJIG) psychometric assessments, nurses job satisfaction levels were compared to the leadership classification...
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...practice provide greater insight to develop an effective clinical teaching strategy in nursing education. The main objective of this study was to investigate student nurses' experience about their clinical practice. Methods Focus groups were used to obtain students' opinion and experiences about their clinical practice. 90 baccalaureate nursing students at Shiraz University of Medical Sciences (Faculty of Nursing and Midwifery) were selected randomly from two hundred students and were arranged in 9 groups of ten students. To analyze the data the method used to code and categories focus group data were adapted from approaches to qualitative data analysis. Results Four themes emerged from the focus group data. From the students' point of view," initial clinical anxiety", "theory-practice gap"," clinical supervision", professional role", were considered as important factors in clinical experience. Conclusion The result of this study showed that nursing students were not satisfied with the clinical component of their education. They experienced anxiety as a result of feeling incompetent and lack of professional nursing skills and knowledge to take care of various patients in the clinical setting. Background Clinical experience has been always an integral part of nursing education. It prepares student nurses to be able of "doing" as well as "knowing" the clinical principles in practice. The clinical practice stimulates students to use...
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...CHAPTER 10 Differential Cost Analysis This chapter deals with the use of differential cost analysis in financial management decision making situations. The basic premise of differential cost analysis is that different costs are treated differently in different financial management decision situations. Hence the name differential costs. Two major applications of differential cost analysis are presented. The first application is called break-even analysis. In break-even analysis, differential cost analysis is used to answer the question, How much service must a human service program provide during a fiscal year in order to recover its total costs? The second application can be called decrease/discontinue decisions. In these types of financial management decisions, differential cost analysis answers the question, What will be the effect on fixed and variable costs of a decision to reduce or discontinue a human service program? Some Concepts and Definitions Before proceeding to the discussion of the applications of differential cost analysis, some basic concepts and definitions need to be introduced including fixed costs, variable costs, step costs, maximum efficiency, and surplus capacity. Fixed Costs and Variable Costs In Chapter 8 the concepts of direct and indirect costs were introduced as part of the discussion of cost analysis. As was noted in Chapter 8, the full cost, or total cost, of a human service program is the sum of its direct costs and indirect costs...
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...The Child Welfare System: Through the Eyes of Public Health Nurses Janet U. Schneiderman ABSTRACT Objective: This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organizationÕs effect on their case management practice. Design: Semistructured interviews were conducted utilizing the Bolman—Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. Sample: A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Results: Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Conclusions: Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in Òhost settings.Ó Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis. Key words: child protective services, organization, public health nursing. The purpose of this exploratory qualitative descriptive study was to investigate how public health nurses working in the child welfare system in a large metropolitan...
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...Various sources of power were first introduced in an organised way by French and Raven (1959) which are legitimate, reward, coercive, expert and referent powers. Hersey and Blanchard (1982) further expanded it with additional two bases: connection and information. Till todays powers are separated into two groups which are personal power that stems from personal characteristics (expertise, personal attraction, effort and legitimacy) and position power obtained from the nature of one’s position (centrality, flexibility, visibility and relevance) (Whetten & Cameron, 2011). From the team setting provided, the six roles can be divided into two groups; surgeon, general practitioner and radiographer in one (high-ranking) and theater nurse, ward nurse and ward clerk in another group (low-ranking). Generally high-ranking personnel have more authority (formal power) than lower-ranking personnel (Mechanic, 1962). As such sources of power for surgeon, general practitioner and radiographer are mainly coming from the personal power group; their professional qualification background-expertise power, effort power where they have to be responsible on patients’ condition and expectations from others, plus legitimate power that they possess to save lives which is congruent with health care system objectives. Oppositely, the lower-ranking group (theater nurse, ward nurse and ward clerk) obtains much of its power in the form of positional power. The group’s broad network of both vertically and...
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...Concept Analysis: Person Charlotte Ramey Eastern Kentucky University Theoretical Foundations for Evidenced Based Practice NSC 840 Dr. Ida L. Slusher September 08, 2014 Concept Analysis: Person The term “person” is not used in healthcare, nursing education and nursing practice. However the terms “client” and “patient” are. In order to be a client or patient one must understand the concept of person. Clarify the Purpose In nursing education students are taught to address people as clients. The American Nurses Association Code for Nurses developed between 1971 and 1976 adopted the universal term client for use in health care. (Davis & Davis, 1992) For nursing students to see clients as individuals with health care needs, they need to first understand that they are people as well. Therefore, the purpose of this analysis and clarification of the concept of person is to allow students to understand the concept of people or person to critically think and formulate nursing diagnosis to provide compassionate and holistic care. Sources of Evidence Merriam-Webster’s dictionary defines client as “a person who pays a professional person or organization for services” or “a customer in a shop or hotel”. ("Merriam-Webster," nd) The definition given for person is a human being. ("Merriam-Webster," nd) When the word client is used in an internet search the received information is business related. Whereas when the word person is searched more personal and human...
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...The Norwegian Version of the Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain: Reliability and Validity Kari Raaum Hovde, Tone Høilo Granheim, Knut-Andreas Christophersen, Alfhild Dihle P ain in children is still both under-estimated and under-treated (Bell et al., 2009; Liossi, 2006; Stinson, Yamada, Dickson, Lamba, & Stevens, 2008; Zempsky, Cravero, & the Committee on Pediatric Emergency Medicine and Section of Anesthesiology and Pain Medicine, 2004). Inadequate treatment of pain in children may cause many negative psychological and physiological consequences, such as fear and anxiety, post-traumatic stress disorder, increased risk of infections, and delayed wound healing. In addition, poor pain control may result in increased length of stay in the hospital, contribute to the development of chronic pain, and even lead to death (American Academy of Pediatrics [AAP] & American Pain Society [APS], 2001; Liossi, 2006; Schechter, Berde, & Yaster, 2003; Vincent, 2005; Zempsky et al., 2004). The purpose of this study was to evaluate the reliability and validity of the Norwegian version of the Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain (PNKAS-N) in nurses who work with children in pain. The PNKAS was translated into Norwegian in accordance with international guidelines and pilot tested with 10 nurses. The reliability was estimated using Cronbach’s alpha coefficient and the test-retest method using Pearson’s r coefficient. Construct validity...
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...Adn vs Bsn: Differences Rachel McAdams Phoenix University September 2, 2010 Adn vs Bsn: Differences may be a Matter of Degree In the late 1850s Florence Nightingale started her own school to train nurses and developed standards by which nurses performed their duties. She may never have envisioned that one day there would be different educational tracks resulting in multiple degrees and disciplines in nursing, each having their own set of criteria for excellence. Associate degree nurse (ADN) and baccalaureate degree nurse (BSN) are the two most common entry level nursing positions. An ADN can be obtained in two or three years whereas the BSN takes four years of education to complete due to additional courses. Differences between the degrees begin with education and mature as the nurse gains experience. Raines and Taglaireni’s (2008) article states ADN and BSN nurses attend the same basic liberal arts and general education courses such as English, literature, history, math, humanities, and arts. Both have basic nursing courses, the same technical skill sets are taught, and nurses must pass the same National Council Licensing Examination for RNs (NCLEX-RN©) which measures minimum technical competency for entry-level nursing practice. Colleges will differ in the exact requirements for each degree but the community college ADN program consists of approximately 75 course credits of which 38 are science and liberal arts prerequisites, and 37 credits are in the...
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...This plan will be illustrating the care pathway for the 2 physiological disorders and the roles of the practitioners involved. The two physiological disorders are eczema and nephrotic syndrome. The practitioners involved in eczema are the GP and pharmacist. General Practitioners (GP): GPs look after the health of people in the local community and deal with a wide range of health problems. They take into account physical, emotional and social factors when diagnosing treatment and recommending the required treatment (AGGAS, 2013). If a GP is unable to deal with a problem themselves, the usually refer the patient to a hospital for tests, treatment, or to see a consultant with specialist knowledge (NHS Choices, 2013). For example in eczema, if the GP sees that the condition is not getting any better, or is worsening, the will refer the patient to see a dermatologist. Also, they assess, plan, implement and monitor the progress and response to treatment; and provide advice and counselling to the patients (AGGAS, 2013). Goal/Objective Completion Date Action to be taken To identify the physiological disorder Immediately 1) Baseline assessment i.e. medical history to identify clinical background and to identify and themes, patterns etc. 2) Assess baseline measurements: pulse and respiration; and observe the affected area i.e. inner elbows. 3) Confirm diagnosis and identify any potential allergies. To successful control the disorder On-going 1) Prescribe mediation i.e. 2) Refer...
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...such as weakness, numbness, vision, and particularly, speech abnormalities (Grear & Bushnell, 2013). As stroke involves difficult communication, healthcare professionals need advanced skills of communication. For the purpose of the essay requirement, I will review how healthcare professional is conducting session with a patient from the therapeutic communication perspective. A patient is recently assigned to a hospital through emergency department. When paramedic team performs clinical handover to a nurse, he describes that the patient is 35 years old, 28 weeks pregnant and has history of hypertension. The nurse learns that she has difficulty in communication and gives a simple guideline. This is where the essence of therapeutic communication plays a great role. Anytime she shakes her head means affirmation and nodding means negation. Afterward, the nurse describes that there will be some other healthcare professionals visiting her. The first healthcare worker coming in after nurse is the radiographer. His intention is to inform and ask a consensual agreement of CT scan to the patient’s brain. The scanning procedure is necessary to determine the where and how far the stroke has attacked the brain. Without informing anything related to the advantages and disadvantages of the procedures, the radiographer simply asks consensual agreement toward the patient. This is where I feel extremely irritated with how the health care professional gives that significant information to the patient...
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...Nursing in general is a broad aspect of the medical field. But in reality nurses are needed through every specialty when dealing with health. Nursing first appealed to me when I would visit the hospital or a group home and see people who needed to be helped. I always wanted to pursue a career in the medical field but didn’t want to become a doctor. In the nursing field, there are different areas within the medical field you can go to. I want to pursue this field because of the many options you can choose and I like to care for people. You can become a neonatal nurse, and work with newborn babies and parents, or you can be a surgical nurse and assist a surgeon during surgery. Currently I’m considering becoming a RN or a neonatal nurse. For nurse education requirements, a student can choose to train to become a license practical nurse (LPN) or a registered nurse (RN). All nurses are required...
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...An ADN nurse is defined as a nurse with two years of schooling focusing on general studies and clinical nursing in a community college setting. Upon graduation the student is qualified to take a national licensure exam to become a registered nurse (RN). In 1952 Mildred Montag created the ADN program due to the rising demand of nurses after the war. This program was offered to increase nurses in the workplace. The programs’ success was determined by satisfactory clinical nursing skills and passing a national exam (Creasia & Friberg, 2010, p.26). A BSN nurse can be defined as a nurse with four years of nurse training. This consists of two years of general studies, followed by a two year nursing program. Upon graduation in order to become a RN students must pass a national exam. According to Creasia and Friberg (2010), the BSN program was founded after World War II. The program was not popular at first and they struggled to find qualified instructors. Now many of the instructors who teach are well respected in the nursing field (Creasia & Friberg, 2010, p.25). The BSN program includes all the courses taught in associate degree programs. However, according to Creasia and Friberg, “liberal education, quality and patient safety, evidence-based practice, information management, health care policy and finance, communication/collaboration, clinical prevention/population health, and professional values” (Creasia & Friberg, 2010, p.25) are taught more in depth. According to Grand Canyon...
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