<p> The purpose of the qualitative empirical phenomenological study was to explore and understand in more depth the lived experiences of the new RNs at a large, urban academic medical center in New York City. The study focused on the influence of the orientation process on the new RNs&rsquo; as they assume the role of the RN. Eighteen new RNs employed within the last the two years in the medical&ndash;surgical clinical division in the medical center were interviewed using a face-to-face semi-structured questions. The analysis of the data occurred by using modified van Kaam method by Moustakas and the NVivo 10 software. Emerging themes fell into five categories: precepted orientation, transitional experiences, and environmental factors, challenges faced during the transition and strategies to overcome challenges. Subthemes to emerge were areas covered by preceptor, areas not covered by preceptors and role of preceptors. Findings from the study reinforced the essential role precepted orientation played in the transitioning of the new RNs and highlighted some of the challenges the new RN faced during the transition. Data from the study may provide clinical leaders with means to improve the orientation process, improve the environment in which the new RNs transition, and academic leaders with the means to improve preparation of the new RNs. The findings will help to close the gap in literature between clinical settings and academia.</p>

<p> The purpose of this ethnonursing study was to discover and describe the culture care meanings and care expressions of men with a spinal cord injury from the Appalachian region of West Virginia. Spinal cord injury is a sudden, traumatic, and life altering event. The impact of this type of injury on the person and their family is devastating. The literature review revealed studies primarily focused on quality of life and life satisfaction. The nature of the phenomena required an open discovery method and the researcher selected the ethnonursing qualitative research method. The guiding framework, research method, and plan for data analysis were developed by Leininger (1991). The setting for the study was the Appalachian region of West Virginia. Approval from the Institutional Review Board was received and data collection commenced. The Four Phases of Qualitative Data Analysis developed by Leininger (1991) provided the plan and method for data management and data analysis. Recruitment was accomplished using the snowball method, was successful due to the promotion from informants participating in the study, and the researcher's continued presence at the monthly SCI support group meetings. Data collection and data analysis were conducted concurrently. Entry in to the field was accomplished via an established spinal cord injury support group in a large city in West Virginia. Twenty-three informants participated in the study: eighteen general informants and five key informants. Procedures to ensure the anonymity and confidentiality of the informants were developed and strictly adhered to during the course of the study. The informants chose the physical location for the interviews to be conducted. Informed consent was obtained and a pseudonym was chosen for use during the interview. A semi-structured interview guide based on the guiding framework of the study was used to facilitate the interview process. Interviews were digitally recorded and transcribed verbatim. Ethnodemographics were collected to describe the informants. Field notes and reflections from the etic view were documented for use by the researcher in the data collection and data analysis process. When saturation was evident from rigorous analysis of the data, thirteen categories were revealed during the second phase of analysis. Five patterns were derived during the third phase of analysis and in the fourth phase, the highest level of data analysis, three themes were abstracted. The categories, patterns, and themes were discussed with key informants to verify their emic view was reported accurately and to enhance the credibility and reliability of the findings. The themes were conceptualized pictorially to depict the essence of the findings of the study. The themes abstracted from the data were: 1. Caring and concern for family, friends, neighbors, and place combined with being inspired by other men with a SCI to promote a sense of belonging; 2. Belief in God, holding onto hope and keeping a positive attitude helps men remain focused on what they can do and not dwell on what they can't do; and 3. A spirit of independence, hard work, changing the environment, and believing you can figure things out are essential for getting back to living. Consistent with the literature, the informants did not identify themselves as Appalachian when asked about culture. A worldview of realism was validated by the informants. The informants exhibited a positive attitude, shared an optimistic narrative, and demonstrated a belief in God, faith, and hope with the realities of life and living with a spinal cord injury. </p>

Background. Maternal skin contact during a tissue breaking procedure lowers pain reactivity and enhances physiological recovery. It is uncertain if this comfort is derived solely from maternal presence or from stabilization of regulatory processes from direct skin contact. No studies have examined whether the contact or presence of a twin would have a similar comforting effect.Purpose. To compare the comfort effect of co-bedding by contrasting preterm twins who are co-bedding and those who are not on pain response during a tissue breaking procedure (heel lance). Methods. Following consent, 67 eligible twin sets, admitted to the Neonatal Intensive Care Unit (NICU) were stratified in pairs by gestational age (≤ 31 6/7 weeks or  32 weeks) and site and then randomly assigned to a co-bedding group, n=36, (cared for in the same incubator or crib) or a standard care group, n=31, (cared for in a separate incubator or crib). Pain response was determined by physiologic and videotaped facial reaction in accordance with the Premature Infant Pain Profile (PIPP). Additional outcomes included physiologic time to recovery, alterations in salivary cortisol, heart rate variability, frequency of additional 24% sucrose doses required, and response of the co-twin. Sample size was calculated using a 2-sided alpha error of 0.05 and a power of 80 percent. Sixty four sets of twins or a total of 128 infants were needed to detect a difference of 1 point or greater change (SD 2.0) in the PIPP scores if such a difference is in fact caused by co-bedding. Analysis was based on the intention-to-treat principle and compared the means in the two groups before and after treatment and contrasted the mean difference between groups using 95 percent confidence intervals and a 2 sided P value of 0.05. Results. Mean PIPP scores were highest at 30 seconds post lance and not significantly different between the groups, 7.1 (SD 2.8) in the co-bedding group and 7.2 (SD 3.4) in the standard care group, P=0.91. Nor were they significantly different at 60 or 120 seconds. At 90 seconds, mean scores were higher in the co-bedding group, 6.0 (SD 3.0) vs. 5.0 (SD 1.8), P=0.04, [95% CI -1.99 to -0.02] in the standard care group. Recovery time post lance was over a minute shorter, M=75.6 seconds (SD 70.0), in the co-bedding condition compared to standard care, M=142.1 seconds (SD 138.1), P=0.001, mean difference of 64.5 seconds (95% CI. 25.6-103.3). No group differences were noted in baseline cortisol levels (0.36 ug/dl if assigned to receive co-bedding and 0.43 ug/dl in the standard group) while cortisol levels 20 minutes post lance were significantly lower in the co-bedding group, 0.28 ug/dl (SD 0.25) versus 0.50 ug/dl (SD 0.73). Similarly, mean change in cortisol from baseline was lower in the co-bedding group, -0.06 ug/dl compared to the standard care group, 0.14 ug/dl, P=0.05. Co-bedding infants were significantly less likely to receive any form of additional non-pharmacologic strategy (non-nutritive sucking, swaddling or facilitated tucking), 58.2% versus 95%, P&lt;0.001. Heart variability, frequency of additional sucrose dosages, co-twin response and incidence of adverse events were not significantly different between the groups. Conclusions. The results of this randomized controlled trial provide evidence that co-bedding enhances physiologic recovery and diminishes the stress response of preterm twins undergoing heel lance in the NICU but did not lead to lower pain scores. Co-bedding did not decrease the frequency of additional 24% sucrose doses. Nor did co-bedding contribute to higher adverse effects for the twin undergoing heel lance or his/her co-twin.Clinical Trial Registry - NCT00917631 / Introduction. Durant une procédure causant un dommage tissulaire, le contact de peau entre un bébé prématuré et sa mère diminue les réactions de douleur de celui-ci et l'aide à récupérer plus rapidement au niveau physiologique. Aucune étude n'a examiné si le contact ou la présence d'un jumeau prématuré pourrait avoir un effet réconfortant sur son jumeau. Objectif. Lors d'une procédure causant un dommage tissulaire (ponction au talon), comparer l'effet réconfortant du partage de lit entre jumeaux, le co-bedding, sur la réponse à la douleur en contrastant les bébés qui sont en co-bedding avec ceux qui ne le sont pas. Méthodes. Après avoir obtenu le consentement, 67 ensembles de jumeaux éligibles admis à l'unité des soins intensifs de néonatalogie furent stratifiés en pairs par âge gestationnel (≤ 31 6/7 semaines ou  32 semaines) et le site. Ceux-ci furent randomisés au groupe de co-bedding, n=36 ou au groupe de soins standards, n=31. La réponse douloureuse fut déterminée par les réactions physiologiques et faciales (captées par vidéo) en lien avec l'échelle de douleur Premature Infant Pain Profile (PIPP). Des résultats additionnels furent collectés tels que le temps de récupération physiologique, altérations du niveau de cortisol salivaire, variabilité du rythme cardiaque, nombre de doses de sucrose 24% administrées, ainsi que la réponse de l'autre jumeau. La taille de l'échantillon fut calculée en utilisant une marge d'erreur à 5% et une puissance de 80%. Soixante-quatre ensembles de jumeaux ou un total de 128 nourrissons étaient nécessaires pour détecter une différence de 1 point ou plus (écart type (ÉT) 2.0) du score PIPP afin de déterminer si ce changement est bel et bien dû au co-bedding. Les analyses furent basées sur le principe de l'intention-à-traiter et ont comparé les moyennes des deux groupes avant et après le traitement, ainsi que les différences moyennes en utilisant un niveau de confiance de 95% et une valeur bilatérale de P à 0.05. Résultats. Les moyennes des scores PIPP furent à leur plus haut 30 secondes suivant la ponction au talon et ne furent pas significativement différentes entre les deux groups, 7.1 (ÉT 2.8) pour le groupe co-bedding et 7.2 (ÉT 3.4) pour le groupe de soins standards, P=0.91. Ces scores ne furent pas significativement différents à 60 ou 120 secondes. À 90 secondes, les scores moyens furent plus élevés dans le groupe de co-bedding, 6.0 (ÉT 3.0) vs. 5.0 (ÉT 1.8), P=0.04, [CI -1.99 à -0.02] pour le groupe de soins standards. Le temps de récupération après la ponction au talon fut de plus de 1 minute, M=75.6 secondes (ÉT 70.0), pour le groupe en co-bedding comparativement au groupe en soins standards, M=142.1 secondes (ÉT 138.1), P=0.001, différence moyenne de 64.5 secondes (CI. 25.6-103.3). Aucune différence entre les groupes fut notée entre les niveaux de bases de cortisol.Les niveaux de cortisol 20 minutes après la ponction au talon furent significativement plus bas dans le groupe du co-bedding, 0.28 ug/dl (ÉT 0.25) versus 0.50 ug/dl (ÉT 0.73). Similairement, la moyenne du changement du niveau de base du cortisol était plus basse dans le groupe du co-bedding, -0.06 ug/dl et 0.14 ug/dl, pour le groupe de soins standards, P=0.05. Les bébés en co-bedding ont eu moins tendance à recevoir des traitements non-pharmacologiques additionnels (succion avec tétine, enveloppement toucher), soit 58.2% versus 95%, P&lt;0.001. La variabilité du rythme cardiaque, la fréquence de doses additionnelles de sucrose, la réponse de l'autre jumeau, ainsi que l'incidence d'événements néfastes ne furent pas significativement différentes entre les deux groupes. Conclusions. Les résultats de cette étude contrôlée randomisée démontrent que le co-bedding entre jumeaux prématurés accroît leur récupération physiologique et diminue leur réponse de stress lors d'une ponction au talon mais sans mener à une réduction de leurs scores de douleur. [NCT00917631]

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

This study explores the experiences of men who are nurses in Aotearoa New Zealand. Utilising discourse analysis a social constructionist reading of men, masculinity and nursing is provided to offer an alternative reading to much of the extant literature with respect to men in nursing. The study draws upon a number of different sources of "text", including over 600 written works, two films and interviews with eighteen men who currently are, have been or are intending to be, nurses. Drawing primarily upon the "literary" textual sources a number of themes were identified for further exploration in interview with the coresearchers. These themes were the construction of masculinity, the construction of images of the nurse, the reaction to men who are nurses, sexuality issues, career development, and men and caring. The findings of this thesis reveal that the literature pertaining to men in nursing is replete with paradox and contradiction and fails to adequately account for the male experience. It is argued that the images and arguments provided in the literature with respect to men in nursing are based on out-of-date models and understandings of gender relations, masculinity and nursing. It is suggested that rather than enjoying patriarchal privilege, men who enter nursing must contend with being constructed as both an inferior man and inferior nurse. Their careers are not, as is alleged in the literature, based on developing "islands of masculinity" and male privilege, nor upon the avoidance of the emotional labour of nursing but reflect a belief that career is one way of doing care. It is argued in this work that men in nursing have fewer "taken-as-givens" upon which to base work and that they work to develop trusting relationships with their patients that are based on communication and empathy within a context defined by the patients' circumstances.

Thesis (Ph.D.)--Indiana University, Dept. of Education, 2007. / Title from PDF t.p. (viewed Nov. 3, 2008). Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0928. Adviser: Jesse Goodman.

Thesis (Ph.D.)--Indiana University, Dept. of Education, 2007. / Adviser: Jesse Goodman.

Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2007. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0935. Adviser: Scott Johnson. Includes bibliographical references (leaves 153-168) Available on microfilm from Pro Quest Information and Learning.