No description available.

No description available.

Models of nursing practice create a context, boundary, direction and expectations for nurses, patients and other members of the health care team. The literature is scanty in regard the experience of Australian nurses faced with the process of redesign in their workplace. This study presents a case study of the process of designing a new model for a surgical ward in a large hospital in Western Sydney and explored the nurses’ experiences of this redesign process. The participants were the nurses working in the ward and the nurse managers associated with the ward management and included the nurse unit manager and directors of nursing. Data for the case study were accessed from a number of sources for different purposes. The case study of the redesign of the model of nursing practice showed that change is a difficult process, which needs to involve all stakeholders. There are a number of implications for clinicians, managers and educators from this case study. Managers and clinicians must share an effective communication process during redesign and identify common outcomes. Clinicians need to be encouraged to work towards a vision of nursing practice through debate and education. Educators must be used to support the redesign process by preparing nurses to undertake change, provide information on models of nursing practice and change theory. Recommendations for future research include evaluations of the role of education in redesign and the effect of redesign from patient perspective. Other studies could include descriptive studies of nurse managers’ experiences of redesign in a clinical setting and reasons why nurses are resistant to change. / Master of Nursing (Hons)

Models of nursing practice create a context, boundary, direction and expectations for nurses, patients and other members of the health care team. The literature is scanty in regard the experience of Australian nurses faced with the process of redesign in their workplace. This study presents a case study of the process of designing a new model for a surgical ward in a large hospital in Western Sydney and explored the nurses’ experiences of this redesign process. The participants were the nurses working in the ward and the nurse managers associated with the ward management and included the nurse unit manager and directors of nursing. Data for the case study were accessed from a number of sources for different purposes. The case study of the redesign of the model of nursing practice showed that change is a difficult process, which needs to involve all stakeholders. There are a number of implications for clinicians, managers and educators from this case study. Managers and clinicians must share an effective communication process during redesign and identify common outcomes. Clinicians need to be encouraged to work towards a vision of nursing practice through debate and education. Educators must be used to support the redesign process by preparing nurses to undertake change, provide information on models of nursing practice and change theory. Recommendations for future research include evaluations of the role of education in redesign and the effect of redesign from patient perspective. Other studies could include descriptive studies of nurse managers’ experiences of redesign in a clinical setting and reasons why nurses are resistant to change. / Master of Nursing (Hons)

The aim of this study was to examine nurses' perceptions and practice of health education and health promotion in the acute care setting. Ward sisters (n=132) working on acute wards in nine District Health Authorities were interviewed using a semi-stuctured schedule. Data were collected on perceptions of health education and health promotion, nurses' role in these activities, and factors influencing nurses' health education and promotion practice on the ward. Data were analyzed using a combination of qualitative and quantitative methods. In the second phase of the study, three wards were selected as case studies of nurses' practice. Data collection methods employed to describe nurses' practice included: non-participant observation, audio-recording of nurse-patient interactions, self-administered questionnaires and reflective field notes. A largely qualitative approach was taken to the analysis of these data. The findings from the interviews indicated that the ward sisters had limited understandings of the meaning of health education and health promotion and nurses' roles in these activities. Findings from the case study wards as a whole suggested that nurses' health education and promotion practice was generally extremely limited, although there were some differences between wards in the extent of this evolution. A number of factors may help explain these findings. These include: nurses' knowledge and skills in health education and health promotion, the philosophy, organization and management of care adopted, and the extent to which these offer opportunities for empowerment in nursing. It is suggested that nurses' perceptions and practice can be conceptualized with reference to a continuum of health promoting nursing practice, and that only limited progress has been made towards nurses' full potential. It is argued that if nurses are to develop their health promoting practice, a philosophical shift in nursing is necessary. Together with the acquisition of appropriate knowledge and skills, this may empower nurses to realise their potential.

No description available.

No description available.

Este estudo focaliza como o enfermeiro está sendo formado para atuar na area de hanseníase e como se configura a realidade concreta de sua prática nos serviços públicos de saúde junto ao programa de controle da endemia. Partiu-se do referencial teórico sobre a questão da saúde no Brasil, com enfoque histórico-social da mesma, sem perder de vista o componente biológico do processo saúde-doença. Fez-se uma análise do sistema de saúde vigente com ênfase na política atual, e a inserção do Programa de Controle da Hanseníase nesse contexto. Buscou-se, ainda, registrar a situação epidemiológica da hanseníase, caracterizando-a como um problema de saúde pública. A formação do enfermeiro foi verificada junto aos docentes responsáveis pelo ensino da hanseníase em 66,60% dos Cursos de Graduação em Enfermagem do Estado de São Paulo. As informações sobre o desenvolvimento de sua prática na área de hanseníase foram obtidas através dos próprios enfermeiros nas unidades ambulatoriais da rede de serviços públicos do Estado; utilizou-se um formulário próprio para o levantamento de dados que ocorreu durante o primeiro semestre de 1989. Os resultados obtidos apontam para uma deficiência no ensino da hanseníase, sendo necessário dar maior importância ao tema, através de uma reformulação do mesmo nos currículos dos Cursos de Graduação em Enfermagem. Foram identificadas como sendo papel do enfermeiro em hanseníase as seguintes funções: educação em saúde, assistência de enfermagem, administração de serviços e vigilância epidemiológica. A prevenção de incapacidade foi a atividade que apresentou a maior freqüência de respostas nas questões relacionadas ao ensino assim como naquelas vinculadas ao papel do enfermeiro no programa de controle da hanseníase. / This study is about how the nurses has been trained to work with hanseniasis and how the concrete reality of that practice is related to the public health services within the control program of that endemic disease. A social historical approach of the health issues in Brazil, has been used as a theoretical framework, without loosing the biological component of the health-sickness process. The present health system has been analysed emphasizing the political system in course, and the insertion of a Hanseniasis Program in the context. The epidemiological situation of Hansen\'s disease was also registered, been characterized as a public health problem. The nurse\'s training was verified in 66,60% graduation nursing training schools of the state of São Paulo, together with the lecturers responsable for the teaching of hanseniasis subjects. The informations about the development of the practice in this field was obtained from nurses working in the outpatients clinics of the public health system of the state. Data was collected during the first semester of 1989, with a specific formulary. The results obtained showed a poor Hansen\'s disease education, being necessary an emphasis on the subject, through a curriculum reformulation. The following functions have been identified as being the nurse\'s role in hanseniasis: health education, nursing assistance, administration services and epidemiological control. The prevention of disabilities was the activity that appeared with a higher frequency in the answers to questions related to teaching as well as those related to the nursing role in the Hansen\'s Disease Control Program.

This thesis investigates the following factors concerning student nurses: (1) demographic background and life experiences; (2) motivations to enter and commitment to nursing school; (3) students' conceptions of the role of a nurse; (4) comparison of students' expectations with their ideals and with the realities of nursing. A questionnaire was administered to first year nursing students at three institutions; a four-year baccalaureate degree program and two community college associate degree programs. The two types of institutions were chosen to allow comparison between students on two different career tracks. The findings indicate that contemporary student nurses are older than typical college students, have had a significant number of prior occupational experiences, and in contrast to the 1960's and earlier, are not exclusively female. They were most strongly motivated to be nurses by the desire to help others and conceive of the role of a nurse as challenging, rewarding, and relatively professional. In general, these students had a good understanding of the role of the average nurse, but they would construct the ideal nursing environment somewhat differently than the actual nursing environment. These findings relate to career exploration and motivational processes associated with occupational training. It can be inferred from survey data that initiates to training programs often are quite aware of what the discipline demands. In many cases they have sought out others who are working in the field. These data also reflect the increasing occupational mobility of American society whereby individuals change careers once or more during their lifetimes.

The solitary position of nurses who practise in geographically isolated communities to provide direct health care to a predominantly Aboriginal population characterises nursing in remote areas. Munoz & Mann (1982) described this practice as unique. The uniqueness of this practice, however, has remained shrouded in superficial descriptions featuring service delivery at a one or two-nurse-post, the physical distance of nursing posts from hospital facilities and the autonomy with which nursing is performed. Only glimpses of the reality of nursing practice in a remote area have been revealed through the study of the educational needs of remote area nurses (Munoz & Mann 1982, Cameron-Traub 1987, Philp 1988, Kreger 1991a, Bell, Chang & Daly 1995). A key problem is the lack of a systematic description and detailed analysis of nursing as it is practised in a remote area.The purpose of this study was to explore, describe and analyse nursing practice in a remote area. The research was undertaken at Warburton, an isolated community mainly inhabited by the Ngaanyatjarra people in the Central Desert of Western Australia. An ethnographic design was chosen for this exploratory inquiry into the social and cultural pattern of everyday nursing practice. In a pre-entry study a suitable setting and informants were found. Fieldwork was conducted at the Warburton nursing post by the researcher and involved living on site for a year. Data gathering techniques were participant observation together with interviewing, collection of pertinent documents and the daily chronological recording of fieldnotes, memos and a personal journal. Data analysis was performed concurrently with data gathering. The process followed the Developmental Research Sequence Method by Spradley (1980). Through a cyclical process of data collection and analysis the domains, taxonomies and componential variables in the ++ / culture of remote area nursing practice emerged.Amorphous practice was the overall theme revealed in the underlying cultural patterns that shaped the practice of nursing in the remote area. The term amorphous practice is defined as the changeable nature of practice from nurse to nurse, from situation to situation, from time to time. This was observed in the recurrent differences between nurses in their knowledge, abilities and attitudes as well as in the variability between nurses in their management of client care. Contributors to the phenomenon of amorphous practice were found in three distinct, but inter-related, tributary themes termed detachment, diffusion and beyond the nursing domain. Detachment explained the nurses' feelings of separateness from the usual professional and organisational structures needed for the enactment of nursing. Diffusion encapsulated the broad spread of the nurses' role in remote area practice. Beyond the nursing domain described an unregulated practice considered to be outside the responsibilities of nursing care. The substantive theory of amorphous practice provided a detailed description of how nursing was practised in the remote area. It also explained why it was so different from nursing as it is generally understood by the profession.