Stress is well known to go hand in hand with registered nurses and the nursing field. The aim was to examine stress related coping strategies experienced and used by registered nurses from different countries all over the world. This qualitative study was done by analyzing the results from 10 different articles. The findings showed that there was multiple coping strategies that is being used by nurses to cope with the stress they experience at work. Some of the coping strategies were done after work; For instance, different physical activities including yoga and sports. Other coping strategies that were found are more work related. For example, the importance of knowing yourself in your nursing role, knowing your limits, and the importance of having a good relationship with your colleagues. Employers can use these strategies on a daily basis both and registered nurses to cope with work related stress.

There is a gap between organizational commitment to professional value of the nurse and the achievement of quality outcomes. This study explored the relationship between the productivity model and the professional value (PVS) model of the hospital-based registered nurse (RN). It was essential to understand how to measure nursing's contribution to patient care as a means to promote patient care outcomes. The current professional nursing dynamic provides an unprecedented opportunity for nurses to achieve their highest professional potential through increased demonstration of advocacy and accountability for the central tenets of nursing. The intent of this project was to explore the elements of the professional nursing workforce in a modern-day hospital. This study was conducted on the medical, surgical, progressive care unit (PCU) and critical care unit (CCU) of a community-based acute care hospital Washington State. A quantitative approach was undertaken utilizing a descriptive correlational study design. RNs on the identified units received electronic invitation and survey via organizational email system, resulting in a participation rate of 47.1% (N=48). The study found that PVS model achievement explained patient outcome variable variance (fall rate 86.4%, HAPU 83.1% and CAUTI 40.9%). Further, large effect size (98%) with work unit variance was demonstrated with PVS model achievement. The innovative PVS model was found to demonstrate a statistically significant difference from existing productivity model, and alignment of RN staffing with organizational quality goals. Recognizing the professional value of the RN could promote meaningful change in the healthcare landscape and optimize patient care and quality outcomes.

Registered Nurses (RNs) have a history of policy leadership that has altered the health care system and the profession. The purpose of the qualitative inquiry was to describe the experiences of six select Saskatchewan formal Registered Nurse leaders (RNLs) in policy. Through open-ended interviews and letters, personal experiences were interpreted using content analysis. The researcher identified key ideas from the interview data and requested a reflective letter expanding or clarifying the chosen text, serving to enhance triangulation and member-checking of personal transcripts. Meaningful patterns and/or similarities describing three themes of values, vision, and career paths emerged from the textual data. The coding framework evolved into ten categories describing individual experiences, such as mentoring, change management, and work-life balance. Three RNLs described how they wished more RNs were involved in policy, as they believed that RNs could harness more power in policy processes. Five RNLs told stories about how graduate education influenced their thinking and they gained appreciation for leading action on policy issues.<p> The qualitative data were presented in categories for discussion. One RNL described how organizational structures may a limiting factor to RNs participation in policy. Implications and recommendations of the findings are outlined for education, practice, administration, research, and policy. Findings are relevant for professional, health care, and government organizations, as well as education programs. Relevance may be found by individual practitioners considering a leadership role, to assist in informing potential career paths.

Registered Nurses (RNs) have a history of policy leadership that has altered the health care system and the profession. The purpose of the qualitative inquiry was to describe the experiences of six select Saskatchewan formal Registered Nurse leaders (RNLs) in policy. Through open-ended interviews and letters, personal experiences were interpreted using content analysis. The researcher identified key ideas from the interview data and requested a reflective letter expanding or clarifying the chosen text, serving to enhance triangulation and member-checking of personal transcripts. Meaningful patterns and/or similarities describing three themes of values, vision, and career paths emerged from the textual data. The coding framework evolved into ten categories describing individual experiences, such as mentoring, change management, and work-life balance. Three RNLs described how they wished more RNs were involved in policy, as they believed that RNs could harness more power in policy processes. Five RNLs told stories about how graduate education influenced their thinking and they gained appreciation for leading action on policy issues.<p> The qualitative data were presented in categories for discussion. One RNL described how organizational structures may a limiting factor to RNs participation in policy. Implications and recommendations of the findings are outlined for education, practice, administration, research, and policy. Findings are relevant for professional, health care, and government organizations, as well as education programs. Relevance may be found by individual practitioners considering a leadership role, to assist in informing potential career paths.

The moral distress experiences of Registered Nurses who work in non-acute, continuing care settings were examined using qualitative methods. Previous research suggests that in general, nurses experience moral distress when they are not able to pursue actions in accordance with their moral conscience. Moral distress in nurses is expressed negatively in both the nurses’ professional and personal lives. However, most research on moral distress among nurses has focused on acute care settings. Registered Nurse participants were recruited from non-acute continuing care settings and described their experiences of moral conflict and distress. Particular attention was placed on the nurses’ experiences and reactions to their experience. The findings from this study indicated that as in other settings, moral distress is present in Registered Nurses practicing in non-acute continuing care. The nurses’ practicing in non-acute continuing care settings experienced moral distress after facing a barrier to their moral conscience involving organizational functioning, end of life decisions, patient advocacy, and resource utilization. Nurses experienced feelings including powerlessness, concern, regret, disappointment, suspicion of others, and feeling devalued. Future studies may focus further on the subspecialties in the non-acute continuing care sector. Research on strategies to resolve moral distress and research on the effectiveness of current interventions to combat moral distress among Registered Nurses in this setting should be pursued. / Thesis (Master, Nursing) -- Queen's University, 2009-09-01 10:02:08.043

Purpose: Describe the perceptions of military registered nurses (RNs) on being prepared to provide nursing care during a deployment. Background: Injuries sustained by war are different from trauma-related injuries occurring within the Unites States. Nurses who provide care during overseas deployment encounter patients with poly-trauma, multiple and highly complex injuries; consequently, this type of nursing requires strong clinical skills beyond what is required in stateside facilities. Additionally, military nurses undergo intense stress related to overseas deployment in a war zone. In fact, military medical providers have one of the highest rates of post-traumatic stress post-deployment. Methods: This project employed a qualitative, case study approach. Semi-structured interviews were conducted with military RNs who worked as nurses during overseas deployment. A script was developed to guide the interview, and further discussion stemmed from participant responses. Recorded interviews were transcribed into text and analyzed for commonalities. Findings: Five military nurses who previously provided nursing care during overseas employment participated in this study. Commonalities included the realization that higher acuity injuries are seen in a deployed setting versus a military stateside hospital. Participants also shared fears that they would not be prepared enough to provide excellent patient care. Another commonality was not knowing how to prepare for an unknown experience. A positive commonality was the sense of pride expressed by the participants regarding their military service and deployment experience. All participants outlined what they had learned and what might have helped them to better prepare for deployment. Unanimously, more clinically relevant training was recommended. The participants shared that they had grown and changed from their deployment experience. Implications: All five participants felt a gap in perceived adequate pre-deployment preparation. They believed they lacked the training to care for the high acuity patients they would encounter during overseas deployment; this shook their self-confidence and caused them to worry about being an effective team member. Military preparedness programs should be expanded to include skills and knowledge relevant to nursing in high acuity, hostile environments. Research looking at the personal preparations, specifically mental and emotional, of military members may be helpful in determining any links between mental resilience and the development of PTSD.

SAMMANFATTNING BAKGRUND: I och med Ädelreformen flyttades vården av äldre till kommunen och sjuksköterskor började arbeta inom den kommunala äldreomsorgen. Arbetet saknar tydliga riktlinjer och rutiner. Det innebär ett stort ansvar för sina arbetsuppgifter samt patientansvar. Vid konsultarbete ansvarar sjuksköterskan för ett stort antal människor och förmåga att prioritera och snabbt göra bedömningar av arbetsuppgifter och sjukdomstillstånd krävs. SYFTE: Syftet med studien var att utifrån sjuksköterskors berättelser beskriva deras upplevelser av sitt arbete inom den kommunala äldreomsorgen. METOD: Det är en deskriptiv studie. Information samlades in genom semi-strukturerade fokusgruppsintervjuer. Totalt tio sjuksköterskor deltog uppdelade på intervjugrupper. Det insamlade materialet bearbetades sedan genom tematisk kvalitativ innehållsanalys. RESULTAT: Resultatet visar att sjuksköterskorna upplever ett stort ansvar för sina bedömningar och arbetsuppgifter. De upplever att de inte har några tydliga riktlinjer för sin specifika funktion i kommunen vilket innebär att de ofta får ansvar för uppgifter som inte är deras. Det ökade administrativa arbetet leder till minskad tid för patienter och omvårdnadsarbete vilket leder till frustration och en känsla av otillräcklighet. SLUTSATS: Sjuksköterskans funktion i kommunen behöver preciseras så att hon kan minska sina administrativa uppgifter och få mer tid till patienter och omvårdnadsarbete. Även teamarbetet behöver utvecklas för att stärka yrkeskategorierna och göra riktlinjerna tydligare. Nyckelord: registered nurse, eldercare, residential homes, professional role, focus group

Syftet var att beskriva arbetstillfredsställelsen hos intensivvårdssjuksköterskor samt undersöka om arbetssituationen förändrats senaste året. Syftet var vidare att se om skillnader förelåg i arbetstillfredsställelsen mellan intensivvårdssjuksköterskor som arbetade treskift och som inte arbetade treskift. Studien var deskriptiv med kvantitativ ansats. Sextiofyra sjuksköterskor deltog och bortfallet var 29 %. Enkäter testade gällande validitet och reliabilitet för arbetstillfredsställelse användes i studien. Arbetstillfredsställelsen var genomgående hög, intensivvårdssjuksköterskorna upplevde sig mötas med respekt av överordnade och samarbetsklimatet var bra. De var en del av ett team, arbetet var intressant och autonomin var hög. Majoriteten upplevde att personaltätheten var otillräcklig för arbetsbelastningen, beslut från överordnade gick inte att påverka och nästan en tredjedel upplevde sig inte få beröm vid bra utfört arbete. Trots genomgående hög arbetstillfredsställelse funderade nästan tjugo procent på att byta jobb. Senaste året hade arbetsbördan ökat med mer administrativt arbete och mindre tid för patientvård. Förtroendet för den offentliga sjukvården hade minskat. Inga signifikanta skillnader fanns gällande arbetstillfredsställelsen mellan intensivvårdssjuksköterskor som arbetade treskift och som inte arbetade treskift. Nattarbetet ansågs behöva värderas högre med mer tid för återhämtning. Konklusion: Arbetstillfredsställelsen var genomgående hög men arbetsbördan hade ökat senaste året, utbrett missnöje förekom gällande återhämtningstiden vid nattarbete. / The objectives were to describe the work satisfaction amongst intensive care nurses, and to investigate if the work situation has changed over the last year. A further purpose was to see if there were any differences in the work satisfaction between intensive care nurses who worked three-shift and those who did not. The study was descriptive with a quantitative approach. Sixty-four nurses participated and the 29 percent decided not to participate. Questionnaires tested regarding validity and reliability for work satisfaction were used in the study. Work satisfaction was overall high; the intensive care nurses perceived themselves as being respected by superiors, and the work situation as good. They felt part of a team; the work was interesting and the levels of autonomy high. The majority perceived that the staffing levels were insufficient for the workload, they could not affect the decisions made by their superiors, and almost a third experienced that they do not get praise for work well done. Despite the overall high work satisfaction almost twenty percent were thinking of changing jobs. During the last year, the workload had increased with more administrative work leaving less time for patient care. The trust in public healthcare had decreased. No significant differences were found regarding the work satisfaction between intensive care nurses working three-shift and those who did not work three-shift. The general opinion was that night work needed to be valued higher, and that more time was needed for recovery. Conclusion: The work satisfaction was overall high, but the workload had increased over the last year, and there was a widespread dissatisfaction regarding recovery time after night work.

Background: In pace with the increasingly aging population will the number of older people in nursing homes and with care in home grow. This means that the nurse will face related to the older more frequently and more widely. Nurses has overall responsibility over both the care of the elderly as a responsibility of maintaining good relationships with related parties. Related parties are of great importance for the older individual, it is therefore relevant for the nurse to be able to interact in a respectful and sensitive manner to involve the relatives in care. Aim: The aim with this study was to highlight nurse's experiences of interaction with related parties to elderly in community health care. Method: A literature review based on nine qualitative articles was conducted. Friberg design was used with the inspiration of Lundman and Hällgren Graneheim regarding the analysis of Articles. Results: The study resulted in four themes. They included information about nurse's experiences of interaction with related parties. These themes describes the importance of communication in the interaction, the attitudes various expressions, cooperation with related parties and experiences with related parties' participation in care. Conclusion: An important conclusion is that the nurse should take advantage of related parties skills and resources in health care around the elderly. The nurses sometimes has difficulties interacting with related parties. Nurses probably need to see the difficulties from different perspectives and seek help of colleagues.

Hospital care is changing, - dominated by the dollar and technology and the patient is taking second place. Nursing, traditionally known as being a caring profession, is not exempt from the changes and the traditional entrance interview to find caring students has been replaced by a computerised system. Graduates from university programs are being branded as non-caring. This research sought to find practical ways in which nurses showed caring to patients, and to develop a framework which could be used to teach and cultivate caring attributes in undergraduate students. A broad sweep of the past was taken to show how, dominated by disease and the necessity to take care of the suffering and infirm, nursing has been inextricably linked to the inability of science to cure. The discussion on the impact of the Therapeutic Revolution and a health care system, dominated by the dollar, places nursing and caring in perspective. Some philosophical, religious and psychological notions of caring were briefly explored. A participative paradigm underpins this research which uses a collaborative inquiry cyclical and reflective process of three phases. In Phase I a group of Graduate Registered Nurses reflected on the enacted/strategies/skills that were used to show caring to patients. Six key enactments were elicited from the total of 64 reflections that were submitted. Phase II constructed a framework that could be used to teach caring, which was then critiqued by an expert group of educators. Phase III returned to Phases I and II and used a process of reflection-on-reflection and a new emergent meaning of caring in nursing ensued. As a result of this reflection-on-reflection, a reconfiguration of the framework resulted in the development of the Care Connections model.