People who are homeless rely heavily on acute health care facilities to meet basic health care needs. Medical-surgical nurses play a fundamental role in the health care and health outcomes of patients who are homeless. According to the Institute of Medicine, health care providers’ bias and stereotyping contribute to health disparities among marginalized and vulnerable populations. Because attitudes are linked to clinical decision making and behaviors, revealing how nurses’ attitudes towards patients who are homeless develop and transform is paramount to improving health disparities of the homeless population. The purpose of this study was to explore nurses’ clinical experiences with patients who are homeless in order to discover how attitudes toward care of the homeless develop and transform. Interpretive phenomenology was used to describe and interpret the experiences of 11 medical-surgical nurses who cared for patients who were homeless and reported their attitudes toward this marginalized population had transformed. Nurses’ clinical experiences ranged from 3 to 40 years. Audiotaped semi-structured interviews were conducted. Data analysis was ongoing throughout data collection as delineated by Diekelmann and Allen (1989) and expanded by Minick (1992). Five themes were revealed through interpretation of the rich data. The themes were ‘Discovering homelessness,’ ‘Finding common ground,’ ‘Piecing it together,’ ‘A daily struggle,’ and ‘Relationships based on distrust.’ Nurses’ attitudes were in constant development and transformation. Nurses’ life and clinical experiences created opportunities for attitude transformations. Experiences associated with attitude transformation were identified. Nurses’ experiences revealed how nurses enter practice with an established attitude toward this marginalized population. As nurses came to realize that homelessness was no longer an abstract, intangible concept rather homelessness existed and was present in their day-to-day nursing practices their attitudes began to transform. Nurses sought common experiences with patients who were homeless to create a sense of connectedness in nurse-patient relationships. Nurses described a daily struggle of maintaining positive, non-judgmental attitudes. Nurses shared how early experiences of negative encounters with patients who were homeless created feelings of distrust thus altering nurse-patient relationships with future patients who were homeless. This study contributes to nursing knowledge by revealing how medical-surgical nurses’ attitudes develop and transform and how experiences are associated with attitude change. Recommendations for nursing practice, education, research are identified.

Many older adults experience complications related to hospitalization. The most prevalent of complications is delirium which often goes undetected and untreated and results in increased morbidity and mortality. Nurses are in an ideal position to detect and manage delirium because of their close patient contact, however delirium remains underrecognized even when using a valid screening tool. This study adopts a qualitative descriptive approach to identify the barriers to nurse detection of delirium. Ten frontline surgical nurses participated in semi-structured interviews from which five major themes emerged through an inductive thematic analysis. Nurses have a knowledge deficit of the features of delirium and find it difficult to access information regarding their patients’ baseline cognitive function. Nurses reported inadequate time with patients that led to a self-perpetuating delirium cycle and furthermore, nurses stated that hyperactive delirium symptoms prevented adequate assessment and care. Nurse-physician communication plays an important role in delirium detection and treatment with both psychological and feminist perspectives offered. Recommendations include improvements in nursing knowledge, management of time and enhancements to current written and verbal communication about delirium. / Graduate

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Nurses are subjected to occupational stress factors that can result in the syndrome of burnout. This study compared levels of burnout in nurses in a medical-surgical ICU setting to those in non-ICU medical-surgical settings. A randomized sample of 40 nurses of an urban hospital in Taiwan, twenty nurses in an ICU and 20 in five non-ICU settings (general medical-surgical wards), who returned the questionnaire used to measure burnout, were included in the study. The instrument utilized was the Staff Burnout Scale for Health Professionals. The study found no significant difference in levels of burnout in the two groups. Both groups in this study experienced a higher level of burnout than was reported in other studies in United States literature. In particular, two general medical-surgical wards which had high patient/nurse ratios, had very high levels of burnout. The study also found that all nurses with lower educational levels and ICU nurses with more years of work experience had more burnout. / 2999-01-01

ABSTRACT The aim of this thesis is to illustrate how surgical operation theatre nurses perceive debriefing within emergency health care. The study has a qualitative design with semi structured interviews that have been performed with seven operating room nurses working in emergency health care. The strategic selection consists of professional operation theatre nurses working in emergency care at Uppsala University Hospital. The main goal of this thesis is to increase the understanding of debriefing and to highlight the need of debriefing after difficult or unexpected events in the emergency health care profession. The interviewed nurses perceive debriefing as an important way to develop the day to day work, but also as a way to unburden the staff at the time of bigger traumas. Even though the effect of debriefing is not univocally positive in the literature, the staff perceives that it reduces different kinds of stress. According to the interviewees, routines need to be written down in order for debriefing to be used in their work. The department should create a smaller work group with knowledge of debriefing. The work group should include two qualified leaders that can act as group leaders as well as instructor. One or two external resources (e.g. priest, behavioral) with appropriate qualifications should also be linked to debrief activities. The expected result is an improved working environment for surgical nurses. This is done as the stress level is reduced. Keywords: debriefing, mental health, defusing, surgical nurses

Abstrakt     Inledning: Att vara ny på arbetet är utmanande och innebär ökad stress. Tidigare studier visar att många upplever sin kunskap som begränsad och att de önskade mer praktisk erfarenhet och hade behov av en god introduktion. Gott lagarbete med goda relationer och tillåtande miljö var viktigt för att arbetet på operationsavdelningen skulle fungera tillfredsställande. Syfte: Studiens syfte var att belysa nyutexaminerade operationssjuksköterskors upplevelser av sin första yrkesverksamma tid. Metod: Studien hade en kvalitativ ansats där datainsamling har genomförts genom semistrukturerade intervjuer. Den utskrivna texten analyserades med en latent innehållsanalys. Resultat: I analysen framkom tre teman; Upplevda faktorer som påverkar utvecklandet av kompetens, Förmågan att inse sitt egenvärde och omgivningens inverkan på upplevelsen av trygghet, samt Behov av kontroll och stöd vid brist på kontroll. Resultatet visar hur nyutexaminerade operationssjuksköterskor upplevde en känsla av att vara dåligt förberedda inför de nya arbetsuppgifterna. Deltagarna beskriver hur de önskade en planerad inskolning med möjlighet till individuell anpassning. Erfarna och hjälpsamma kollegor upplevdes ge ökad trygghet och stöd från en kollega som det fanns förtroende för ansågs vara viktigt. Det framställdes hur betydelsefull självinsikten var över den egna kunskapen samt att ansvaret för kunskapsinhämtning låg på dem själva. Deltagarna menade också att det var viktigt att acceptera rollen som novis och därmed bristen på erfarenhet. Slutsats: Att belysa nyutexaminerade operationssjuksköterskors upplevelser av sin situation gör det möjligt att sträva efter en öppen och tillåtande arbetsmiljö. Detta ökar förutsättningarna för god inskolning av nyutexaminerade operationssjuksköterskor, vilket kan bidra till en mer patientsäker vård.   Nyckelord: Handledning, Innehållsanalys, Inskolning, Nyutexaminerade operationssjuksköterskor, Upplevelser. / Abstract     Introduction: To be new at work is challenging and involves increased stress. Earlier studies show that many experienced that their knowledge was limited and wished for more practical experiences and where in need of a good introduction. Good teamwork with good relationships and a permissive environment was important for work at the surgical department to perform satisfactorily. Aim: The purpose of the study was to highlight newly graduated surgical nurses experiences of their first professional career. Method: The study had a qualitative approach where data collection was carried out through semi-structured interviews. The transcript was analyzed with a latent content analysis. Results: The analysis revealed three themes: Perceived factors influencing the development of skills, the ability to recognize their intrinsic value and ambient effects on the perception of the Översätt från: svenskaSkriv text, ange adressen till en webbplatöversätt ett dokument.AvbrytExempel på hur "" kan användas:automatiskt översatt av Googlesense of security, and need for control and support in the lack of control. The result shows how graduates surgical nurses experienced a feeling of being not enough prepared for their new jobs. Participants describe how they wanted a planned induction with the possibility of individual adaptation. Experienced and helpful colleagues felt to provide greater security and support from a colleague that there was confidence was considered important. It was made how important self-realization was over their knowledge and that the responsibility for the acquisition of knowledge lay on them. Participants also felt that it was important to accept the role of a novice and thus the lack of experience. Conclusion: To highlight newly graduated surgical nurses' perceptions of their situation makes it possible to pursue an open and tolerant environment. This increases the chances of a good induction of newly graduated surgical nurses, which can contribute to a more patient-safe care.   Keywords: Content Analysis, Experiences, Induction, Newly graduates surgical nurses, Tutorial.

Čalko T. Organų persodinimo operacijose dalyvaujančių operacinės slaugytojų darbo motyvacijos aspektai, magistranto baigiamasis darbas / mokslinė vadovė dr. D. Zagurskienė; Lietuvos sveikatos mokslų universitetas, Slaugos fakultetas, Slaugos ir rūpybos katedra. – Kaunas, 2014. – 92 p. Organų persodinimas – didžiausias chirurgijos ir medikų komandos profesinio meistriškumo pasiekimas. Operacinės slaugytojai, dalyvaujantys organų persodinimo procese, yra svarbūs komandos nariai, jų atliekamas darbas – atsakingas, sudėtingas, reikalaujantis naujų žinių, didelio profesionalumo. Nors nemonotoniškas darbo pobūdis galėtų būti suvokiamas kaip patraukli veikla, tačiau personalo trūkumas, nepasitenkinimas atlyginimu, skubėjimas, viršvalandžiai, neįprastos procedūros, daug fizinių bei emocinių pastangų – veiksniai, išvedantys iš pusiausvyros ir darantys neigiamą įtaką operacinės slaugytojų darbo motyvacijai. Tyrimo tikslas – išanalizuoti organų persodinimo operacijose dalyvaujančių operacinės slaugytojų darbo motyvacijos aspektus. Tyrimo uždaviniai: įvertinti psichosocialinių veiksnių raišką operacinės slaugytojų darbe; ištirti darbo motyvacijos veiksnių raišką ir jų sąsajas su slaugytojų sociodemografinėmis savybėmis; nustatyti veiksnius, didinančius organų persodinimo operacijose dalyvaujančių operacinės slaugytojų darbo motyvaciją. Tyrimo metodas – 2013 m. rugpjūčio 25 – spalio 30 dienomis buvo atlikta anoniminė anketinė apklausa. Dalyvavo 127 operacinės slaugytojai, dirbantys... [toliau žr. visą tekstą] / T. Motivational aspects at work of surgical nurses assisting at organ transplantation surgeries, final thesis for Master's Degree/ supervisor Dr. D. Zagurskienė; Nursing and Care Department, Faculty of Nursing, Lithuanian University of Health Sciences. – Kaunas, 2014. - 92 p. Organ transplantation is the highest achievement of professional excellence of the surgical and medical team. Surgical nurses assisting at organ transplantation process are important team members, their work is responsible, complicated, requiring continuously-refreshed knowledge, high-level professionalism. Lack of monotony at work could be regarded as attractive feature, but shortage of staff, dissatisfaction with remuneration, rush, overtime, unusual procedures, lots of physical and emotional efforts are the factors that break the balance and negatively impact work motivation of surgical nurses. The purpose of the research was to analyse the aspects of work motivation of surgical nurses assisting at organ transplantation surgeries. Objectives of the research included evaluation of manifestation of psychosocial factors at surgical nurses' work; examination of manifestation of work motivation factors and their links with nurses' socio demographic qualities; determination of factors increasing work motivation for surgical nurses assisting at organ transplantation surgeries. Research method: anonymous questionnaire conducted on 25 August - 30 October 2013. Respondents of the research were 127 surgical... [to full text]

Background: Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. Purpose: The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses' behavioral intent to use evidence-based practice in preventing pressure ulcers. Theoretical Framework: The theoretical framework for this study was the theory of planned behavior. Methods: This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. Results: The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. Conclusions: A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers.

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The purpose of this study was to explore and describe the surgical nurses’ perceptions about the management of post-operative pain and strategies employed in management of pain in patients who have undergone total hip or knee replacement surgery in King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Qualitative, exploratory-descriptive research design was applied. Purposive nonprobability sampling was used and data collected by means of audio-recorded semistructured individual interviews. Data saturation was reached after interviewing twenty surgical nurses. Themes and categories emerged from adopting Creswell’s (2013) “data analysis spiral”. One of the key findings was that patients reportedly experience moderate to severe pain during the first three days after surgery, before it is controlled on mild to moderate levels or before the patient is pain free. Conclusions were drawn, and one of the major ones was that multimodal strategies are employed by the surgical to manage post-operative pain. Recommendations were also made from findings of this study, and one key recommendation was that expatriate nurses to have access to Arabic speakers to overcome language barriers. / Health Studies

The purpose of this study was to explore and describe the surgical nurses’ perceptions about the management of post-operative pain and strategies employed in management of pain in patients who have undergone total hip or knee replacement surgery in King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Qualitative, exploratory-descriptive research design was applied. Purposive nonprobability sampling was used and data collected by means of audio-recorded semistructured individual interviews. Data saturation was reached after interviewing twenty surgical nurses. Themes and categories emerged from adopting Creswell’s (2013) “data analysis spiral”. One of the key findings was that patients reportedly experience moderate to severe pain during the first three days after surgery, before it is controlled on mild to moderate levels or before the patient is pain free. Conclusions were drawn, and one of the major ones was that multimodal strategies are employed by the surgical to manage post-operative pain. Recommendations were also made from findings of this study, and one key recommendation was that expatriate nurses to have access to Arabic speakers to overcome language barriers. / Health Studies / M.A. (Health Studies)