Beata Dobrowolska

Moral Obligations of Nurses Based on the ICN, UK, Irish and Polish Codes of Ethics for Nurses

A code of professional conduct is a collection of norms appropriate for the nursing profession and should be the point of reference for all decisions made during the care process. Codes of ethics for nurses are formulated by members of national nurses’ organizations. These codes can be considered to specify general norms that function in the relevant society, adjusting them to the character of the profession and enriching them with rules signifying the essence of nursing professionalism. The aim of this article is to present a comparative analysis of codes of ethics for nurses: the ICN’s Code of ethics for nurses, the UK’s Code of professional conduct, the Irish Code of professional conduct for each nurse and midwife, and the Polish Code of professional ethics for nurses and midwives. This analysis allows the identification of common elements in the professional ethics of nurses in these countries.

Patterns of clinical mentorship in undergraduate nurse education: A comparative case analysis of eleven EU and non-EU countries.

BACKGROUND In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries. OBJECTIVES To describe and compare the CMs role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries. DESIGN A case study design. PARTICIPANTS AND SETTING A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA). METHODS A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country. RESULTS In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden. CONCLUSIONS Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation.

Clinical practice models in nursing education: implication for students' mobility.

BACKGROUND In accordance with the process of nursing globalization, issues related to the increasing national and international mobility of student and qualified nurses are currently being debated. Identifying international differences and comparing similarities for mutual understanding, development and better harmonization of clinical training of undergraduate nursing students is recommended. AIMS The aim of the study was to describe and compare the nature of the nursing clinical practice education models adopted in different countries. METHODS A qualitative approach involving an expert panel of nurses was adopted. The Nominal Group Technique was employed to develop the initial research instrument for data collection. Eleven members of the UDINE-C network, representing institutions engaged in the process of professional nursing education and research (universities, high schools and clinical institutes), participated. Three data collection rounds were implemented. An analysis of the findings was performed, assuring rigour. RESULTS Differences and homogeneity are reported and discussed regarding: (a) the clinical learning requirements across countries; (b) the prerequisites and clinical learning process patterns; and (c) the progress and final evaluation of the competencies achieved. CONCLUSIONS A wider discussion is needed regarding nursing student exchange and internalization of clinical education in placements across European and non-European countries. A clear strategy for nursing education accreditation and harmonization of patterns of organization of clinical training at placements, as well as strategies of student assessment during this training, are recommended. There is also a need to develop international ethical guidelines for undergraduate nursing students gaining international experience.

Bologna process, more or less: nursing education in the European economic area: a discussion paper.

Abstract The Bologna Declaration and the subsequent processes is the single most important reform of higher education taking place in Europe in the last 30 years. Signed in 1999, it includes 46 European Union countries and aimed to create, a more coherent, compatible, comparable and competitive European Higher Education Area. The purpose of this paper is to discuss the Bologna Declaration achievements in nursing education at 2010 within eight countries that first signed the Declaration on 1999. Researchers primarily identified national laws, policy statements, guidelines and grey literature; then, a literature review on Bologna Declaration implementation in nursing was conducted on the Medline and CINAHL databases. Critical analyses of these documents were performed by expert nurse educators. Structural, organizational, functional and cultural obstacles are hindering full Bologna Process implementation in nursing education within European Economic Area. A call for action is offered in order to achieve a functionally unified system within nursing.

Theoretical Foundations of Nursing Practice in Poland

This authors of this column explore the use of nursing theory in Poland. A quasi-experimental pretest-posttest study was conducted to explore what, if any nursing theories were used by nurses in Poland, and if an education program on nursing theory increased the use of nursing theory. The study found that while there were discrepancies between the nurses’ theoretical knowledge base and their use of these theories in practice, there is evidence of the use of the ideas and theory of Nightingale, Orem, and Henderson in nursing practice in Poland.

Age discrimination in healthcare institutions perceived by seniors and students

Background: Old age–based discrimination is observed as the most tolerated prejudice in society and has also been witnessed in healthcare institutions. Aims: The aim of this study is to explore age-based discrimination in healthcare institutions as perceived by seniors and students of Medicine and Nursing. Research design: A multi-method study design, by involving a triangulation design. Participants and research context: A purposeful sample of individuals aged 65+ (n = 80) and medical and nursing students (n = 100) in the eastern region of Poland. Ethical considerations: Ethical approval of the research protocol was received from the Ethics Committee at the Medical University of Lublin. Findings: ‘Old age’ was perceived by groups of participants based on three themes: (a) positive, (b) negative and (c) neutral connotations. The negative connotations predominated. The beginning of old age was defined by the metric of age and described by showing the complexity of the ageing process involving subjective, objective and societal aspects. Experience of age discrimination in healthcare institutions was reported by 24 (30%) seniors and witnessed by 47 (47%) students surveyed and for both groups occurred mainly at the hospital level and by physicians. Only 48 students (48%) declared a willingness to work with the older people in the future, and barriers were reported at the personal and professional levels, and also in some visions of older people. Conclusion: The conceptualization of old age as reported by seniors and students mainly carried negative connotations, reflecting the profoundly based stereotypes within society regarding the older people. Seniors have reported being exposed to ageism and have witnessed ageism episodes in HCIs; also, students have faced ageism episodes during their clinical education. There is a need for ethical education within medical and nursing courses to shape positive attitudes towards the older people. A positive vision of ageing should be promoted not only among young people but also among adults and older people to avoid self-stereotyping of older people and seeing old age from negative perspective.

An image of nurses and nursing in Poland in the media and in the opinion of various social groups. Systematic review of scientific literature from the years 2010-2017

Abstract Introduction. Nursing is a profession of public trust with a fairly high position in various rankings examining the prestige of professions. Aim. Analysis of published research results on the image of nurses and nursing in Poland in the media and in the opinion of various social groups. Material and methods. A systematic review of Polish scientific literature from the years 2010-2017 was undertaken. A multi-stage search process was carried out in accordance with the adopted inclusion criteria, and then articles identified and accepted were subjected to a qualitative analysis. Results. Searching the Google Scholar database by accepted key words resulted in 10,663 records. After analyzing the titles and abstracts of these papers, 19 articles were subjected to further analysis. As a result of searching journals included in the Arianta database according to established key words, 10 articles were identified, 8 of which were qualified for further analysis. After removing duplicates, 17 articles were approved for the final analysis. Qualitative analysis of the research results published in these papers allowed to distinguish the following categories: an image of nurses and nursing in various social groups, elements of nurses’ image in the media and society, actions aiming at improving the image of nurses and nursing in Poland, changes in the image of nurses and nursing in Poland over the years and the direction of these changes. Conclusions. The issue of an image of nurses and nursing in the media and in the society has been a frequent subject of research of nurses in Poland in the recent years. These studies concern primarily opinions on the image of nurses and nursing, factors which determine the image of nurses and nursing in Poland, constitutive elements of the image, the possibility of improving the image and people/ institutions responsible for it.

The health locus of control and health behaviours declared by students of health sciences

Abstract Introduction. Health locus of control is an essential factor affecting lifestyle which plays a major role in choosing health behaviours by individuals including young ones. Aim. The aim of the study was the determination of selected conditions of health control and health behaviours in students of health sciences. Material and methods. The study encompassed 175 students of health sciences at the Medical University of Lublin. The multidimensional health locus of control scale (MHLC), version B, by Z. Juczyński was applied as it measures expectations in three dimensions of health control: internal, external (influence of others) and chance. A special authors’ questionnaire compiled for the purpose was used to assess health behaviours. Results. The results of the study show that the internal dimension of health control (25.86 points) has the greatest impact on health in the group studied. The oldest study participants dwelling in the countryside gave this dimension a higher ranking than other study participants. For the students health behaviours included fastening seat belts, healthy nutrition and doing sports. Conclusions. The internal dimension of health control constitutes an essential factor determining health behaviours of the study participants. The students who are not able to assess whether they are healthy individuals, significantly more frequently perceive the greatest influence of others on their health.

Evaluation of the health behaviors of women in multiple pregnancies — a preliminary study

OBJECTIVES The aim of the paper was to assess which health behavior indicators were characteristic for women with a multiple pregnancy. MATERIAL AND METHOD The study involved 35 women in multiple pregnancies. The inclusion criteria were: the completion of the 22nd week of pregnancy (22 Hbd, i.e., 22 weeks and 1/7) and the consent of the women to participate in the study. We used an original questionnaire devised by us specifically for our study, as well as a standardized research tool, Juczyńskis Health Behavior Inventory questionnaire, for the assessment of the pregnant womens health behaviors. RESULTS The overall rate of health behaviors was high and was on average 93.9 ± 10.8 points (7 sten scores). Indicators of the health behaviors of women in multiple pregnancies were high across all categories. However, the highest rate was observed in preventive behaviors. CONCLUSIONS The overall rate of health behaviors of women with a multiple pregnancy and all the individual behavior category indicators were high. However, the highest rate was for preventive behaviors. The indicator values of the health behaviors of the pregnant women in the study were not dependent on the variables adopted in this paper.

Human rights conflicts experienced by nurses migrating between developed countries

Background: Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. Aims: To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. Research design: A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. Findings: In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Discussion: Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. Conclusion: The call for investing in nurses and nurses’ care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.