Joyce Hendricks

Generational diversity: what nurse managers need to know

Aim This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. Background The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. Data sources An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000–2012. Discussion Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. Implications for nursing An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. Conclusion Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion.AIM This article presents a discussion of generational differences and their impact on the nursing workforce and how this impact affects the work environment. BACKGROUND The global nursing workforce represents four generations of nurses. This generational diversity frames attitudes, beliefs, work habits and expectations associated with the role of the nurse in the provision of care and in the way the nurse manages their day-to-day activities. DATA SOURCES An electronic search of MEDLINE, PubMed and Cinahl databases was performed using the words generational diversity, nurse managers and workforce. The search was limited to 2000-2012. DISCUSSION Generational differences present challenges to contemporary nurse managers working in a healthcare environment which is complex and dynamic, in terms of managing nurses who think and behave in a different way because of disparate core personal and generational values, namely, the three Cs of communication, commitment and compensation. IMPLICATIONS FOR NURSING An acceptance of generational diversity in the workplace allows a richer scope for practice as the experiences and knowledge of each generation in the nursing environment creates an environment of acceptance and harmony facilitating retention of nurses. CONCLUSION Acknowledgement of generational characteristics provides the nurse manager with strategies which focus on mentoring and motivation; communication, the increased use of technology and the ethics of nursing, to bridge the gap between generations of nurses and to increase nursing workforce cohesion.

Never ending stories: visual diarizing to recreate autobiographical memory of intensive care unit survivors

AIM The aim of this study was to explore the potential use of visual diarizing to enable intensive care unit (ICU) survivors to create their story of recovery. BACKGROUND An ICU experience can have deleterious psychological and physical effects on survivors leading to reductions in quality of life which for some may be of significant duration. Although there has been exploration of many interventions to support recovery in this group, service provision for survivors remains inconsistent and inadequate. DESIGN AND PARTICIPANTS A qualitative interpretive biographical exploration of the ICU experience and recovery phase of ICU survivors using visual diarizing as method. This paper is a component of a larger study and presents an analyses of one participants visual diary in detail. METHODS Data collection was twofold. The participant was supplied with visual diary materials at 2 months post-hospital discharge and depicted his story in words and pictures for a 3-month period, after which he was interviewed. The interview enabled the participant and researcher to interpret the visual diary and create a biographical account of his ICU stay and recovery journey. FINDINGS The analysis of one participants visual diary yielded a wealth of information about his recovery trajectory articulated through the images he chose to symbolize his story. The participant confirmed feelings of persecution whilst in ICU and was unprepared for the physical and psychological disability which ensued following his discharge from hospital. However, his story was one of hope for the future and a determination that good would come out of his experience. He considered using the visual diary enhanced his recovery. CONCLUSIONS The participant perceived that visual diarizing enhanced his recovery trajectory by enabling him to recreate his story using visual imagery in a prospective diary. RELEVANCE TO CLINICAL PRACTICE Prospective visual diarizing with ICU survivors may have potential as an aid to recovery.

Burns education for non-burn specialist clinicians in Western Australia

BACKGROUND Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. DESIGN/METHODS A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. RESULTS Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. CONCLUSIONS Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia.

Research is not a ‘scary’ word: Registered nurses and the barriers to research utilisation:

The aim of this study was to find out whether registered nurses read research articles, understand them and translate the research to practice. There is a problem with research knowledge translation in the clinical setting. Despite exposure to research, registered nurses often distance themselves from reading nursing research. A point-prevalence survey was conducted on a sample of registered nurses in a peripheral hospital in Western Australia. The survey was distributed to all wards of the hospital (n = 7). One-hundred and five (n = 105) registered nurses were eligible to participate. Ninety-five (n = 95) completed and the survey. The survey consisted of 11 general questions and an open-ended question. The majority of registered nurses in clinical practice found research articles difficult to understand because of research jargon. Most indicated that they sometimes or never understood what they are reading. Almost all nurses revealed that if research articles were in a ‘simpler’ language they would read them more and apply what they had learned. Promoting a common, user-friendly language in a research abstract or summary which is targeted to the registered nurse audience may assist in finding a common knowledge exchange between researchers and nurses and so help bridge the gap between research and practice.

Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings

INTRODUCTION Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. AIM To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. METHOD A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. RESULTS Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. CONCLUSION This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service.

Perceptions of exercise for older people living with dementia in Bangkok, Thailand: an exploratory qualitative study

BACKGROUND Dementia is a significant issue globally, including in Thailand, and exercise is known to have health benefits for people living with dementia. However, little is known about exercise acceptable to, and feasible for, this population group in low-to-middle income countries although, more broadly, it is recognised that health-related behaviours are influenced by the perceptions of the individual, which exist within a cultural context. OBJECTIVES To explore and describe perceptions of appropriate exercise for people living with dementia in Bangkok, Thailand. DESIGN Qualitative exploratory descriptive. SETTING Bangkok, Thailand. PARTICIPANTS Nine professionals - experts in exercise, dementia care and relevant policy development - and nine dyads of people with dementia and their family caregivers all recruited using purposive sampling. METHODS Semi-structured interviews subjected to thematic analysis. RESULTS Three themes emerged: how exercise was defined, perceived benefits of exercise and how exercise should be implemented. Professionals recognised three exercise elements: aerobic exercise plus balance and strength training. Dyads recognised home-based activities (e.g., housework) and walking. Both groups recognised benefits of exercise in maintaining health and function and improving mood and sleep. Only health professionals identified falls risk reduction. There was limited appreciation of benefits for caregivers by maintaining function in care recipients. Professionals deemed that exercise should address all three elements, using easily accessible low-cost resources. The need for safety was emphasised, and there was agreement that in-home exercise was appropriate. Family/cultural values were evident that could present barriers to exercise implementation. CONCLUSION Changing health-related behaviours requires an understanding of individual perspectives, which exist within a cultural context. This study has illuminated the Thai context and has implications beyond this. Findings emphasise a need for potential benefits to be sufficiently understood by family caregivers to overcome any culturally based reluctance to promote exercise in older people. IMPLICATIONS FOR PRACTICE Nurses have a key role in supporting care givers of older persons with dementia supervise home based exercise. Nurses need to develop knowledge of aerobic exercise to teach caregivers and the older person with dementia. Muscle strength and aerobic exercise assists in the older persons ability to undertake ADL.

Lived experience of Thai women and their changing bodies in midlife

This study focused on the lived experience of Thai women and their changing bodies in midlife. The methodology chosen was a phenomenological approach. Eighteen women aged 46-55 years, who lived in the southern Thailand and identified themselves as experiencing physiological changes, participated in the study. Five themes became apparent during the analysis of the womens stories: changing in midlife, sensing normal phenomena, searching for explanation, sense of loss, and self-managing. This study reveals that Thai womens traditional ties to Buddhism play a major role in their acceptance of midlife as part of the life cycle; an event that is best managed with support from other women. Health professionals should reconsider their understanding of womens midlife experiences in order to provide effective healthcare support to Thai women.

Toward an Understanding of Caring in the Context of Telenursing

The aim of this study was to explore the dimensions of caring in the telenursing environment. A literature search was performed to identify the body of research related to telenursing and caring using the CINHAL, MEDLINE, and PsychINFO databases. Results indicated that caring is essential to the nurse-patient/relationship. The telenursing setting adds a dimension to care due to the non-visibility of those in the telenursing relationship context. An understanding of caring in the telephone triage environment has synthesized traditionally learned and modelled caring practices into this nursing specialty.

The Specialist Breast Care Nurse's Role in the Identification and Minimisation of Distress in a Members' Only, Breast Cancer Focused Online Support Community

To show how a specialist breast care nurse (SBCN) can use the distress thermometer to determine an online community member’s distress level and then use the information in their posts and blogs to identify the cause(s) and deal with them appropriately. To highlight the use of a structured written emotional expression (SWEE) format online, as a way of minimising distress.

Munchausen by Internet and Nursing Practice: An Ethnonetnographic Case Study

This paper used Feldman’s clues to factitious illness behavior on the Internet (FIBI), to determine whether the online behaviour of one member of an online breast cancer support community www.breastcancerclick.com , moderated by a specialist breast cancer nurse (SBCN), could be Munchausen by Internet (MBI) and why identification of this behaviour is important for online nursing practice. This was a focused ethnonetnographic and qualitative research study whereby the online behaviour of one member was observed and compared with Feldman’s clues to factitious behaviour on the Internet. The online data showed that nine out of ten of Feldman’s clues were applicable to the member’s behavior in the Click online community. The relevance of these findings are discussed in relation to the effects this behaviour can have on other community members, the attendant legal ramifications and the necessity for nurses and other health professionals, who are employed or who participate in online support communities, to be aware of this behaviour and how to recognize it.