Marie Alderson

Voices That Care: Licensed Practical Nurses and the Emotional Labour Underpinning Their Collaborative Interactions with Registered Nurses

Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patients status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPNs emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs.

Reflective Practice: A Comparative Dimensional Analysis of the Concept in Nursing and Education Studies.

AIM This paper reports on an analysis of the concept of reflective practice. BACKGROUND Reflective practice, a concept borrowed from the field of education, is widely used in nursing. However, to date, no study has explored whether this appropriation has resulted in a definition of the concept specific to the nursing discipline. DATA SOURCES A sample comprised of 42 articles in the field of nursing drawn from the CINAHL database and 35 articles in education from the ERIC database (1989-2013) was analyzed. REVIEW METHOD A concept analysis using the method proposed by Bowers and Schatzman was conducted to explore the differing meanings of reflective practice in nursing and education. RESULTS In nursing, the dimensions of the concept differ depending on context. In the clinical context, the dimensions may be summarized as theory-practice gap, development, and caring; in training, as learning, guided process, and development; and in research, as knowledge, method, and social change. In education, the concept is also used in the contexts of training (the dimensions being development, deliberate review, emotions, and evaluation) and research (knowledge, temporal distance, and method). The humanist dimension in nursing thus reflects a use of the concept more specific to the discipline. CONCLUSION The concept analysis helped clarify the meaning of reflective practice in nursing and its specific use in the discipline. This observation leads to a consideration of how the concept has developed since its appropriation by nursing; the adoption of a terminology particular to nursing may well be worth contemplating.

Positive deviance and hand hygiene of nurses in a Quebec hospital: What can we learn from the best?

HighlightsThe mobilizing leadership of a head nurse can instigate social cohesion in a care team.Sharing a philosophy of care based on humanism in a care team can lead to social cohesion.Social cohesion can generate positive deviance regarding hand hygiene practice.Positive deviance can equally be applied to care teams and to individuals. Background: Although it is well known that hand hygiene is the most effective measure to prevent health care–associated infections, hand hygiene adherence is low in Quebec, as it is elsewhere. For this study, an innovative framework was used to explore the clinical practice of nurses regarding hand hygiene and the factors that influence it: positive deviance, or the idea that there are people who find better solutions to problems than their peers. This study investigated positive deviance at the level of the care team to shed light on group dynamics. Methods: We conducted focused ethnographies on 2 care units—a medical‐surgery unit and a palliative care unit—at a Montreal university hospital. Data collection consisted mainly of systematic observations and individual interviews with nurses. Results: The results show that positive deviance related to hand hygiene is instigated by social cohesion within a care team, created, in this study, by the mobilizing leadership of the head nurse in the medical‐surgery unit and the prevailing humanist philosophy in the palliative care unit. Conclusions: In health care, it can be useful to apply the positive deviance approach to care teams instead of individuals to better understand the ideologic and structural differences linked to better hand hygiene performance by the nurses.

Supporting and Empowering Nurses Undergoing Critical Care Certification.

Purpose: Nurses working in critical care settings face multiple sources of stress, such as complex clinical situations and the use of new advanced technologies, which can affect their psychological health. Literature suggests that the promotion of educational activities, such as a certification process within a specialty, can contribute to nurses’ empowerment, professional growth, and personal satisfaction. However, it is of utmost importance that the institutional organizations support nurses undergoing the certification process to optimize positive impacts of this educational activity on the nurses, on the patients, and within the institutions. Description of the Project: In the course of a graduate studies stage, an educational program aiming at supporting and creating an empowering environment for nurses undergoing a critical care certification process was developed and implemented, in a Canadian intensive care unit, over a 7-month period. The Humanist model was used as a theoretical framework and was complemented by the problem-based learning pedagogical approach. Outcomes: A postintervention qualitative questionnaire revealed that the program was tailored to nurses’ learning needs and that participants felt supported by their institution throughout the process. Conclusion: This program could help institutions support nurses in achieving higher professional and personal development levels through specialty certification.

Les difficultés/souffrances vécues par les infirmières : stratégies permettant de préserver leur santé mentale, leur sens au travail et leur performance au travail

The nursing profession is faced with an issue of growing concern, that of the mental health of its practitioners. The many difficulties that nurses experience in the workplace may prove to be detrimental to the maintenance of an optimal mental state. With respect to these difficulties, several strategies can be implemented and used by nurses and managers. The present literature review aims to identify the difficulties and suffering experienced by nurses and the strategies employed to ensure the preservation of mental health, as well as maintaining the calling of the profession and job performance. It also aims to provide nurses and managers of the health care system with ideas to promote optimal mental health for nurses. In this context, « psychodynamique du travail » was chosen as the framework to structure the analysis of the literature dealing with elements surrounding the suffering and difficulties experienced by nurses. The use of this theoretical framework deepens and supports the relationship between the suffering experienced at work and the mental health of nurses.

A Caring Environment To Promote Quality of Working Life: A Phenomenological Study with Male Nurses in Community Settings

86 (1992) attributes of caring, the survey’s questions were designed to explore the usefulness of the portfolio as a personal expression of living caring. Results revealed study participants strongly agreed or agreed that the assignment allowed them to “know myself better” (85%), increased their awareness of personal strengths and weaknesses (90%), and provided a link between the reflective and practical components of their professional practice (93%). In addition, participants strongly agreed or agreed that faculty evaluation of their portfolios was helpful (95%), the assignment contributed to their “feeling cared for by faculty” (63%), and the assignment contributed to faculty coming to know them as person (88%). This study suggests that a professional portfolio assignment with the explicit intention of coming to know self and other as caring is a useful educational strategy. Through its reflective and practical content the professional portfolio can represent an RN to BSN student’s expression of knowing self as living caring.