Rebecca Bergman

Sexuality Among Institutionalized Elderly Patients with Dementia

The subject of sexuality among elderly patients with dementia was examined, focusing on two main aspects: the sexual behaviour of institutionalized elderly people with dementia; and the reactions of other patients, staff and family members to this behaviour. The behaviour was found to be mostly heterosexual and ranged from love and caring to romance and outright eroticism. Reactions varied, being accepting of love and care but often objecting to erotic behaviour. Understanding of the sexual needs of elderly people should become an integral part of the training and continued education of health care staff, thus helping to resolve conflicts and clarify common misconceptions.

The Use of Physical Restraints for Patients Suffering from Dementia

This study reviews the ethical dilemmas of nursing staff about using restraints on patients suffering from dementia in two types of health care settings in Israel: internal medicine wards of three general hospitals; and psychogeriatric wards of three nursing homes. The nurses’ level of knowledge about the Patient’s Rights Law, the Israeli Code of Ethics, and the guidelines on restraints was analysed. The purposes of restraints were defined as beneficial to: (1) the patient; (2) other patients; or (3) the institution. The concept was evaluated in a realistic situation (expressing views of daily practice) and in an idealistic situation (expressing personal and professional beliefs and values). It was shown that nurses in internal medicine wards of general hospitals agreed more with the use of restraints than those in psychogeriatric wards in nursing homes. Differences were more pronounced when restraints were beneficial to the institution. In addition, nurses working in psychogeriatric wards of nursing homes had more knowledge about the guidelines on restraints and were less inclined than their counterparts to agree with the use of restraints for the benefit of other patients or the institution.

Interventions used by nursing staff members with psychogeriatric patients resisting care

Although resistance to care can have a major impact on the provision of care, relatively limited research has been reported on the topic. This research examined differences in the use of interventions by nurses in different care settings to manage resistance to care with eating and dressing. A convenience sample of 50 nurses (34 working in psychiatric hospitals and 16 in nursing homes) participated in the study. Nurses in both settings reported using similar interventions for both problems. Non-nursing interventions were consistently mentioned to be more common when resistance was accompanied by physical aggression than by verbal aggression.

Work-life of the Israeli registered nurse

EXPANDING health services in today’s world require careful programming. Health manpower is a major aspect of such planning. Nursing personnel, who comprise at least one quarter of the working health personnel, are in short supply in most parts of the world. Israel is no exception; it has been estimated that 17,500 nurses will be needed in 1978, 3000 more than the expected supply. In 1972, there was a shortage of 1500 nurses in hospitals, and 500 in other services.7 This study was undertaken to gather and analyse reliable data which facilitate planning for nursing manpower. It was believed that computation of the nurses’ work-life and of the work profile of succeeding cohorts of graduates could facilitate projection for the future. Knowledge of when and why nurses leave work could also indicate desirable measures for preventing attrition and attracting unemployecl nurses back into the labour force. In seeking a method to study the work-life of nurses, consultations and correspondence were conducted with manpower experts in the World Health Organisation; Israeli Ministries of Health and Labour; other Israeli health agencies; Division of Health Manpower, Department of Health, Education and Welfare, U.S.A. and others (Appendix 1).

Evaluation of nursing care- could it make a difference?*

The topic selected by the committee for this paper is “Evaluation of nursing care-could it make a difference?” I was intrigued by the word “could”. Why did the committee not use “should”, “has” it, or “will” it make a difference? I assume that “should” was not selected because the committee accepted at face value that evaluation should make a difference. “Has it (past tense) make a difference” was probably not used because evaluation of nursing practice has been all too meagre, and what has been done has had little or no follow-up. Will it make a difference presupposes the existence of firm plans for evaluation. Could it make a difference says-to me at least-“Let us look at what we need to evaluate and what we know about methodology, and then ask ourselves if, under specified conditions, evaluation could make a difference”. This is a future-oriented, positive, cautious approach to an area into which we often tend to rush without sufficient forethought. What do we mean by “evaluation of nursing care”? There are probably nearly as many perceptions of these terms among us as there are people in the room. How we perceive things makes a difference in how we act. Some of us tend to see more, some to see less. Some tend to quickly see the obvious, and settle for that. Others persist until they discover all the hidden possibilities. Each of the above approaches has advantages and disadvantages in terms of time available, priority, depth, comprehensiveness. What do we mean by nursing care? My perception of nursing care is that it is the sum of interventions by nursing personnel, for the purpose of achieving (i.e. attaining, maintaining or recovering) the optimal health status of individuals, groups and communities. It includes outreach to those who need nursing, as well as accessibility to those who come to health services of their own volition. It ranges from promotion of self-care (without which the health care systems will collapse) to meeting needs of the totally dependent. It is *Keynote Speech delivered at the Second Conference of European Nurse Researchers, Copenhagen, 1979.

Follow-up study of the Tel Aviv University nursing graduates

One of the major tools for evaluation of educational programs is follow-up of the graduates. Such studies endeavour to learn how the graduate perceives her studies, and whether she applied her learning in practice. Tel Aviv University opened the first academic nursing studies in Israel in 1968. This post-basic baccalaureate program initially admitted only 25 students, and gradually increased the number to 75 by 1980. By the end of the 1980-81 academic year, 268 nurses had received their degrees, and an evaluation of the baccalaureate program was desirable. In addition, the move to academize all registered nurse education in Israel raised many questions regarding the contribution of university studies to nursing practice.

From diploma to degree: Follow up of R.N.-B.A. graduates of Tel Aviv University

The Tel Aviv University post-basic nursing program, established in 1968, was the first step of nursing academization in Israel. Since then, one-third of the nursing schools in Israel have been academized. The objectives of the present study were to document changes in the worklife of the graduates since completion of the program, to learn about the influence of the program, and to identify factors promoting or impeding study in the program. A mailed questionnaire to 709 graduates produced a 46.8% response. At the time of this study 93% were working, almost half of them in hospital. Data also showed upward mobility, with 38% employed at the institutional to national supervisor level. Recommendations include continuation of the post-basic program, expansion of the clinical content, and enhanced interaction between students, graduates and faculty.

Socio-demographic characteristics of Israeli student nurses

Abstract This study analysed the socio-demographic characteristics of 444 students admitted to 15 of the 16 schools for registered nurses in Israel in 1967. Findings were compared with a similar project carried out with 252 students in nine schools in 1965 to learn if the introduction of the higher educational admission criteria (from 11 to 12 years) in 1966 influenced the composition of the student population. Major findings were: 1.a. A. marked increase in the number of applicants and admissions. 2.b. Mean age rose from 18·23 to 18·84 years. 3.c. Married and male students each made up about 3 per cent of the population. 4.d. The per cent of students of Asian-African origin grew from 9·9 per cent to 17·7 per cent. 5.e. Over half of the students were born in Israel, one-fifth immigrated to Israel within the past ten years. 6.f. Twelve years of education increased from 41 per cent to 95 per cent; full matriculation from 10·7 per cent to 43·1 per cent. 7.g. One-quarter of the students came from rural settlements (which have 11 per cent of the total population). 8.h. Over half of the 1967 students were eligible for army service. The main conclusion was that the higher educational criteria had a salutary effect on the recruitment of candidates with desirable qualifications in 1967. Several areas were suggested for further study.

Contribution ofacademia to nursing practice in Israel

Academic education for nursing has made a major impact on the development of nursing science, on the quality of nursing practice, and on the image of nursing. This was possible because of the close cooperation between education and nurses working in the various health services. Examples from several countries illustrate the process and outcomes of such mutual collaboration.

Worklife of the graduates of schools for practical nurses in Israel

Abstract Licensed practical nurses comprise about one half of the nursing manpower in Israel. The first LPN school opened in 1951, and by 1973, 25 schools had graduated 4600 nurses. Selected data were gathered in 1975 on 2857 graduates from 10 LPN schools by school-classmate method. Depth information on personal and professional characteristics, worklife history and opinion were obtained by questionnaire from a random - stratified sample of 431 graduates. Major findings were: 1. 1. the mode nurse at the time of the study was female (88%), 33 yr of age, born in Asia-Africa (46%), immigrated to Israel in the 1950s. She belonged to the low-middle social class. She was married (80%) and the mother of two children, one of whom was less than 5 yr of age. The LPN had 10 yr of general education, and in the middle of the 1960s had graduated from an 18-month program. She was interested in continuing study for RN status. The mode nurse worked in a full-time job in a hospital as a staff nurse. She was satisfied with her choice of nursing as an occupation, and found personal satisfaction in her work. However, she was less content with career opportunities, salary, and work conditions. 2. 2. At the time of the study 83.2% of the respondents were employed in nursing, 3.3% were on approved leave and 13.5% were not working in nursing. Two-thirds of the employed nurses worked full-time. 3. 3. Worklife patterns were similar among cohorts of nurses who graduated at different periods in time. 4. 4. The respondents worked 83% of all the possible years between graduation and the time of the study. 5. 5. The strongest influence on work retention was the sex of the nurse, with male nurses having higher retention. 6. 6. The major factors influencing work retention of women were number and age of children, with lower retention during the child bearing and rearing years. 7. 7. Three-quarters of the graduates who were not active in nursing were ready to return to work—conditions for same being improved work conditions and arrangements for child care. 8. 8. Thre-quarters of the respondents stated that they wished to continue study; most of them for achieving RN status.