Sheri Price

Becoming a nurse: a meta-study of early professional socialization and career choice in nursing.

AIM This paper is a report of a meta-study of early professional socialization and career choice in nursing. BACKGROUND The current and growing shortage of nurses is a global issue, and nursing recruitment and retention are recognized priorities internationally. The future of nursing will lie in the ability to recruit and retain the next generation to the profession. DATA SOURCES Studies were identified through a search of the CINAHL, PsycInfo, Sociological Abstracts, PubMed; Medline and Embase databases from 1990 to 2007. REVIEW METHODS Studies were included if they gave insight into the experience of choosing nursing as a career, used qualitative methodology and methods, and were published in English. Analysis was undertaken using Paterson et al.s framework for qualitative meta-synthesis. RESULTS Ten primary studies were included in the review. Their methodologies included: ethnography (4); descriptive qualitative (3); grounded theory (2); and phenomenology (1). The location of the research was Canada (3), United Kingdom (2), United States of America (2), Australia (1), Japan (1) and Sweden (1). Three main themes were identified: influence of ideals; paradox of caring and role of others. CONCLUSION Career choice and early professional socialization are influenced by multiple factors. In future recruitment and retention strategies to address the critical nursing shortage, it is important to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions. It is also necessary to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions.

When respect deteriorates: incivility as a moderator of the stressor–strain relationship among hospital workers

AIM To test whether incivility at work exacerbates the relationship between stressors and strain for hospital workers. BACKGROUND A climate of incivility and disrespect among colleagues was expected to heighten the impact of work stressors on the mental and physical health of care providers. METHODS Members of 17 care-providing units from five hospital systems in Canada completed surveys, before and after a civility intervention (eight intervention vs. nine comparison units). Analyses tested whether (1) incivility moderated the stressor-strain relationship at baseline (n=478), and (2) the stressor-strain relationship decreased for the intervention units relative to comparison units 6 months later (n=361). RESULTS (1) Pre-intervention, individuals reporting more incivility on their unit showed a stronger stressor-strain relationship. (2) The negative relationship between work overload and mental health was mitigated among intervention group staff 6 months after the introduction of a colleague-based civility programme. CONCLUSIONS Besides being a stressor itself, incivility exacerbates the relationship between existing job role stressors and strain among health care workers. IMPLICATIONS FOR NURSING MANAGEMENT Colleague civility and respect have an important ripple effect of buffering inevitable work stressors, helping health care providers respond to stress with greater health and resiliency.

Future directions for career choice research in nursing: A discussion paper

The last few decades have seen considerable changes in the characteristics of the healthcare workplace and workforce. There is a significant emphasis on recruitment and retention of healthcare providers internationally especially within the profession of Nursing, where there is a critical and growing shortage of nurses. Career choice is a critical component of recruitment and retention strategies and has significant organizational implications in regards to person-environment fit, career satisfaction and commitment. Many extant career choice theories fail to capture the challenges, complexities and uncertainties of the 21st century. Moreover, some early theories do not recognize the unique characteristics of upcoming generational cohorts and the multivariate influences on their career decisions. An extensive review and synthesis of the related literature provide the basis for a critical discussion on the adoption of new methodological approaches to exploring career choice in Nursing. The use of qualitative and mixed method approaches, a focus on generational differences and an exploration of adaptive and adjustment processes to career change provide a foundation for future career choice research and theoretical development which are reflective of the characteristics of the contemporary employee and the reality of modern healthcare organizations.

The spiritual experience of high-risk pregnancy.

OBJECTIVE To uncover the spiritual beliefs and practices of women experiencing high-risk pregnancies. DESIGN Qualitative, naturalistic inquiry via face-to-face, semistructured interviews, with thematic analysis of interview transcripts. SETTING A prenatal special care unit of a tertiary health centre. PARTICIPANTS A purposeful sample of 12 women admitted for high-risk pregnancy complications. RESULTS Analysis of the womens interviews uncovered the following themes: high-risk pregnancy as a challenge, seeking a spiritual language, what makes you who you are, and everything will be OK. CONCLUSIONS Findings from this study highlight that within the challenges of a high-risk pregnancy, the women often struggled to define their spirituality yet recognized spiritual expression as key to their health and healing. Each woman identified aspects of their spirituality that enabled them and their families to deal with the stress of their high-risk pregnancy experience, which they believed enhanced outcomes for themselves and their unborn child.

The historical social positioning of nursing and medicine: implications for career choice, early socialization and interprofessional collaboration

Abstract For almost half a century, research has identified that effective teamwork is essential in order to enhance care provision and health outcomes for patients. Although the value of teamwork is well-recognized in healthcare, the historically rooted dynamics of workplace relationships create a myriad of challenges to creating collaborative teams. Understanding the history of interpersonal dynamics between health professionals can provide direction for future interprofessional education and collaboration strategies. The aim of this paper is to provide a historical overview of the social positioning of nursing and medicine in the context of interprofessional collaboration. Few professions work as closely as nursing and medicine. Despite the well-recognized benefits of interprofessional collaboration, these two professions are often socially positioned in opposition to one another and depicted as adversarial. This analysis will seek to advance our understanding of the historical roots between these two professions and their relationships with and among each other in relation to career choice, early socialization and patient care delivery. An exploration of the historical social positioning of nursing and medicine can provide an enhanced understanding of the barriers to interprofessional collaboration and inform future successes in interprofessional education and practice among all health and social care professions.

Blame, Shame, and Lack of Support: A Multilevel Study on Obesity Management

In this research, we examined the experiences of individuals living with obesity, the perceptions of health care providers, and the role of social, institutional, and political structures in the management of obesity. We used feminist poststructuralism as the guiding methodology because it questions everyday practices that many of us take for granted. We identified three key themes across the three participant groups: blame as a devastating relation of power, tensions in obesity management and prevention, and the prevailing medical management discourse. Our findings add to a growing body of literature that challenges a number of widely held assumptions about obesity within a health care system that is currently unsupportive of individuals living with obesity. Our identification of these three themes is an important finding in obesity management given the diversity of perspectives across the three groups and the tensions arising among them.

The Power of Relationships: Exploring How Public Health Nurses Support Mothers and Families During Postpartum Home Visits

Postpartum home visiting by Public Health Nurses (PHNs) has been used by many health departments across Canada as a way of supporting new mothers and their families. Although positive health outcomes are linked with support from PHNs, little is known about how this occurs during the home visit. The purpose of this research was to explore how home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia, Canada. Feminist poststructuralism was used to guide the research and semi-structured face-to-face interviews were conducted with 16 PHNs, 16 mothers, and 4 managers. Participants described how relationships were an essential part of supporting mothers and families. These findings also challenge dominant health discourses and stereotypes that are often associated with mothering and the practice of PHNs with families.

More than meets the eye. Feminist poststructuralism as a lens towards understanding obesity

AIM   This paper presents a discussion of the application of a feminist poststructuralist-based theoretical framework as an innovative approach towards understanding and managing the complex health issue of obesity. BACKGROUND   Obesity is often viewed as a lifestyle choice for which the individual is blamed. This individualistic, dichotomous and behavioural perspective only allows for a narrow understanding of obesity and may even lead to misperceptions, stereotypes and marginalization of clients experiencing obesity. Feminist poststructuralism can provide a critical lens to understand the social construction of obesity and the broader environmental and cultural contexts of this health issue. DATA SOURCES   The theoretical framework draws from the writings of Foucault, Scott, Butler, Cheek, and Powers, published between 1983 and 2005. DISCUSSION   The concepts of discourse analysis and power relations are explored and discussed in a clear manner so that nurses can easily apply this framework to their practice as they observe, question, analyse, critique and assess the care experienced by clients who are obese. The concepts of personal and social beliefs, values and stereotypes are also discussed and examples of how to apply them in practice are provided. IMPLICATIONS   It is imperative that we continue to question our everyday nursing practices as we work to support clients, especially those who feel marginalized. This focus on power relations and reflective practice can give direction to new possibilities for change in obesity management.

Spirituality and high-risk pregnancy: another aspect of patient care.

A high-risk pregnancy can be a stressful situation for a woman, her partner and her family. Many women utilize their spiritual beliefs as a way to make sense of their situation. Health care professionals, including nurses, midwives and physicians, can provide effective spiritual care and support consistent with their professional scopes of practice. Spiritually focused interventions can help to reduce stress and anxiety and create a more open and confident approach to the management of pregnancy complications.A high-risk pregnancy can be a stressful situation for a woman, her partner and her family. Many women utilize their spiritual beliefs as a way to make sense of their situation. Health care professionals, including nurses, midwives and physicians, can provide effective spiritual care and support consistent with their professional scopes of practice. Spiritually focused interventions can help to reduce stress and anxiety and create a more open and confident approach to the management of pregnancy complications.

The use of information and communications technologies in the delivery of interprofessional education: A review of evaluation outcome levels

Abstract Interprofessional education (IPE) in health and human services educational and clinical settings has proliferated internationally. The use of information and communication technologies (ICTs) in the facilitation of interprofessional learning is also growing, yet reviews of the effectiveness of ICTs in the delivery of pre- and/or post-licensure IPE have been limited. The current studys purpose was to review the evaluation outcomes of IPE initiatives delivered using ICTs. Relevant electronic databases and journals from 1996 to 2013 were searched. Studies which evaluated the effectiveness of an IPE intervention using ICTs were included and analyzed using the Barr et al. modified Kirkpatrick educational outcomes typology. Fifty-five studies were identified and a majority reported evaluation findings at the level 1 (reaction/satisfaction). Analysis revealed that learners react favorably to the use of ICTs in the delivery of IPE, and ICT-mediated IPE can lead to positive attitudinal and knowledge change. A majority of the studies reported positive evaluation outcomes at the learner satisfaction level, with the use of web-based learning modalities. The limited number of studies at other levels of the outcomes typology and deficiencies in study designs indicate the need for more rigorous evaluation of outcomes in ICT-mediated IPE.