Sonia Acorn

Workplace violence in Alberta and British Columbia hospitals

Workplace violence is a significant and widespread public health concern among health care workers, including nurses. With growing awareness of how practice environments influence patient outcomes and the retention of health professionals, it is timely to consider the impact of workplace violence in hospitals. Registered nurses in Alberta and British Columbia, Canada were surveyed on their experiences of violence in the workplace over the last five shifts. Our results suggest that nurses are experiencing many incidences of violence in a given work week, particularly in the emergency, psychiatric, and medical-surgical settings. Most violent acts are perpetrated by patients, but there is also a significant portion of violence and abuse committed by hospital co-workers, particularly emotional abuse and sexual harassment. Our results also indicate that the majority of workplace violence is not reported. We suggest that using the Broken Windows theory might be a useful tool to conceptualize why workplace violence occurs, and that this framework be used to begin to develop new violence prevention policies and strategies.

Chronic Illness Experience: Insights from a Metastudy

Concurrent with the recent enthusiasm for qualitative research in the health fields, an energetic call for methods by which to synthesize the knowledge has been generated on various substantive topics. Although there is an emerging literature on meta-analysis and meta-synthesis, many authors overestimate the simplicity of such approaches and erroneously assume that useful knowledge can be synthesized from limited collections of study reports without a thorough analysis of their theoretical, methodological, and contextual foundations and features. In this article, the authors report some of the insights obtained from an extensive and exhaustive metastudy of qualitative studies of chronic illness experience. Their findings reveal the complexities inherent not only in any phenomenon of interest to health researchers but also in the study of how we have come to know what we think we know about it.

Decentralization as a determinant of autonomy, job satisfaction, and organizational commitment among nurse managers

The purpose of this study was to test a theoretical model of the following variables, decentralization, professional autonomy, job satisfaction, and organizational commitment. Data were collected through a comprehensive survey of first-line nurse managers (N = 200) in acute care hospitals with more than 100 beds in British Columbia, Canada. The final model excluded all explored personal characteristics of the nurse manager-gender, health or vitality status, marital status, age, education, and years of supervisory or management experience. Job satisfaction was found to be an important predictor of organizational commitment. However, decentralization was most important because it affected organizational commitment directly, as well as indirectly, through professional autonomy and job satisfaction.

Relationship of role conflict and role ambiguity to selected job dimensions among joint appointees

The purpose of this study was to examine perceptions of role conflict and role ambiguity experienced by nurse faculty in joint academic-clinical appointments and non-joint-appointed faculty (traditional faculty), and to examine the relationships of these two constructs with social support, job satisfaction, and propensity to leave the joint appointment. Scholarly productivity of the two groups was also examined. Five hypotheses were proposed. The sample (N = 113) was drawn from the five Canadian university nursing faculties with the largest proportion of joint academic-clinical appointees. Findings indicate that assuming a joint appointment does not necessarily lead to an increase in role conflict and role ambiguity, and that joint appointees do not differ from traditional faculty in levels of role conflict and role ambiguity, scholarly productivity levels, or job satisfaction. Within the joint-appointee group (N = 33), role conflict was significantly higher than role ambiguity, both role conflict and role ambiguity had an adverse effect on job satisfaction and are determinants of intent to leave the joint appointment. In addition, social support was found to have a buffering effect on role conflict.

Depression in multiple sclerosis: critique of the research literature.

&NA; Depression has been found to be increased in individuals with multiple sclerosis (MS). Depression is currently being studied as either a reactive response, a part of the symptomatology or a precipitating factor of the disease The purpose of this article is to provide a review of the research literature on depression in multiple sclerosis. In addition, implications for neuroscience nurses who work with MS individuals are identified.

Use of the brief psychiatric rating scale by nurses.

1. Nurses are intimately involved in the assessment of patients in inpatient clinical settings and in community settings--and nurses have a role to play in the systematic rating of severe psychopathology. 2. The Brief Psychiatric Rating Scale (BPRS) provides a means of assessing mental health status from an interview using 16 rating concepts. Analysis of BPRS rating profiles obtained from a variety of patients and settings have consistently revealed four syndromes: withdrawal-retardation, anxious depression, hostile-suspiciousness, and thinking disturbance. 3. Once properly trained regarding the BPRS, nurses can use the scale effectively in the assessment and ongoing monitoring of patient conditions. The scale is an added tool for nurses to use in monitoring the effectiveness and outcome of both medical and nursing interventions.

Head injury: impact on the wives.

&NA; Wives of head‐injured patients often need considerable support because of the myriad of role transitions and role changes they experience. The impact of the head injury on the wife of a survivor is presented in this article. Content analysis was used to analyze data with the themes of role changes, emotional impact of the injury, hope and need for support emerging. Implications for practice and research include need for support groups with nurses as facilitators, the importance of fostering hope, and need for education of health care professionals.

First-Line Managers: Scope of Responsibility in a Time of Fiscal Restraint

Fiscal restraint and government cost control have contributed to the downsizing and restructuring of Canadian health care organizations. As key players in the hospital sector, the role and responsibilities of first-line nurse managers have been significantly affected by these changes. This paper presents data from a survey of 200 first-line nurse managers in British Columbia which investigated the current scope of the first-line managers role, the number of hierarchical levels within nursing departments, and views on managerial union membership.

Emergency shelters in Vancouver, Canada

The shelter experiences, employment history, income and social service needs utilization were examined among 124 emergency shelter users in Vancouver, British Columbia. Thirty-six (30.5%) reported this as their first experience with living in a shelter; the length of stay in the present shelter ranged from one to 90 days. Reasons for shelter use included: eviction from last place of residence, loss of job, or suffering from health problems rendering one unable to work. The highest unmet service needs were finding affordable housing and finding a job. This combination of scarcity of low-cost housing, health problems, and difficulty in finding employment have led to a situation where emergency shelters have become extended places of residence, a “home” to many.The shelter experiences, employment history, income and social service needs utilization were examined among 124 emergency shelter users in Vancouver, British Columbia. Thirty-six (30.5%) reported this as their first experience with living in a shelter; the length of stay in the present shelter ranged from one to 90 days. Reasons for shelter use included: eviction from last place of residence, loss of job, or suffering from health problems rendering one unable to work. The highest unmet service needs were finding affordable housing and finding a job. This combination of scarcity of low-cost housing, health problems, and difficulty in finding employment have led to a situation where emergency shelters have become extended places of residence, a “home” to many.

Patients' Loneliness: A Challenge for Rehabilitation Nurses

&NA; The purpose of this study was to determine the degree of loneliness felt by young and middle‐aged adults in a long‐term rehabilitation center and the relationship among such variables as loneliness, age, and length of institutionalization. A convenience sample was taken from a long‐term rehabilitation center in Vancouver, BC, Canada. Findings indicate that loneliness is present among young and middle‐aged adults in this long‐term rehabilitation center and is more prevalent among those who have been admitted more recently. Nursing intervention strategies to deal with loneliness are presented.