Wendy C. Kooken

A big word for something we do all the time: oncology nurses lived experience of vigilance.

Background: Oncology nurses are responsible to be vigilant for patients to keep them safe from harm. Yet, nurse vigilance and its role in preventing error are not well understood. Increased knowledge of how oncology nurses practice vigilance may lead to interventions that enhance nurses’ abilities to be vigilant, decrease error rates, and protect patients from harm. Objective: This article describes oncology nurses’ lived experiences of vigilance while practicing in an acute care hospital setting. Methods: The study design was an adaptation of Colaizzi’s empirical phenomenology. Data were obtained from a purposive sample of oncology registered nurses (n = 7) who were identified as being vigilant by patients and family members, following their own interviews about their experiences of vigilance. Results: Four theme categories indicated the following: (1) nurses use vigilance to keep patients safe; (2) vigilance is incorporated into expert practice over time; (3) barriers impede nurses’ abilities to be effectively vigilant; and (4) nurses expect patients and families to participate in vigilance partnerships with them because it enhances the nurses’ abilities to be vigilant. Conclusion: Nurse vigilance is a complex phenomenon that is not well understood but is used by nurses in daily practice to protect patients from harm. Implications for Practice: Ways in which nurses can enhance vigilance are identified, as well as barriers to vigilance, which if addressed may promote patient safety and well-being. A theory of vigilance and a measure of it could provide objective feedback, which will enhance nurses’ abilities to be effectively vigilant.

Blending the liberal arts and nursing: Creating a portrait for the 21st century

The liberal arts and sciences serve as a core part of the educational discipline in nursing curriculum and are believed to undergird abilities for critical-thinking, creativity, and holistic care (Hermann, 2004; McKie, 2012). Over time, science has taken on a more central role in nursing education, despite the acknowledged importance and contributions of liberal arts. The humanities are an essential part of liberal arts education and generally include disciplines such as history, literature, religion, philosophy, architecture, or fine arts (e.g., music, painting, sculpture, drama, or film) (Hermann, 2004). Nursing students identify that liberal arts improve their skills to communicate, think globally, navigate diversity, make decisions, and improve their human selves (McKie, 2012), therefore the purposeful inclusion of liberal arts and humanities into nursing pedagogy should be assured. Schools of nursing seated within liberal arts universities are in a position to take advantage of campus environments that seek to improve student knowledge, skills, abilities, and values (Scott, 2014). When caring for patients with complex medical, psychosocial, spiritual, and economic concerns, the ability to differentiate between what is true among a myriad of competing issues, and to identify solutions to these problems, are critical skills (Scott, 2014). This manuscript describes one type of focused effort by school of nursing (SON) faculty to integrate the humanities on a small, liberal arts campus into the nursing curriculum. The desire to do this led to a large, interdisciplinary project intended to enhance campus, community, faculty, and student opportunities to understand and ponder the complexities involved in caring for patients with Alzheimers disease (AD).