Nursing Inquiry最新文献

Stereotypes in mass media depict harmful and inaccurate portrayals of nurses and nursing work. As memes are understood to be units of culture, they may be examined as artifacts, deepening understandings of contemporary culture. This critical qualitative analysis of nursing memes from two popular social media platforms seeks to identify current cultural narratives and social meanings of nursing reproduced within the public domain. Memes were selected from popular hashtags and nursing meme accounts with more than 2500 followers. Memes were included if they followed traditional meme format and content-centered discourses of gender, race, and other aspects of power and oppression within nursing and healthcare systems. Our analysis employed a qualitative descriptive design within an overarching critical social theoretical framework. We identified that nursing memes reproduced stigmatizing and discriminatory narratives of patients and perpetuated harmful notions of "who" nurses are and "what" nurses do, while also drawing attention to systemic challenges facing the profession. Memes therefore serve as a valuable artifact for communicating contemporary cultural narratives about nursing and nursing work. Generating and distributing memes to raise awareness of systemic pressures may serve as a valuable social strategy toward advocating for systemic shifts in nursing and healthcare to address persistent challenges.

Amidst a global nursing shortage, ensuring sufficient nurses are available to care for patients is an international policy priority. High-income countries have developed and implemented numerous models to ensure safe nurse staffing, yet evidence to recommend any single methodology remains limited. Existing research primarily evaluates nurse staffing systems by inputs and outcomes, neglecting their internal dynamics. Using qualitative case study data from England and Wales and drawing on practice perspectives and Actor Network Theory, this paper examines these socio-material relations. Healthcare systems are complex, diverse and constantly evolving. Whilst identifying a single 'best' model may prove both impractical and elusive, this paper demonstrates the value of this theoretical approach for understanding the interplay of system components and the mediating effects of context. These insights can inform future research and help improve systems to meet the demands of late modernity.

Studies into the experiences of Black nurses in Canada's healthcare system provide policymakers with a deeper understanding into designing policies and practice guidelines to best support equity and diversity. With male nurses making up 9% of the nursing population in Canada, there remains a paucity of studies into their experiences and significantly less for Black male nurses (BMNs). The World Health Organization's call for more nurses means an increase in Internationally Educated and Canadian-born BMNs who will experience sociocultural stereotypes and biases that underpin nursing practices. BMNs are left to navigate intersections of race and gender power relations within nursing. Remaining invisible and voiceless within nursing literature, and discriminated against in the workplace culture, this study uses an exploratory qualitative approach to understand the experiences of six BMNs working in the Greater Toronto Area and the strategies they use to navigate the intersections of race and gender that sustain the negative stereotypes and tropes of the Black man. The findings disclose the need for policymakers, nursing administrators, and organizations to co-create policies that support dynamically tailored mentorship programs and practice guidelines when dismantling anti-Black racism and promote inclusivity and a sense of belonging.

Artificial intelligence (AI) is revolutionizing nursing by enhancing decision-making, patient monitoring, and efficiency. Machine learning, natural language processing (NLP), and predictive analytics claim to improve safety and automate tasks. However, a structured analysis of AI applications is necessary to ensure their effective implementation in nursing practice. This umbrella review aimed to synthesize existing systematic reviews on AI applications in nursing care, providing a comprehensive analysis of its benefits, challenges, and ethical implications. By consolidating findings from multiple sources, this review seeks to offer evidence-based insights to guide the effective and responsible integration of AI in nursing practice. A systematic umbrella review approach was employed following PRISMA guidelines. Multiple databases, including PubMed, CINAHL, Scopus, Web of Science, and IEEE Xplore, were searched for review articles published between 2015 and 2024. Findings were synthesized thematically to identify key trends, benefits, limitations, and research gaps. This review synthesized 13 studies, emphasizing AI's impact on clinical decision support, patient monitoring, nursing education, and workflow optimization. AI enhances early disease detection, minimizes diagnostic errors, and automates documentation, improving efficiency. However, data privacy risks, biases, ethical concerns, and limited AI literacy hinder integration. AI presents significant opportunities for improving nursing care, yet its successful implementation requires addressing ethical, legal, and practical challenges. Adequate AI training, robust data governance frameworks, and policies ensuring responsible AI use are essential for its integration into nursing practice. Future research should explore long-term AI impact, training models for nurses, and strategies to balance AI-driven efficiency with human-centered care.

The death of a resident, caused by another resident in Residential Aged Care Facilities (RACFS) is uncommon, yet under-reported. The perpetrator of the violent act may not be legally culpable, and the act may be unintended; however, media reports suggest that this is an increasing phenomenon. This article reports an integrated review that sought to critically report homicide or an unintentional incident where one resident causes the death of another in RACFs and to explain and understand how older people are supported within and external to RACFs and their under-representation in policy. The search was registered with PROSPERO registration number CRD42023409775. The databases CINHAL ultimate, Cochrane review, Embase, Psych Info, PubMed were searched. Additionally, a grey literature search was conducted of Analysis and Policy Observatory, Google Search, and Trove. Identified themes included: exhibitor and target attributes, incident details, staff and facility experiences, incident reporting and improved resident safety related to un/intentional homicide. From the findings, we extracted two discursive elements: (1) Space and perception of a person living with dementia and unequipped environments and (2) The disregarded deaths in RACFs and other systematic problems. Within RACFs factors, such as unacceptably low staffing numbers, a lack of clinically trained nurses, poorly designed environments and a lack of skills in caring for people who have dementia or mental illness were identified. More emphasis on research into this area is essential. Several key risk factors are identified in this review on the issue of un/intentional homicides in RACFs. There is a need for governments and policy makers to consider different models of care, responsive to the needs of people who live with dementia.

Relational practice is the basis for human connection and is linked to enhanced healthcare experiences and involvement with healthcare services. Although the nurse-patient relationship is typically built around behavioural communication skills, relational practice requires developing awareness, connectedness and responsiveness to others. The task-oriented ways of working have eroded these attributes. This study explored how Indigenous values and practices can transform relational practice in a publicly funded acute hospital in Aotearoa, New Zealand. Kaupapa Māori (Māori philosophy and practice) and grounded theory were used to generate and analyse data from interviews with Māori staff and consumers. Three culturally informed processes culminated in the culturally grounded theory of achieving a culture of whanaungatanga (belonging and inclusion): tikanga mahi (work ethic), whakawhanaungatanga (developing kinships) and manaakitanga (cultural and social responsibility). The study highlights the necessity of developing and maintaining relationships and creating an environment that enables relational practice. Findings show that developing a sound work ethic supported by solid and committed leadership and espousing Māori values is the catalyst for change. Applying an Indigenous mentoring model like the tuakana-teina (leader-learner) model may create an environment supporting organisational culture change.

Operational failures in hospitals, such as communication breakdowns and equipment malfunctions, challenge nurses by disrupting patient care, workflow, and clinical processes. These failures are primarily addressed with short-term solutions, rather than comprehensive, long-term strategies. This study investigates the impact of operational failures on patients and examines whether nurses alter their problem-solving behavior in response to the perceived direct impact on patients. A qualitative, exploratory study was conducted in 23 wards across five Belgian hospitals. Data were collected through in-depth semi-structured interviews with 26 nurses and a group discussion with ward managers (n = 6). Findings reveal that barriers such as nurses' limited awareness regarding the broader impact of operational failures on patients, poor communication, and excessive workloads hinder problem-solving efforts. However, when operational failures result in patient harm, nurses are more likely to take corrective action to prevent recurrence. Enablers to enhance problem-solving behaviors include using narrative medicine to highlight patient safety risks, improvements to communication frameworks, the streamlining of reporting systems, and the allocation of adequate time and resources to address underlying issues. Furthermore, a proactive approach, grounded in Safety-II principles, emphasizes nurses' flexibility and adaptability, recognizing their indispensable role in learning from successful outcomes and making real-time adjustments to strengthen resilience within healthcare systems.

In recent years, global forced migration due to conflict, violence, and persecution has increased dramatically, affecting numerous countries, with Türkiye being particularly impacted. Despite global trends showing a significant decline in positive attitudes toward refugees, the limited existing literature on racism in nursing education primarily focuses on themes related to white supremacy. This focus inadequately addresses the issue of personally mediated racism toward various ethnic groups, especially within the context of nursing education and research. Considering the ongoing migration influx, it is crucial to examine personally mediated racism and its underlying causes among nursing students in countries most affected by this issue. This study examined personally mediated racism among nursing students toward refugees in Türkiye by creating an environment conducive to productive discussions, utilizing a participant-driven photo-elicitation method. The study identifies two key themes to address gaps in the literature: "The Road to Personally Mediated Racism" and "Uncontrollable Exclusivism," emphasizing the existence of personally mediated racism among nursing students. This study's findings underscore the essential need to integrate antiracist education and promote open discussions about current societal developments and dynamics within nursing education.

Professional education for licensed nurses in Australia is a complicated matter involving two education systems-vocational education and training, and higher education-each characterized by a different curriculum model. The contribution of the two systems follows a division of the workforce into Enrolled Nurses and Registered Nurses, with vocational education serving the first division and higher education the second. Although the systems are intended to provide connecting educational and career pathways, it results in a binary education landscape featuring two distinct forms of curriculum and contrasting assumptions about knowledge. This discursive discussion analyses the impact of the competency-based curriculum on Enrolled Nurses' education, entry to the profession of nursing, and their aspirational educational pathways towards registered nursing. Many Enrolled Nurses successfully articulate to become Registered Nurses; however, we argue that traversing between the two distinct curriculum approaches creates barriers to these transitions. We also argue that apart from undermining the learning trajectories of nurses, the influence of the competency-based curriculum model threatens the coherence of the profession at a time when conditions of work are both intensified and globalized, calling for a solution in the form of curriculum harmonization.

Healthcare workplaces mirror broader societal inequities, embedding racialized power dynamics that shape professional relationships, communication, and collaboration. While systemic racism in healthcare is well-documented, little research captures how these dynamics unfold in real-time. This study employs a 2-year qualitative participant-observation approach in a medium-sized acute care hospital to examine racialized workplace interactions among nursing professionals, offering a context-rich understanding of how systemic exclusion operates daily. Unlike studies relying on self-reported experiences, this approach minimizes recall bias and uncovers the subtle mechanisms that sustain inequities-non-verbal exclusion, coded language, racialized delegation of tasks, and strategic adaptation by Black staff. Findings reveal disparities in respect distribution, inequitable workload assignments, and help-giving patterns that reinforce in-group favoritism and out-group marginalization. Black professionals faced exclusion, heightened scrutiny, and dismissive communication, leading to workplace stress and high attrition. By applying Social Identity Theory to hierarchical healthcare environments, this study illustrates how professional hierarchies intersect with race to perpetuate exclusionary dynamics. Addressing these patterns requires structural interventions that foster equity, accountability, and inclusive leadership to disrupt systemic barriers and create collaborative workplaces that support professional growth and patient care outcomes.