Nursing management (Harrow, London, England : 1994)最新文献

Resilience is increasingly described as an essential personal trait for nurses, enabling them to endure the psychological, emotional and physical demands of their role. However, an overemphasis on individual resilience may obscure the systemic and structural factors contributing to nurse burnout. This article calls for a redefined, more inclusive approach to resilience which acknowledges the shared responsibility between nurses, healthcare organisations and policymakers. The author discusses how fostering nurses' well-being requires support for resilience through structural reforms, supportive workplace environments and access to mental health resources. A broader definition of resilience, incorporating trauma-informed leadership and inclusive workplace policies, is essential for addressing the root causes of nurse burnout and enhancing the quality of patient care.

Self-awareness is a foundational quality of professional nursing practice, shaping how nurses understand themselves and relate to others. This article explores the concept of self-awareness and its role in supporting emotional resilience, building confidence and fostering effective leadership and team collaboration. It also examines how self-awareness underpins professional accountability and aligns with regulatory expectations. The author provides some practical strategies for developing self-awareness that aim to support nurses to strengthen their personal insight, enhance their collaborative practice and foster their personal and professional growth. The article is aimed at nurses at all levels, in clinical or non-clinical roles, who wish to enhance their leadership potential through deeper self-understanding.

Background: Despite efforts to promote equality and diversity in the NHS, data show persistent disparities and a slow pace of progress toward achieving workforce race equality. Advanced practitioners can promote inclusivity and drive cultural change, but there is a lack of data on the composition and workplace experiences of the advanced practitioner workforce.

Aim: To collect detailed data on the ethnic profile of trainee advanced practitioners in the North East and Yorkshire region of England and on their experiences of equality and diversity, and to identify barriers and enablers to developing a diverse and inclusive advanced practice workforce.

Method: Trainee advanced practitioners were recruited through purposive sampling to complete a survey about their demographic characteristics (including ethnicity), their experiences of equality and diversity, and their perceptions regarding equality of opportunities for professional development. Some respondents' experiences and perceptions were explored in greater depth through focus groups and one-to-one interviews.

Findings: A majority of the 152 survey respondents were nurses, female and from a white ethnic background. Twenty seven (90%) of the 30 respondents who reported experiencing discrimination were from a minority ethnic background. Participants expressed concern about the lack of representation of minority ethnic groups in advanced practice roles and about unclear and unfair recruitment and promotion practices. Participants often found equality, diversity and inclusion initiatives insufficient, superficial or failing to address structural barriers.

Conclusion: Sustained, organisation-led strategies are needed to embed equality and inclusion in policies and practices. The study findings have informed the development of a toolkit that supports equitable recruitment and career development for advanced practitioners.

Evidence and change management often fit together in clinical settings. Evidence alone will not impact the quality of care unless it is carefully led and managed to embed the change in practice. Selecting good quality, relevant evidence that addresses a research question can be used to improve the quality of nursing care, inform new research and develop understanding of a topic. This is useful when seeking to implement policy or new strategies for nursing care. This article discusses various factors that may influence the decision-making process for managing change when seeking to introduce pet therapy to the older adult clinical setting.

Clinical policies in healthcare, such as guidelines, protocols, procedures and care pathways, are essential to guide decision-making and standardise practice. Investigations into patient safety incidents have often found that clinical policies had not been followed by staff, attributing this to inadequately designed and inaccessible policies that are detached from the realities of clinical practice. In this article, the author discusses clinical policy design and patient safety, explores the effects of inadequately designed policies on patients, staff and organisations, and considers some of the reasons why policies may fail to support patient safety. The author also outlines ways of addressing inadequate clinical policy design and provides some principles and recommendations for ensuring that clinical policies are accessible and usable.

Nurses' well-being and resilience are negatively affected by work pressures and unprecedented demand on the healthcare system, against a backdrop of underfunding and staff shortages. While it has been recognised that nurses' well-being and resilience are important for high-quality of patient care, these concepts are not always well understood and the onus is often on individual nurses to maintain their well-being and develop resilience. Healthcare organisations, nurse managers and nurse leaders have a fundamental responsibility to support staff and develop a more resilient workplace. This article discusses the theoretical underpinnings of well-being and resilience and introduces two conceptual models - the Muchness Model and the availability and vulnerability framework - which can be used to support nurses' well-being and resilience. It also presents individual, team and organisational tools and practices for enhancing well-being and resilience.

The nursing associate (NA) role, introduced in England in 2019, was initially designed to bridge the gap between healthcare assistants and nurses and widen access to a career in healthcare while helping to address workforce shortages. The literature suggests that there has been a shift in perceptions, with many now viewing the NA role as an alternative route to becoming a nurse rather than as a profession in its own right. However, if a substantial proportion of NAs choose to become nurses, the original purposes of the role can no longer be achieved. This article discusses the evolving role of NAs, highlighting research findings on aspirations, professional identity, recognition, integration and possible exploitation. The authors stress the importance of clarifying role boundaries, integrating and supporting NAs in the healthcare team, and providing them with opportunities to develop professionally within their role so that progression to registered nurse status is not their only career perspective.

Rationale and key points: Cultural competence, which encompasses cultural awareness, cultural skills, cultural desire, cultural encounters and self-efficacy, is essential for delivering effective, equitable, person-centred care and improving health outcomes in a diverse population. This 'How to' article details ways in which nurses can promote cultural competence in nursing practice, by taking practical steps to ensure they and the organisations they work for are providing accessible and culturally relevant care and services that meet the needs of local populations. • Nurses should critically reflect on their cultural background and consider how it may influence their practice and interactions with patients from backgrounds different to their own. • Reviewing, evaluating and updating local resources related to cultural competence can help to ensure these are current and fit for purpose. • Interacting with diverse cultural groups, for example through local community events, can enhance cultural awareness and connection between healthcare providers and patients from diverse backgrounds. • Requesting and sharing constructive feedback on interactions with and care approaches to patients from diverse cultural backgrounds can help nurses to identify cultural competence development needs. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when delivering care to individuals from cultural groups different from your own. • How you could use this information to educate nursing students or enable colleagues to practise and promote cultural competence.

Moving from a career in clinical nursing to academia is a major shift that comes with various challenges. Many new lecturers are unprepared for the demands of teaching, research and curriculum development, which significantly differ from the fast-paced, patient-focused nature of clinical practice. This article details a service evaluation that was undertaken to explore the initial experiences of new nurse lecturers. Three respondents who had recently transitioned from clinical nursing practice to academia completed a qualitative questionnaire on their experiences. The service evaluation identified issues such as ineffective induction programmes, a lack of training in teaching skills and limited access to mentorship. Respondents also described challenges in adjusting to academic culture, managing their workload and understanding institutional policies, which often left them feeling overwhelmed and unsupported. The findings suggest a need for tailored induction programmes for nurses transitioning to academia, incorporating targeted training in pedagogy, structured mentorship and continuing professional development.

Background: Canadian nurses have a long history of promoting social justice through their work, yet patients continue to experience discrimination in Canadian healthcare services. Advancing nurses' commitment to work towards equitable, diverse and inclusive nursing care requires an understanding of their perceptions and experiences in relation to equity, diversity and inclusion (EDI).

Aim: The overall aim of the study was to enhance understanding of the perceptions and experiences of nurses in Alberta, Canada, in relation to EDI.

Method: This article reports the quantitative results. A cross-sectional quantitative design was used. An anonymous online survey was developed incorporating a sociodemographic questionnaire and the Perceived Discrimination Scale, the Workplace Prejudice/Discrimination Inventory Scale and the Perceived Ethnic Discrimination Questionnaire - Community Version. A total of 104 nurses completed the survey.

Results: Respondents who belonged to any racialised group were more likely to perceive discrimination than those who did not belong to any racialised group. Age, gender and number of years of nursing practice had no relationship with perceived discrimination, indicating that nurses from racialised groups may continue to experience discrimination throughout their careers.

Conclusion: The study provides evidence that some groups of nurses in Canada experience racism and discrimination in the workplace. This has implications for their mental health and well-being and for their career progression. Nurse leaders should consider how to ensure equitable access to career development opportunities for nurses who are underrepresented in leadership. In addition, processes should be implemented in healthcare organisations that provide support to nurses from racialised groups throughout their careers.