Canadian journal of nursing administration最新文献

In this exploratory, descriptive survey of 295 nursing preceptors it was found that 98.3 per cent had evaluated nursing students. They cited numerous reasons as to why they should be involved in the evaluation process. Only 28.8 per cent had been taught to evaluate and 5.4 per cent had failed students. There is a discrepancy between how little preceptors are prepared for the evaluation role and how frequently they are expected to do so. Consequently, there is an onus on nurse educators to prepare clear evaluation forms, to assess students for suitability for preceptorship experiences, and to recognize evaluation as part of the preceptor's professional relationship with the student.

Difficult economic times, competition for scarce resources and changing organizational paradigms are driving health care institutions to re-examine the ways in which they provide care. They must continually strive to provide excellent patient care and ensure positive patient outcomes while responding to increasing fiscal constraint. At Toronto's Hospital for Sick Children, consistent with current trends, nurse managers are asked to take on broad spans of responsibility. The need to decentralize much of the decision making, problem identification and problem solving functions to the multidisciplinary team is a reality of those changes. This paper describes a process the dialysis staff undertook to better understand new organizational imperatives using an orchestra metaphor as a suggestive tool to help people clarify new roles and relationships in organizations that are evolving from a hierarchical model to a knowledge-based team approach to work. The intervention was successful for some people and not others. An analysis of the outcomes is provided from the nurse manager's perspective.

This study used Rosabeth Kanter's (1977) structural theory of organizational behaviour to examine differences in the perceptions of access to job related power and opportunity of 91 nurse managers in first line and middle management positions. A convenience sample of nurse managers in three Canadian acute care urban hospitals was used to investigate the study questions. Consistent with Kanter's (1977) theory, middle managers perceived themselves as having significantly greater access to the empowerment structures than the first line managers (M = 14.66 and 12.82, respectively). Also, nurse managers in positions higher in the hierarchical structure reported having greater personal power in their organizational settings than those in lower positions.

In Canada, advance directives have been developed to ensure individual's decisions about health care are known in the event of mental incapacity. This randomized control trial examined the proportion of chronically ill elders receiving Victorian Order of Nurses (VON) services in the home who would complete an advance directive, factors associated with directive completion, treatment choices, and satisfaction with care. The participants consisted of 163 elders with a chronic illness residing within the Hamilton-Wentworth and Haldimand-Norfolk regions in South Central Ontario. Seventy percent of the experimental group completed the directive. Younger patients (p = 0.01) and patients with particular nurses (p = 0.04) were more likely to complete a directive. Psychosocial variables such as mood, depression, and uncertainty in illness did not influence directive completion. Satisfaction with involvement in health care decisions was not changed by this intervention (p = 0.576).

Hospitals in Canada and indeed throughout the world are in the midst of significant and even dramatic change. The impact of these changes on the role of the nurse manager is just beginning to be identified and research in this area is limited. As hospitals' structures and functions change, so must the roles of their managers and providers. The nurse manager is key in both facilitating patient care and in ensuring the quality of worklife of staff nurses. If the nurse manager role is to be maintained and more importantly, if the role is to develop as a significant one in the hospital infrastructure, more understanding, more study, and clear directions for the future are required. This article provides an overview of the literature on nurse managers, examines the roles, perspectives and needs of those managers and discusses the implications for future research in this area.

Hospitals currently are involved in a restructuring of the medical and nursing workforce as fiscal restraint and downsizing proceed. Changes in organizational structure, reductions in medical school enrollments and available resident positions, and the reconfiguration of nursing positions are common events. Noted gaps in the provision of care to patients are creating an opportunity to develop a new provider, an acute care nurse practitioner (ACNP). The need for ACNPs was identified in a series of consultations between the Faculty of Nursing at the University of Toronto and affiliated hospitals. In response to this need the Faculty of Nursing, with the assistance of the Max Bell Foundation, developed a three month post masters Fast Track Acute Care Nurse Practitioner Program in collaboration with 10 hospitals. Fifty-nine masters prepared nurses successfully completed one of four cycles of a concentrated program which included courses in Pharmacology, Advanced Assessment and Clinical Decision Making, Roles and Issues, and a four-week Clinical Practicum. Evaluation of graduates' competence to fulfil the nursing and medical role expectations included focus group discussions, an external review of case studies, and a questionnaire to hospital partners about their satisfaction with the program graduates.

The Canadian nursing education system is the most significant contributor to the country's supply of registered nurses. This article provides current data on the numbers of nursing graduates produced in each province in 1994. The authors highlight some of the differences in the numbers produced and use the national average of new graduates as the percentage of the population of Canada as one method to arrive at the numbers of new graduates per year which each province could attempt to produce. This article provides a national perspective on current and future nursing human resources and will assist nursing administrators in their staffing plans related to registered nurses.