Nursing Inquiry

Thorne, Sally

doi: 10.1111/nin.12529pmid: 36302715

Lewis, Robin

doi: 10.1111/nin.12489pmid: 35279899

To address longstanding workforce shortages, increase efficiency and control the costs associated with the modern health‐care provision, there has been a worldwide policy to promote increased flexibility within the health‐care workforce. This is being done primarily by extending the ‘scope of practice’ of existing occupational roles into what is referred to as ‘advanced’ practice. The development of the advanced practice nurse (APN) has occurred within the context of a shortage of medical staff, and the need to control cost. However, the means by which substantially repurposed occupational groups such as these, are incorporated into complex, hierarchical organisations such as the UK national health service (NHS) remains poorly understood. Using modern sociological theory, the development of the APN role has been examined in terms of power, control, professional identity and gender relations. Each of the theoretical approaches used adds to the quality of the discussion, although none provide a comprehensive picture. However, when synthesised, they do provide an enhanced insight into the evolution of the role. It is argued here that by critically examining the development of the APN role, this will enable both a better understanding of, and the means to influence, its future direction of travel.

doi: 10.1111/nin.12435pmid: N/A

Johansson, Jim A.; Holmes, Dave

doi: 10.1111/nin.12480pmid: 34843148

Nurses working in forensic psychiatric settings face unique challenges in practice, where they take on a dual role of custody and caring. Patient resistance is widespread within these restrictive settings and can take many forms. Perhaps the most disturbing form of resistance entails a patient's weaponization of their bodily fluids, with nurses as their target. The tendency in assigning motive for this act is to relegate to the psychopathology of the patient. This paper will adopt a poststructuralist perspective to reexamine this phenomenon as an act of resistance through the lens of Kristeva's concept of abjection. Patients confined in these settings have little sense of control, and in resistance may resort to the only thing available: their bodily fluids. By weaponizing the abject, patients actively violate and permeate the physical and psychological boundaries of nurses—the very boundaries considered crucial to safe and professional forensic psychiatric nursing practice. By recognizing this phenomenon as an act of resistance to confinement and loss of control, nurses may reorient their approach to care in forensic psychiatric settings.

Cooper Brathwaite, Angela; Versailles, Dania; Juüdi‐Hope, Daria; Coppin, Maurice; Jefferies, Keisha; Bradley, Renee; Campbell, Racquel; Garraway, Corsita; Obewu, Ola; LaRonde‐Ogilvie, Cheryl; Sinclair, Dionne; Groom, Brittany; Grinspun, Doris

Arde, Bernardo O. A.; Purisima, Epifania M. R.; Ito, Hirokazu; Locsin, Rozzano C.

doi: 10.1111/nin.12481pmid: 34897884

This article aimed to explore issues of concern related to quarantine, its social consequences and influences, challenging its effects on human behavioral expressions during social isolation. The advent of the coronavirus disease 2019 (COVID‐19) pandemic impacted human lives in multifarious ways, threatening the meaning of normalcy. Quarantine, lockdown, isolation, and other terms reflecting conditions limiting human freedoms have become synonymous in importance to safety, security, and survival. To understand human defiance in the face of maintaining limited mobility during the COVID‐19 pandemic, reimagining situations of “unfreedoms” is explained as thinking of changes to inspire and improve the meaning of living lives meaningfully. During the pandemic, issues regarding healthcare practices and social behaviors focused much attention on interactive challenges that enhance ways to mitigate the spread of contagious diseases. Illuminating these issues, discussing concerns and highlighting recommendations to engage in alternative approaches and practices, heightens the declaration of efficiency of quarantine outcomes and effectiveness. Implications are proposed with the hope that they may lead the way forward in exercising contemporary healthcare practices.

Ramsey, Sarah M.; Brooks, Jane; Briggs, Michelle; Hallett, Christine E.

doi: 10.1111/nin.12486pmid: 35266239

The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009–2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid‐Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high‐profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re‐evaluated in the current Covid‐19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy‐in to strategy documents.

Rosi, Ivana Maria; Milos, Roberto; Galimberti, Paolo Maria; Rancati, Stefania

doi: 10.1111/nin.12479pmid: 34865284

In the last year of the Great War, Italy was also hit by the Spanish flu. The Civic Hospitals faced a deadly disaster with insufficient resources. All the heavy workload fell on the female nursing staff, who were the only ones able ensure the continuity of the hospital services. This study aimed to explore the impact of the influenza on the health of the nurses at the Maggiore Hospital in Milan during the second and third epidemic waves. Historical research was conducted between February and May 2020. Primary sources were retrieved from the historical archives of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and the daily newspaper Corriere della Sera. In the autumn of 1918, the Maggiore Hospital in Milan changed its organization to hospitalise patients affected by the influenza pandemic. Although the hospital managers wanted to protect their healthcare staff from the risks of contagion by means of prophylaxis rules, 388 lay nurses and 80 religious sister nurses were affected by this insidious disease. The second and third waves of the pandemic claimed 25 victims of duty. Remembered for their altruism and spirit of abnegation, the hospital community honoured their sacrifice, and the citizens expressed their gratitude.

Birnbaum, Shira

doi: 10.1111/nin.12534pmid: 36302716

Nyborg, Vibeke Narverud; Hvalvik, Sigrun

doi: 10.1111/nin.12490pmid: 35362190

The professionalization of modern nursing education from 1850 and forward is closely linked to values and virtues underpinned by Christian ideals, sex‐based stereotypes and class. Development in the late 19th century of modern hospital medicine, combined with a scientific understanding of antisepsis and asepsis, hygiene, contagion prevention and germ theory, were highly influential insights to the dominant position of modern medicine in health care. This development constituted a key premise for what nurses, by virtue of being women, and combined with their education, could offer in terms of medical assistance. It enabled them to challenge the prevailing sex‐based stereotypes‐ and class‐based hierarchies, allowing modern nursing to retain aspects of both traditional Christian and womanly values, while at the same time adhering to the medical science paradigm. In this paper, we argue that modern nursing education developed in a context characterized by traditional female and religious values, while at the same time being increasingly dominated by the influence of scientific and medical progress. This conflict between traditional and modern values caused dilemmas and tensions as the nursing profession developed. We argue further that similar dilemmas and tensions continue to pervade contemporary nursing and nursing education.