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doi: 10.1111/j.1365-2702.1997.tb00313.xpmid: N/A
Summary • Empathy appears to be an important concept in the interpersonal repertoire of the nurse. There are a number of definitions and models of empathy available in the literature. • These definitions and models are explored and analysed using Walker & Avant's (1983) approach to concept analysis. A model case of the concept is described and the relevant defining attributes identified. A borderline case and an example of ‘not the case’ are also examined. • This concept analysis may assist practitioners to develop the behavioural skills of empathy and to recognize and coach it in their students and colleagues.
doi: 10.1111/j.1365-2702.1997.tb00314.xpmid: N/A
Summary • This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so‐called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed. • The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence. • It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders. • Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda. • The future of the nursing profession is uncertain. It is clear that evidence‐based practice is centre stage, and there is a need for nursing to re‐negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.
RETSAS, ANDREW; WILSON, JANICE
doi: 10.1111/j.1365-2702.1997.tb00315.xpmid: N/A
Summary • Repertory grids were completed by gerontological nurses (N= 60) to elicit the personal constructs they used to characterize gerontological nurses, effective gerontological nurses and the extent to which participants believed themselves to be effective as nurses working in this specialist field. • Analysis of pooled repertory grids indicated that the personal construct ‘caring, compassionate, empathetic’ was rated most highly as characteristic of gerontological nurses in general and of effective gerontological nurses. • Cluster analysis of individual repertory grids showed no significant difference between self‐perceptions of participants as effective gerontological nurses and the ideal gerontological nurses they would like to become. • Other findings of this research indicate that a variety of aspects of gerontological nursing need improvement if negative perceptions of this area of nursing practice are to be altered.
MANLEY, KIM; HAMILL, JANE‐MARIE; HANLON, MARTHA
doi: 10.1111/j.1365-2702.1997.tb00316.xpmid: N/A
Summary • This study explores the perceptions of staff who have been practising primary nursing for more than 4 years in intensive care. • It considers what primary nursing is, what its benefits, disadvantages, and role impact are and other issues within an intensive care setting from the staff's perceptions and experiences. • Although many of the perceived advantages and disadvantages are similar to experiences from other areas of nursing, there are some differences. • The differences seem to relate to the way primary nursing is practised within the research setting – each primary nurse works with the same small team of associates, which is perceived as providing added benefits in terms of personal support and development of junior staff. • The changes in role are seen to reflect other models in the literature which focus on becoming more patient centred and on working therapeutically. • A number of future issues are addressed.
BYRNE, GERALDINE; HEYMAN, ROBERT
doi: 10.1111/j.1365-2702.1997.tb00317.xpmid: N/A
Summary • Structured interviews were carried out with a sample of 96 patients to identify the sources of anxiety for patients in the accident and emergency (A & E) department. • Only two patients reported that they were not at all anxious about any aspect of being in A & E. The average number of anxieties reported was 69. • The most frequently reported anxieties were ‘not being able to carry on your usual activities’, ‘not knowing what will happen to you in the department’, ‘having to undergo an uncomfortable procedure’, ‘feeling pain’ and ‘not knowing what is wrong’. • The findings indicate that patients were as concerned with psychological and social aspects associated with admission as they were about psysical factors. • The authors suggest that it is essential for nurses in A & E to assess patients holistically and consider their psychological state and social circumstances as well as their physical condition. There is also a need for closer links to be developed between accident and emergency departments and other community health agencies and for more emphasis to be placed on referral to other bodies.
KRISTENSSON‐HALLSTRÖM, INGER; ELANDER, GUNNEL; MALMFORS, GERHARD
doi: 10.1111/j.1365-2702.1997.tb00318.xpmid: N/A
Summary • Day care is currently a common way of providing treatment for minor and average paediatric surgical procedures. • The purpose of this study was to assess possible benefits of increasing parental involvement in the care of operated children in a day‐care surgery unit. • By giving parents information and education about post‐operative care, the goal was to facilitate recovery and minimize time spent in hospital. • Results show that parents in the intervention group were well prepared to assume a greater part of the care of their children. • Children in the intervention group appeared to have less pain and fewer children vomited post‐operatively than children in the control group.
doi: 10.1111/j.1365-2702.1997.tb00319.xpmid: N/A
Summary • This paper reports on a qualitative study which examined the interpretation of patient advocacy by practising nurses. • Focus group interviews, which allowed respondents to recount and share their particular ‘stories’ of patient advocacy, were used to collect data. • Results indicate that a triadic model of advocacy predominated which involved the nurse in a conflict/potential conflict situation. The patient's requests, the patient's fear, the patient's vulnerability or threats to the patient's human rights provoked an advocacy response in the perceptive nurse. The nurse was sustained in the role through patient recognition, the nurse–patient relationship, emotional strength, moral justification and knowledge/expertise legitimacy. • The nurse used direct and indirect means to protect the patient against incompetent/inappropriate practice and/or represent patient/family choice, the advocacy activity resulting in positive or negative outcomes. • In conclusion it is argued that if the triadic conflict model of advocacy outlined by this research is to be sustained by practising nurses, the potential risks involved should be recognized. Professionalization of the role may be the only way forward if the ethical code (United Kingdom Central Council, 1992) continues to make patient advocacy a mandatory activity for the professional nurse.
doi: 10.1111/j.1365-2702.1997.tb00320.xpmid: N/A
Summary • Provision of adequate nutrition is recognized as essential, yet malnutrition continues to be reported in patients admitted to hospital. • The effects of malnutrition in hospital patients have been well documented; however, most work relating to nutritional management has been produced by members of Nutrition Support Teams, nurse specialists and interested clinicians, whilst the majority of hospitals are still without such specialist posts. • This study used two data collection methods to gain information about the attitudes, nutritional knowledge base and nutrition‐related nursing care in a large trust hospital in the South of England. • A survey of care plans for documentation of nutrition‐related nursing activities, carried out on the day of discharge for all patients from five wards over a period of a fortnight (totalling 141 sets of documentation), was followed by a questionnaire to all qualified nurses on these and a further four wards (110 nurses). • Results demonstrated that nurses generally felt that nutritional assessment was primarily their responsibility. • Whilst there was evidence of knowledgeable and proactive nursing care, it also appeared that there were fairly widespread deficiencies in the knowledge, communication and co‐ordination required to ensure consistent good practice.
doi: 10.1111/j.1365-2702.1997.tb00321.xpmid: N/A
Summary • This study examines what psychiatric nurses regard as the nature of expert psychiatric nurse practice. • The study focuses on the beliefs and principles of psychiatric nurses currently working within a psychiatric unit. • Using grounded theory methodology, data were coded and analysed, producing an integrated framework of expert psychiatric nurse practice comprised of four core variables: ‘attitudes/philosophy’, ‘knowledge’, ‘skills’ and ‘roles’. • It is suggested that the nature of expert psychiatric practice is an evolutionary concept and that as this practice develops the integrated theory presented will need to develop in parallel.
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