Today's constrained healthcare environment can make it very difficult for nurses to provide compassionate, competent, and ethical care, and yet their continued commitment to care is viewed as requisite. Nurses' commitment to care of patients, enmeshed with professional identity, may be understood as heroic. A few nursing scholars have advanced the concept of a nurse-patient covenant to explain or inspire nurses' commitment to care.
View Article and Find Full Text PDFBackground: Persons with albinism face challenges to their wellbeing, safety, and security, ranging from vision impairment and skin cancer to stigma and discrimination. In some regions, they also face human rights atrocities including mutilation and murder. Research on human rights and albinism is a relatively new field that has gained momentum since the United Nations appointment of an Independent Expert on the enjoyment of human rights by persons with albinism.
View Article and Find Full Text PDFAlthough spiritual practices such as prayer are engaged by many to support well-being and coping, little research has addressed nurses and prayer, whether for themselves or facilitating patients' use of prayer. We conducted a qualitative study to explore how prayer (as a proxy for spirituality and religion) is manifest-whether embraced, tolerated, or resisted-in healthcare, and how institutional and social contexts shape how prayer is understood and enacted. This paper analyzes interviews with 21 nurses in Vancouver and London as a subset of the larger study.
View Article and Find Full Text PDFOur intention is to contribute to the development of Canadian Nursing and Medical Education (NursMed) and efforts to redress deepening, intersecting health and social inequities. This paper addresses the following two research questions: (1) What are the ways in which Decolonial, Intersectional Pedagogies can inform Canadian NursMed Education with a focus on critically examining settler-colonialism, health equity, and social justice? (2) What are the potential struggles and adaptations required to integrate Decolonial, Intersectional Pedagogies within Canadian NursMed Education in service of redressing intersecting health and social inequities? Briefly, Decolonial, Intersectional Pedagogies are philosophies of learning that encourage teachers and students to reflect on health through the lenses of settler-colonialism, health equity, and social justice. Drawing on critical ethnographic research methods, we conducted in-depth interviews with 25 faculty members and engaged in participant observation of classrooms in university-based Canadian NursMed Education.
View Article and Find Full Text PDFBackground: Few studies in academic literature involve the application of a spiritual health intervention for the purpose of mitigating compassion fatigue in nurses.
Objectives: The purpose of this qualitative study was to explore the perspectives of Canadian spiritual health practitioners (SHPs) in their support for nurses to prevent compassion fatigue.
Method: Interpretive description was utilized for this research study.
The global COVID-19 pandemic has revealed healthcare settings as sites of much-needed scrutiny as to the workings of racism and racialization in shaping healthcare encounters, health outcomes, and workplace conditions. Little research has focused on how healthcare chaplains experience and respond to social processes of racism and racialization. We apply a critical race lens to understand racism and racialization in healthcare chaplaincy, and inspired by Patricia Hill Collins, propose a "critical multifaith approach.
View Article and Find Full Text PDFIn sociological studies of religion and chaplaincy, there is little research on how gender plays a role in structural inequalities and experiences of women chaplains. Through research on the work of women chaplains in public healthcare in Vancouver (Canada) and London (England) this qualitative study revealed that while they have opportunities for leadership and ministry in chaplaincy, they are often on the margins of the religious institutions they are affiliated with and the secular medical organisations that employ them. Simultaneously, they confront the social structuring of gender and race that can affect them being overlooked.
View Article and Find Full Text PDFBackground: Critical care physicians and nurses have significant roles in the complex process of end-of-life decision making.
Objective: To understand how nurses' and physicians' emotions, psychosocial factors and professional roles influence end-of-life decision making in critical care.
Research Design/methodology: An interpretive descriptive qualitative approach was applied to collect and analyse data from semi-structured interviews with five critical care nurses and four critical care physicians from April to June 2018.
Background: Substantial literature has highlighted the importance of patient-reported outcome and experience measures (PROMs and PREMs, respectively) to collect clinically relevant information to better understand and address what matters to patients. The purpose of this systematic review is to synthesize the evidence about how healthcare providers implement individual-level PROMs and PREMs data into daily practice.
Methods: This mixed methods systematic review protocol describes the design of our synthesis of the peer-reviewed research evidence (i.
Worldviews Evid Based Nurs
June 2020
Background: There is increased acknowledgment of the importance of knowledge translation (KT) in the role of graduate-prepared healthcare practitioners, such as nurses, as change agents in the mobilization of evidence-based knowledge. The offering of flexible educational programming online and hybrid course delivery in higher education is a response to insufficient didactic methods for providing graduate students with the competencies to facilitate KT.
Aims: To describe the development, implementation, and evaluation of a cohort-based, online, innovative KT curriculum using a theoretical approach to KT called the Knowledge-As-Action Framework, which focuses on the knower, knowledge, and context as being inseparable.
Nurs Leadersh (Tor Ont)
March 2020
Clinical placements in correctional settings offer nursing students unique opportunities for learning mental health and community health concepts, including social justice, restorative justice and the impact of poverty and marginalization on health and life choices. Although there is some evidence to suggest that a small number of nursing programs use clinical placements in correctional settings, relatively little scholarly literature addresses nursing education in such settings, or the implications for nursing leadership when students do have an opportunity to learn in correctional settings. In this paper, we examine the literature that is available on this topic and present the findings of a secondary analysis of interviews with undergraduate nursing students at our nursing program in relation to their clinical placements in correctional settings.
View Article and Find Full Text PDFSocial inclusion and social determinants of health (SDH) are key to healthy aging, and a failure to adequately address these influences can lead to negative health consequences such as the development and worsening of chronic conditions. Health policy is needed that prioritizes aging well in place as an "upstream" approach to address SDH and thereby improve health outcomes and promote quality of life. Globally, nurses are well positioned to advocate for such policy, given their commitment to fostering social inclusion and quality of life for older adults.
View Article and Find Full Text PDFNursing, with its socially embedded theory and practice, inevitably operates in the realm of power and politics. One of these political sites is that of religion, which to varying degrees continues to shape beliefs about health and illness, the delivery of healthcare services and the nurse-patient encounter. In this paper, I attempt to complicate nursing's views on religion and politics in healthcare, with the intent of thinking critically and philosophically about questions that arise at the intersection of religion, politics and nursing/healthcare.
View Article and Find Full Text PDFBackground: Despite access to quality care at the end-of-life (EOL) being considered a human right, it is not equitable, with many facing significant barriers. Most research examines access to EOL care for homogenous 'normative' populations, and as a result, the experiences of those with differing social positioning remain unheard. For example, populations experiencing structural vulnerability, who are situated along the lower rungs of social hierarchies of power (e.
View Article and Find Full Text PDFThis qualitative secondary analysis explored the narratives of 14 nurses from various practice settings. Data analysis identified that although nurses share responsibility for spiritual caregiving for their patients, the ability to provide this care is greatly influenced by intrinsic and the extrinsic factors. Spiritual caregiving was seen as both a discrete act that facilitated patients' spiritual practices and, in other situations, took the form of integrative spiritual caregiving that was part of the interpersonal connection in the nurse-patient relationship.
View Article and Find Full Text PDFWhile for decades nursing has advocated for theory-informed practice, more recent attention has tended to focus on mid-range theory rather than the earlier focus on developing grand theory to encompass all of nursing practice. However, there has been continued interest in the holistic nursing community on grand theory and, in particular, on Integral Theory. Although Integral Theory's four-quadrant (AQAL) perspective is familiar in nursing, little is known about how it is being used by nurses in direct practice.
View Article and Find Full Text PDFBackground: Quality of life (QOL) assessment instruments, including patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs), are increasingly promoted as a means of enabling clinicians to enhance person-centered care. However, integration of these instruments into palliative care clinical practice has been inconsistent. This study focused on the design of an electronic Quality of Life and Practice Support System (QPSS) prototype and its initial use in palliative inpatient and home care settings.
View Article and Find Full Text PDFThe process of dying pronounces inequities, particularly for structurally vulnerable populations. Extending recent health geography research, we critically explore how the 'places' of formal healthcare settings shape experiences of, and access to, palliative care for the structurally vulnerable (e.g.
View Article and Find Full Text PDFThis article applies a micro-meso-macro analytical framework to understand clinicians' experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electronic tablet-based tool among hospital-based palliative clinicians to assess patients' and their family caregivers' quality of life concerns and experiences of care. Our analysis identified three categories of practice tensions shaping clinicians' use of PROMs and PREMs in routine care: tensions surrounding implementation, tensions in standardization and quantification, and tensions that arose from scope of practice concerns.
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