The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration (...) -- Clients with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Background:Nurses must balance their perceived duty to care against their perceived risk of harm to determine their willingness to report during disaster events, potentially creating an ethical dilemma and impacting patient care.Research aim:The purpose of this study was to investigate nurses’ perceived duty to care and whether there were differences in willingness to respond during disaster events based on perceived levels of duty to care.Research design:A cross-sectional survey research design was used in this study.Participants and research context:Using a (...) convenience sample with a snowball technique, data were collected from 289 nurses throughout the United States in 2017. Participants were recruited through host university websites, Facebook, and an American Nurses Association discussion board.Ethical considerations:Institutional review board approval was obtained from the University of Texas at Tyler and the University of Arkansas.Findings:Analysis of willingness to report to work based on levels of perceived duty to care resulted in the emergence of two groups: “lower level of perceived duty to care group” and “higher level of perceived duty to care group.” The most discriminating characteristics differentiating the groups included fear of abandonment by co-workers, reporting because it is morally the right thing to, and because of imperatives within the Nursing Code of Ethics.Discussion:The number of nurses in the lower level of perceived duty to care group causes concern. It is important for nursing management to develop strategies to advance nurses’ safety, minimize nurses’ risk, and promote nurses’ knowledge to confidently work during disaster situations.Conclusion:Level of perceived duty to care affects nurses’ willingness to report to work during disasters. Primary indicators of low perceived duty to care are amenable to actionable strategies, potentially increasing nurses’ perceived duty to provide care and willingness to report to work during disasters. (shrink)

Background:Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its (...) kind carried out in New Zealand.Aim/objective:The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate.Research design/participants/context:This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research.Ethical considerations:Ethics approval for this study was granted by the New Zealand Ministry of Health’s Central Regional Health and Disability Ethics Committee on 14 June 2012.Findings:The themes identified in the data centred on three dominant elements that – together – shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff.Discussion:While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses’ ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere.Conclusion:Moral distress is inevitable in an ethical climate where the organisation’s main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care. (shrink)

Background:In the face of scarcity, nurses may inevitably delay or omit some nursing interventions and give priority to others. This increases the risk of adverse patient outcomes and threatens safety, quality, and dignity in care. However, it is not clear if there is an ethical element in nursing care rationing and how nurses experience the phenomenon in its ethical perspective.Objectives:The purpose was to synthesize studies that relate care rationing with the ethical perspectives of nursing, and find the (...) deeper, moral meaning of this phenomenon.Research design:A systematic review and thematic synthesis of qualitative studies was used. Searching was based on guidelines suggested by Joana Brigs Institute, while the synthesis has drawn from the methodology described. Primary studies were sought from nine electronic databases and manual searches. The explicitness of reporting was assed using consolidated criteria for reporting qualitative research. Nine studies involving 167 nurse participants were included. Synthesis resulted in 35 preliminary themes, 14 descriptive themes, and four analytical themes. Discussion of relationships between themes revealed a new thematic framework.Ethical consideration:Every effort has been taken, for the thoroughness in searching and retrieving the primary studies of this synthesis, and in order for them to be treated accurately, fairly and honestly and without intentional misinterpretations of their findings.Discussion:Within limitations of scarcity, nurses face moral challenges and their decisions may jeopardize professional values, leading to role conflict, feelings of guilt, distress and difficulty in fulfilling a morally acceptable role. However, more research is needed to support certain relationships.Conclusions:Related literature is limited. The few studies found highlighted the essence of justice, equality in care and in values when prioritizing care—with little support to the ethical effects of rationing on nurses. Further research on ethical dimension of care rationing may illuminate other important aspects of this phenomenon. (shrink)

This is a descriptive qualitative study using phenomenological approach involving 46 nurses working in hospitals that cater to COVID-19 patients. This was conducted in April 2020. Results show that the challenges of nurses during the tour of duty in COVID-19 wards includes physical, procedural, psychological and protection. Likewise, nurses uncovered some difficulty with regard to the following experiences: struggle to be in complete PPE and with lack of PPE, not always being able to provide timely care, increased (...) workload, nursing care limitations, their risk to safety and having anxiety. This most often leads to some opportunities that bridges the gap towards achievement of their personal development and professional growth, as such, nurses became more compassionate, confident, resilient and resourceful, altruistic, and develop a stronger faith in God. Their leadership skills were also enhanced as they learned new knowledge and developed skills through education, trainings and experience. All the challenges and difficulties became avenue for the nurses to be able to unleash their potentials and further develop them into a God fearing and humane health care providers. Furthermore, the nurses being in the forefront of health care should be given assurance of safety and protection. Likewise, the nurse should closely adhere to standard protocol designed for COVID-19 infection control. It is thus recommended that there should be effective communication system to address issues and resolve conflicts. Lastly, emotional support and positive feedback should be given to nurses during the critical situations in the ward and collaborative working environment should be established all the time. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect (...) class='Hi'>nurses globally in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

Within the literature that circulates in the discourses organizing nursing education, there are embedded assumptions that link student performance on maths examinations to safe medication practices. These assumptions are rooted historically. They fundamentally shape educational approaches assumed to support safe practice and protect patients from nursing error. Here, we apply an institutional ethnographic lens to the body of literature that both supports and critiques the emphasis on numeracy skills and medication safety. We use this form of inquiry to open (...) an alternate interrogation of these practices. Our main argument posits that numeracy skills serve as powerful distraction for both students and teachers. We suggest that they operate under specious claims of safety and objectivity. As nurse educators, we are captured by taken‐for‐granted understandings of practices intended to produce safety. We contend that some of these practices are not congruent with how competency actually unfolds in the everyday world of nursing practice. Ontologically grounded in the materiality of work processes, we suggest there is a serious disjuncture between educators' assessment and evaluation work where it links into broad nursing assumptions about medication work. These underlying assumptions and work processes produce contradictory tensions for students, teachers and nurses in direct practice. (shrink)

Background Nowadays, patients in Thailand have easier access to public health services, resulting in an increased number of patients undergoing surgery. Therefore, the Royal College of Anesthesiologists produces nurse anesthetists to reduce the shortage of anesthesiologists who can perform general anesthesia under the physician’s supervision. As a result, nurse anesthetists must have the consciousness to work on the basis of ethics and professional standards. Nurse anesthetists have work experience that aims to benefit patients and make them as safe as possible. (...) Objective To investigate the working experience of nurse anesthetists with beneficence for patients. Methods This study employed qualitative research using in-depth interviews. The sample consisted of 33 nurse anesthetists who volunteered to participate in the research project with more than ten years of work experience and worked in tertiary care hospitals. The researcher used a qualitative content analysis method. Ethical considerations: Study after approval and certification of the research project from the Human Ethics Committee of Mahidol University, and Naval Medical Department. Results The working experience of nurse anesthetists with beneficence for patients involves communicating and listening with compassion, being considerate, knowledgeable, and standard operations, team communication, and awareness of patient safety, as a productive and non-harmful work experience. Discussion: Nurse anesthetists working in situations of beneficial approaches to patient care need experience in appropriate communication, professional knowledge and skills to thoroughly assess patients, pass critical information to the team, and be aware of potential risks. Make patients receive care in a more suitable and safe way. Conclusion Working experience of nurse anesthetists with beneficence for patients exists with communication and listening with compassion, being considerate, communicating and forwarding the patient’s necessary information to the team to be aware of abnormalities, knowledgeable and standard operations, and awareness of patient safety in every phase of the performance consistently. (shrink)

Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical (...) theoretical perspectives that foster a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of 'culture', 'safety', and 'cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a 'social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. (shrink)

Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the (...) questionnaire used in validation of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage. (shrink)

Nurses are positioned on healthcare's front line, intimately connected to individuals, families, and communities. How can they leverage this position to work for the common good? In Toward ward a Better World, Mark Lazenby, a philosopher and a nurse, presents a plan of action. He argues that nurses advance the good society when they fulfill fundamental obligations. Promoting equality, peace and respect, providing assistance and safety, and safeguarding the health of our planet are among these obligations. By (...) acting upon them, nurses become a force for social change in their communities. But through the collective power of more than 20 million nurses worldwide, nurses become a global force for making the world a better place--in the present and for the future. (shrink)

The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. It is from within the context of nursing in Aoteaoroa/New Zealand (A/NZ) that the concept developed and was subsequently integrated into nursing education. Cultural safety is based within a framework of biculturalism, and is congruent with the tenets of the nation's founding document, the Treaty of Waitangi. Clarification of the concept is offered, together with a (...) review of the historical shift in nursing attitudes that has led to the emergence of ‘cultural safety’ as a viable and valued component of nursing practice.The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses’ attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of A/NZ nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion.The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the ‘end-point’ or ‘outcomes’ of the process. (shrink)

This article explores the social and ethical elements of cultural safety and combines them in a model of culturally safe practice that should be of interest and relevance for nurses, nurse educators and nurse ethicists in other cultures. To achieve this, the article briefly reviews and critiques the main underpinnings of the concept from its origins and development in New Zealand, describes its sociocultural and sociopolitical elements, and provides an in-depth exploration of the key socioethical elements. Finally, a (...) model is presented to illustrate the strong connection between the social and ethical components of cultural safety that combine to produce culturally safe practice through the activities of a ‘socioethical’ nurse. (shrink)

Surgical patient safety remains a concern worldwide as, despite World Health Organization recommendations and implementation of its Surgical Safety Checklist, adverse events continue to occur. The aim of this qualitative study was to explore the views and experiences of perioperative nurses regarding the factors that impact surgical patient safety. Data were collected through five focus groups involving a total of 50 perioperative nurses recruited from four public hospitals in Spain. Content analysis of the focus groups (...) yielded four main themes: personal qualities of the perioperative nurse, the surgical environment, safety culture, and perioperative nursing care plans. One of the main findings concerned barriers to the exercise of leadership by nurses, especially regarding completion of the Surgical Safety Checklist. Some of the key factors that impacted the ability of perioperative nurses to fulfil their duties and ensure patient safety were the stress associated with working in the operating room, time pressures, and ineffective communication in the multidisciplinary team. Targeting these aspects through training initiatives could contribute to the professional development of perioperative nurses and reduce the incidence of adverse events by enhancing the surgical safety culture. (shrink)

Collegiality among nurses is necessary for the accomplishment of the tasks of care, for safety and quality improvement and for professional self‐regulation. Nurses, especially in hospitals, are more likely to work in groups than other professionals, yet those relationships have not been well explored. Bullying, intimidation and fear are frequently identified, while respectful disagreements are rarely described. In this paper, a single story by a nurse about her conversational conflict with another nurse is given a close reading. (...) I use the ‘triadic line’ of William Carlos Williams to format an extended excerpt of interview text, in order to make visible the rhythms and organization of spoken language. Mills' concept of a ‘vocabulary of motives’ is used to examine the rhetorical strategies deployed by each nurse. Finally, I analyze the narrative structure of the story, highlighting the ways that moral certainty and uncertainty function to involve the reader in the story, and the complex role of virtue in nursing discourse. (shrink)

Background:There is controversy concerning the use of physical restraint. Despite this controversy, some nurses still consider the application of physical restraint unavoidable for some of their clients.Aim:Identify the perceptions and practice of physical restraint in China.Research design:This was a descriptive study that combined qualitative interviews with a quantitative cross-sectional survey.Participants:A total of 18 nurses were interviewed and 330 nurses were surveyed.Ethical considerations:Approval of the study was obtained from the hospital ethics committee. Permission to conduct the study was (...) obtained from the director of nursing. Participants were assured that their participation is voluntary.Results:Physical restraint was commonly used to protect patients’ safety. Naturally, intensive care unit nurses used physical restraint much more frequently than general medical/surgical ward nurses ( p < 0.01). In addition, night shift nurses tended to use physical restraint more frequently.Conclusion:Nursing managers should be aware of the role nurses play in the use of physical restraint. In-service training regarding the proper use of physical restraint should be strengthened and nurse staffing levels should be improved in order to minimize the use of physical restraint in China. (shrink)

This article considers the development of nurse-led services as a part of a pilot study and explores the therapeutic nature of the role of the nurse. In particular it suggests a need for reconsideration of the fundamental values of nurse-led care in the context of changing organizational culture. Within the UK there has been pressure from policy makers to extend the role of the specialist nurse and create new nursing roles, shifting the boundaries between professional health groups. The philosophy of (...) nurse-led initiatives has therefore been driven mainly from a service redesign and clinical need standpoint rather than necessarily focusing on enhancing patients’ experience and the changes in organizational culture required to achieve this. While several studies have focused on the safety, comparative cost and comparative patient outcomes in nurse-led care in relation to traditional or doctor-led care, little attention has been given to the changing organizational values underlying the nursing role. Exploring this context is essential if new nursing roles are to provide more than relief for bottlenecks in the system and also meet their potential for providing patient centred and innovative models of care. (shrink)

Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma‐ and violence‐informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity‐oriented care (...) for primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma‐ and violence‐informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice. (shrink)

Nurses and midwives are the majority of healthcare professionals globally, including Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was (...) reiterated that nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk. (shrink)

Background Changes in health needs led to an increase in virtual care practices such as telemedicine. Nursing plays an essential role in this practice as it is the key to accessing the healthcare system. It is important that this branch of nursing is developed considering all the ethical aspects of nursing care, and not just the legal concepts of the practice. However, this question has not been widely explored in the literature and it is of crucial relevance in the new (...) concept of care. Objective The purpose of this scoping review is to identify the ethical aspects of the development of telemedicine from a nursing practice perspective. Methods A scoping review of the literature based on Arksey and O’Malley’s framework. The search was conducted in Scopus, PubMed/MEDLINE and CINAHL databases, from 2012 to 2022. A total of 1322 articles were retrieved, of which 12 met the inclusion criteria. Ethical considerations The research was conducted in accordance with the best scientific practices. Findings The most relevant aspects were the safety of the patient, the benefits for the user and the digital competence of the professionals. Informed consent and patient’s willingness to use new technologies were relevant to the practice, as was person-centered care and how telemedicine can influence the quality of the therapeutic relationship. Another relevant issue was the concern about professional competence for optimal outcomes. Conclusion It is necessary to further explore and develop the ethical aspects of the new practices, disassociating them from the legal aspects only. Professionals demand more training providing them with more competence and confidence. (shrink)

Fog in August is a German film based on Robert Domes' historical novel of the same name. The film provides a fictionalized account of the institutionalization and eventual killing of children and adults labelled as a burden on the State and unworthy of life. On one level, this is a story of good versus evil, where innocent patients are manipulated by callous doctors and nurses. At a deeper level, however, it is possible to read the characters as more complex (...) and such a reading gives an insight into the paradox of how a genocidal policy was able to be systematically implemented by health care professionals who had previously taken an oath to provide care to all people. Carl Jung argued that powerful stories, told across generations, contain mythical archetypes that help drive the plot and convey beliefs about humanity. The aims of this paper are to explore Jungian ideas within Fog in August that help the historical story it is based on resonate with viewers today, and demonstrate how the application of these insights can help health care professionals more fully understand morally distressing events and, as a result, support and improve the safety of patients. (shrink)

There is growing evidence demonstrating that nursing students encounter unsafe and poor clinical practice when on clinical placement. The impact on nursing students remains relatively under‐explored, especially in the Australian context. This two‐phased qualitative study used Interpretive Description to explore 53 pre‐registration nursing students’ perceptions and experiences of speaking up for patient safety. Results of the study identified students believe speaking up is the right thing to do, and their professional responsibility. The study results add to previous research by (...) describing the dissonance students experience due to the inconsistencies between what is taught at university and performed in practice. Student's distress arises when observing nurses taking short cuts, justifying such actions and making excuses about poor practice. Students report experiencing dissonance, bewilderment and confusion and at times, anger when observing poor practice. The clinical environment culture influences students’ decisions to speak up or remain silent. Understanding students’ perceptions and responses will promote awareness and discussion essential to the future development of curricula and clinical support strategies that will enable students to speak up. (shrink)

The purpose of the study was to develop an understanding of how nursing students gained perspective on nursing care of diverse populations through watching documentaries in a cultural diversity course. The basis of this paper is our analyses of students’ written responses and reactions to documentaries viewed in class. The guiding theoretical frameworks for the course content and the study included postcolonial feminism, Foucauldian thought, and cultural safety. Krathwohl's Taxonomy of the Affective Domain was used to identify themes and (...) determine how undergraduate nursing students were progressing in achieving learning outcomes. Our findings suggest that while the use of documentaries serves as a tool for deepening students’ understanding of the realities of various populations, this activity, in the absence of critical reflection, may inadvertently promote stereotypes and further marginalize different people groups. Even though nursing students reflected on the importance of cultural safety in nursing, our findings indicate that their actions may not reflect this, especially since these students are in the early stages of the nursing program. Students need to be provided with a space where they can explore implicit biases evoked by exposure to new information about different people groups as a way of enhancing culturally safe care. (shrink)

The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in ‘the ethical imperative’ of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers’ decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge (...) in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected. (shrink)

Immigrant nurses make up a large percentage of the Australian nursing workforce. Since the support in the workplace is expected to be inclusive for all nurses, the aim of this article is to explore how support and opportunities for professional growth, learning and development are distributed across different categories of nurses working in a neonatal intensive care unit (NICU). An ethnographic approach has opened an examination of the everyday workplace practices in the NICU to gain insight into (...) how nurses made sense of the social and power relations occurring between themselves and their senior colleagues and how they experienced the support and opportunities they received in their workplace. As today's workplaces such as the NICU are diverse in races, culture and experiences, the concepts of intersectionality and cultural safety assisted in identifying inequality and injustice related to such diversity. The results showed how patronage relations rendered nurses with immigrant status with major disadvantage and left them clinically and culturally vulnerable. Such inequity defeats the reasons for encouraging skilled migration of nurses and poses questions on the cultural competency of recruiting organisations. Considering how cultural safety might guide staff development offers opportunities for authentic support to culturally diverse nurses. (shrink)

Registered nurses in psychiatric-mental health nursing continuously balance the ethical principles of duty to do good (beneficence) and no harm (non-maleficence) with the duty to respect patient choices (autonomy). However, the problem of nurses’ level of control versus patients’ choices remains a challenge. The aim of this article is to discuss how nurses accomplish their simultaneous responsibility for balancing patient safety (beneficence and non-maleficence) with patient choices (autonomy) through the theory of protective empowering. This is done (...) by reflecting on interview excerpts about caring from 17 registered nurses taking part in a grounded theory study conducted in three acute urban psychiatric hospital settings in Canada. The interplay between the protective and empowering dimensions of the theory of protective empowering was found to correspond with international, national, and local nursing codes of ethics and standards. The overall core process of protective empowering, and its associated reflective questions, is offered as a new lens for balancing patient safety with choices. (shrink)

Nursing practice occurs in the context of conversations with healthcare users, other healthcare professionals, and healthcare institutions. This discussion paper draws on symbolic interactionism and Fairclough's method of critical discourse analysis to examine language that nurses use to describe the people in their care and their practice. We discuss how nurses’ use of language constructs meaning about healthcare users and their own work. Through language, nurses are articulating what they believe about healthcare users and nursing practice. We (...) argue that the language nurses use can contribute to viewing their practice as tasks on bodies that must be accomplished efficiently and objectively within the biomedical model, rather than relational and person‐centered. Moreover, the language nurses use can perpetuate a sense of powerlessness within healthcare systems yet paradoxically they are in a position of power over healthcare users. Nurses’ compliance with the efficiency and biomedical model results in a lack of emphasis on the full breadth of nursing work, which could be enacted in relational rather than power‐laden practices. We conclude by positing that careful use of language among nurses in all settings is essential, if we are to begin to articulate what nursing is to ourselves and to others. (shrink)

Background:The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice. In order to increase nursing actions as a patient advocate, a comprehensive and clear definition of this concept is necessary.Research objective:This study aimed to offer a comprehensive and clear definition of patient advocacy.Research design:A total of 46 articles and 2 books published between 1850 and 2016 and related to the concept of (...) patient advocacy were selected from six databases and considered for concept analysis based on Rodgers’ evolutionary approach.Ethical considerations:This study was approved by the Research Ethics Committee of Tarbiat Modares University.Findings:The attributes of patient advocacy are safeguarding (track medical errors, and protecting patients from incompetency or misconduct of co-workers and other members of healthcare team), apprising (providing information about the patient’s diagnosis, treatment, and prognosis, suggesting alternatives of healthcare, and providing information about discharge program), valuing (maintaining self-control, enabling patients to make decisions freely, maintaining individualization and humanity, maintaining patient privacy, and acting in the patients’ values, culture, beliefs, and preferences), mediating (liaison between patients, families, and healthcare professionals, being patients’ voice, and communicate patient preferences and cultural values to members of the healthcare team), and championing social justice in the provision of healthcare (confronting inappropriate policies or rules in the healthcare system, identifying and correcting inequalities in delivery of health services, and facilitating access to community health services and health resources).Discussion and conclusion:The analysis of this concept can help to develop educational or managerial theories, design instruments for evaluating the performance of nurses in patient advocacy, develop strategies for enhancing patient advocacy, and improve the safety and quality of nursing care in the community and healthcare system. (shrink)

Background:Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them.Purpose:To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic.Design:Qualitative descriptive component within a larger mixed-methods study.Participants and research context:Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis (...) was used to analyze the data.Ethical considerations:The study was approved by the ethics committee at the researchers’ university in eastern Canada.Results:A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety.Discussion:Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed.Conclusion:Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)

Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision‐making. The boundaries between human‐ and nonhuman‐driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment (...) like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision‐making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed. (shrink)

Background Scientific advances have resulted in more complex medical systems, which in turn have led to an increase in the number of patient safety incidents. In this environment, the importance of honest disclosure of PSIs is rising, which highlight the need to settle a reliable system. This study aimed to investigate the effects of patient safety culture and ethical awareness on open disclosure of PSIs. Methods Data were collected from 389 nurses using self-reported perceptions of open disclosure (...) of PSIs, perceptions of patient safety culture, and ethical awareness. Results Perception of open disclosure of PSIs was significantly correlated with ethical awareness and perception of patient safety culture. Ethical awareness had the greatest impact on perception of PSIs, and two components of the perception of patient safety culture, namely overall knowledge about patient safety and staffing, were found to have significant effects. Conclusions To enhance nurses’ perception of open disclosure of PSIs, educational curriculum and programs that teach and practice fundamental ethical values are needed. Furthermore, it also calls for effort on the part of healthcare institutions and the government, as well as people’s trust, to implement a legal safety net and foster patient safety culture to promote honest disclosure of PSIs to patients. (shrink)

BackgroundRationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding.MethodsThe review followed Preferred Reporting Items for Systematic Reviews and Meta‐analysis guidelines, and (...) literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty‐seven quantitative studies were included in the review.FindingsThe review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses.DiscussionsThis review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing. (shrink)

This article explores risk in professional nursing practice. Professional risk refers to the threat of professional discipline if it is found that a registered nurse has violated professional nursing practice standards. We argue professional risk is socially constructed and understood differently by nurse regulatory bodies, unions, professional associations and frontline nurses. Regulatory bodies emphasize professional accountability of nurses; professional associations focus on system problems in health‐care; unions undertake protecting nurses' right to health and safety; and frontline (...) nurses experience fear and uncertainty in their attempt to interpret practice standards to avoid professional discipline. Perspectives of professional risk are investigated by analyzing three professional nursing bodies' views of professional codes governing the right of nurses to refuse unsafe work assignments. The workplace dynamics surrounding work refusal experienced by frontline nurses are illustrated primarily through the lens of the 2003 SARS influenza outbreak in Ontario, Canada. We conclude that frontline nurses in Ontario are required to manage risk by following professional protocols prioritizing patient care and professional accountability which disregard the systemic, unpredictable and hazardous circumstances in their everyday practice. Moreover, we argue professional protocols cannot anticipate every eventuality in clinical practice creating the fear of professional discipline for nurses. (shrink)

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through (...) in‐depth interviews with nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational ‘rule‐centred’ culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child‐centred approach. (shrink)

The administration of pro re nata medications is the responsibility of the nurse. However, ethical uncertainties often happen due to the inability of incapacitated patients to collaborate with the nurse in the process of decision making for pro re nata medication administration. There is a lack of integrative knowledge and insufficient understanding regarding ethical considerations surrounding the administration of pro re nata medications to incapacitated patients. Therefore, they have been discussed in this paper and practical strategies to avoid unethical practices (...) have been suggested. The complicated caring situation surrounding the administration of pro re nata medications is intertwined with ethical issues affecting the consideration of the patient's wishes and interventions that override them. The patient's right of autonomy and treatment refusal, surrogacy role, paternalism, and coercion are the main ethos of ethical pro re nata medication administration. Education and training can help nurses avoid legal and ethical issues in pro re nata medicines management and improve the quality and safety of healthcare. Empirical research is needed to improve our understanding of this phenomenon in the multidisciplinary environment of medicines management. (shrink)

Indigenous nurse scholars across nations colonised by Europeans articulate the need for accomplices (as opposed to mere performative allies) to work alongside them and support their ongoing struggle for health equity and respect and to prioritise and promote culturally safe healthcare. Although cultural safety is now being mandated in nursing codes of practice as a strategy to address racism in healthcare, it is important that white nurse educators have a comprehensive understanding about cultural safety and the pedagogical skills (...) needed to teach it to undergraduate nurses. We open this article with stories of our journeys as two white nurses in becoming accomplices and working alongside Indigenous Peoples, as patients and colleagues. Our lived experience of the inertia of healthcare and education organisations to address systemic and institutional resistance to the practice of cultural safety underpins the intention of this article. We understand that delivering this challenging and complex topic effectively and respectfully is best achieved when Indigenous and white educators work together at the cultural interface. Doing so requires commitment from white nurses and power holders within universities and healthcare institutions. A decolonising approach to nurse education at individual and institutional levels is fundamental to support and grow the work that needs to be done to reduce health inequity and increase cultural safety. White nurse accomplices can play an important role in teaching future nurses the importance of critical reflection and aiming to reduce power imbalances and racism within healthcare environments. Reducing power imbalances in healthcare environments and decolonising nursing practice is the strength of a cultural safety framework. (shrink)

BackgroundNursing documentation as a pivotal part of nursing care has many implications for patient care in terms of safety and ethics.ObjectivesTo explore factors influencing nursing documentation from nurses’ perspectives in the Iranian nursing context.MethodsThis qualitative study was carried out using a qualitative content analysis of data collected from 2018 to 2019 in two urban areas of Iran. Semi-structured interviews (n = 15), observations, and reviews of patients’ medical files were used for data collection.Ethical considerationsThis study was conducted in (...) accordance with the ethical principles of research and regulations in terms of confidentiality of data, anonymity, and provision of informed consent.FindingsThe main theme of this study was “unsafe documentation.” Two categories, “types of errors in reporting” and “reasons of errors in reporting,” and 12 subcategories were developed indicating factors influencing nursing documentation in the Iranian nursing context.ConclusionIn general, individual, organizational, and national factors affected nursing documentation in Iran. In this respect, hiring more nurses, application of reforms in the healthcare management structure, devising appropriate regulations regarding division of labor, constant education of healthcare staff, establishment of clinical governance, improvement of interpersonal relationships, development of hardware and software techniques for documentation, and provision of support should be done to improve the quality of nursing documentation. The above-mentioned suggestions can help nurses with a safe, ethical, lawful, and reliable documentation in nursing practice. (shrink)

Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the (...) Newcastle Ottawa checklist. Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its’ 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg’s Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis. Ethical consideration The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773. Results Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0–10 scale [95% Confidence Interval: 2.27–2.84, I2: 98.4%, Tau2:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance. Conclusion The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare. (shrink)

This paper assesses the relational effects of perceived organizational support, fear of COVID-19, and work-related stress on the safety performance of healthcare staff. The sample for this research was extracted from the University College Hospital in the Oyo State of Nigeria. The participants were midwives, doctors, auxiliary services staff, and nurses who functioned in a COVID-19 hospital ward, fever or respiratory ICU, Auxiliary services, or outpatient clinics. This investigation espoused a clinical cross-sectional survey involving self-reported surveys. Of the (...) 150 questionnaires distributed, 147 were fit for scrutiny and analyzed with Statistical Packages for the Social Sciences. This paper established a relationship between POS and safety performance. Besides, it showed a significant positive correlation between FOC-19 and SP. It further noted that work-related stress negatively relates to safety performance. Moreover, this study showed the significant joint strong influence of POC, FOC-19, and WRS on the safety performance of healthcare workers. Hence, healthcare institutions are encouraged to create adequate support for healthcare workers, particularly during a global health crisis. Government and healthcare institutions should also develop an awareness program on the danger and consequences of getting infected by the virus or infecting other significant others. This will increase the fear of COVID-19 and, consequently, health workers’ safety performance. Besides, it is recommended that the management of healthcare institutions provides a proper work structure and schedule to help reduce workloads, consequently reducing WRS, as lowering it improves healthcare workers’ safety performance. (shrink)

Transformative unlearning: safety, discernment and communities of learning This paper aims to stimulate awareness about the intellectual and emotional work of ‘unlearning’ in knowledge workers in the emerging learning age. The importance of providing a safe space for dialogue to promote transformative learning, through building ‘communities of learning’, is highlighted. Unlearning is conceptualized within a transformative education paradigm, one whose primary orientation is discernment, a personal growth process involving the activities of receptivity, recognition and grieving. The author utilizes the (...) metaphor of an unfolding spiral path to explore her experience of needing to ‘unlearn’ a trusted nursing practice prior to ‘learning’ new best caring practices related to infant sleep positions. Macro and micro approaches to facilitating unlearning in organizations, in learners and in nurses are suggested. (shrink)

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of ‘proficiency’ in nurse education—prescribed by the regulator—impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical‐legal challenges posed by sanctioned powers to restrict (...) patients' freedom at the same time as the desire (and obligation) to promote patients' self‐determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain. (shrink)

Se presenta una revisión bibliográfica en la que se valora la implementación de las estrategias curriculares en la Licenciatura en Enfermería, a partir de las asignaturas impartidas en el segundo año de la carrera. Se destaca la importancia de estos recursos pedagógicos en la formación de los estudiantes, su desarrollo y contribución a la solución de situaciones relacionadas con el cuidado, la calidad de la atención de salud, la disminución de eventos adversos y la seguridad del paciente. Las estrategias curriculares (...) vinculadas a la carrera de Enfermería constituyen una forma particular de desarrollar el proceso docente, caracterizadas por una direccionalidad coordinada que responde al perfil de salida del egresado, en la que se imbrican los contenidos y métodos teóricos y prácticos de las unidades curriculares correspondientes al plan de estudio, a partir de una estructura metodológica que garantiza su funcionamiento. Ello contribuye a la formación integral de un profesional competente. A bibliographic revision is presented in order to assess the implementation of curricular strategies in Nursing 2nd year subjects. The importance of teaching aids in students' training, their development and contribution to solve issues related to care and quality of the health system, the lowering of adverse events and the patient´s safety are pointed out. Curricular strategies related to Nursing represent a particular way to develop the teaching process, characterized by a coordinated direction which responds to the graduate's experience, in which theoretical and practical methods and contents of the curricular units that belong to the syllabus are interwoven, starting from a methodological structure that ensures these strategy functions. It contributes to the comprehensive formation of a competent professional. (shrink)

The aim of this paper is discussion of a new middle‐range theory of patient safety goal priming via safety culture communication. Bedside nurses are key to safe care, but there is little theory about how organizations can influence nursing behavior through safety culture to improve patient safety outcomes. We theorize patient safety goal priming via safety culture communication may support organizations in this endeavor. According to this theory, hospital safety culture communication activates (...) a previously held patient safety goal and increases the perceived value of actions nurses can take to achieve that goal. Nurses subsequently prioritize and are motivated to perform tasks and risk assessment related to achieving patient safety. These efforts continue until nurses mitigate or ameliorate identified risks and hazards during the patient care encounter. Critically, this process requires nurses to have a previously held safety goal associated with a repertoire of appropriate actions. This theory suggests undergraduate educators should foster an outcomes focus emphasizing the connections between nursing interventions and safety outcomes, hospitals should strategically structure patient safety primes into communicative activities, and organizations should support professional development including new skills and the latest evidence supporting nursing practice for patient safety. (shrink)

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate (...) purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

Background:Prisons are contexts where nurses are required to have specific skills to ensure that, in a setting designed for the expiation of crime, prisoners receive the same type of care as anyone else. But this is not always the case, giving rise to ethical issues.Research questions:‘How do correctional nurses describe their working experience in prisons? What issues emerged?’Methodology:This is a qualitative descriptive study. Following purposive sampling, we conducted five focus groups. Thematic analysis was used to analyse the data.Participants (...) and research context:Our sample included 31 correctional nurses in seven prisons in Northern Italy.Ethical considerations:The scientific merit of this study was recognized by the Academic Board of the University of Genoa. Approval to conduct the study was obtained from the Liguria Regional Government that funded this study and from the Local Health Authority that was the prison nurses’ employer. Formal consent was obtained from all the nurses who volunteered to participate in this study.Findings:Five themes emerged from the focus groups: prisoners’ healthcare needs, negotiation between custody and care, satisfaction of working in prisons, obstacles to quality care and safety. ‘Manipulation’ was a transversal theme that emerged from all the focus groups.Discussion:The problems generated by the clash between prison security and nursing care priorities did not enable nurses to practice autonomously and provide the best possible to care prisoners, giving rise to ethical issues and moral distress. This in turn causes high nursing turnover rates that negatively impact continuum of care.Conclusion:In Italy, correctional nurses urgently require specific education interventions with the participation of all those who work in prisons. Interventions based on the post-modern concept of restorative nursing could offer prison nurses the opportunity to both resolve ethical issues and reduce moral distress. (shrink)

Nursing migration: global treasure hunt or disaster‐in‐the‐making?International nurse migration — moving from one country to another in the search of employment — is the focus of this article. The majority of member states of the World Health Organization report a shortage, maldistribution and misutilisation of nurses. International recruitment has been seen as a solution. The negative effects of international migration on the ‘supplier’ countries may be recognised today but are not effectively addressed.Nurse migration is motivated by the search for (...) professional development, better quality of life and personal safety. Pay and learning opportunities continue to be the most frequently reported incentives for nurse migration, especially by nurses from less‐developed countries. Career opportunities were considered key incentives for nurses emigrating from high‐income countries. Language was reported to be a significant barrier. The positive global economic/social/professional development resulting from international migration needs to be weighed against a substantial ‘brain and skills drain’ experienced by supplier countries. The vulnerable status of migrant nurses is also of concern in certain cases. The focus on short‐term solutions as opposed to resolving the problem of a worldwide shortage of nurses causes great concern. Recent initiatives attempt to curb or channel international recruitment. The delicate balance between recognising the right of individual nurses to migrate and a collective concern for the health of a nation’s population must be achieved. (shrink)

Nursing Law and Ethics explores a variety of key legal and ethical issues in nursing practice using a thought-provoking and holistic approach. It addresses both what the law requires and what is right, and explores whether these two are always the same. The book provides an overview of the legal, ethical and professional dimensions of nursing, followed by exploration of key issues in greater depth. This edition features updated legislation and new material on patient safety. Key topics are accompanied (...) by both a legal and an ethical perspective, covering both law and ethics Case examples throughout place concepts in a real-life context Written by experts in the field and includes contributions from leading nurses, lawyers and ethicists Accessible, relevant, and comprehensive, this title is ideal for pre- and post-registration nurses. (shrink)