Repensar la formación y la práctica especializada de enfermería desde la óptica unitaria del ser humano / Rethinking specialized nursing training and practice from the unitary perspective of the human being

El propósito del presente texto es repensar la formación y la práctica especializada de enfermería desde la óptica de las ciencias humanas que estudian la subjetividad y que encuentran su sentido científico más allá del saber disciplinar. Se trata de distinguir con claridad entre las ciencias de la naturaleza y las ciencias del espíritu a partir de la óptica unitaria del ser humano. Esto debido a la creciente percepción de deshumanización y tecnificación de la práctica del cuidado de enfermería vinculada a la formación especializada para el manejo de determinados procedimientos y aparatos que parcelan el conocimiento y desvían la perspectiva y el enfoque disciplinar. Por lo tanto, pensar en cómo se puede comprender mejor el fenómeno de la salud y la enfermedad humanas desde la formación y la práctica de enfermería tiene la posibilidad de reconsiderar el perfil académico de formación básica y especializada de enfermería, congruentemente articulados los saberes de una enfermería contemporánea con los sentires y los saberes de las personas que cuidan con las otras personas a las que se cuida.

The purpose of this text is to rethink specialized nursing training and practice from the perspective of the human sciences that study subjectivity and find its scientific meaning beyond disciplinary knowledge. It is about clearly distinguishing between the sciences of nature and the sciences of the spirit from the unitary perspective of the human being. This is due to the growing perception of dehumanization and technification of nursing care practice linked to specialized training for the management of certain procedures and devices that fragment knowledge and divert the disciplinary perspective and approach. Thus, thinking about how the phenomenon of human health and disease can be better understood from nursing training and practice has the possibility of reconsidering the academic profile of basic and specialized nursing training, coherently articulated the knowledge of contemporary nursing with the feelings and knowledge of the people who care for with the other people who are cared for.

Patients' Rights.

Maeva, a student nurse on placement, and Sophie, her mentor, discuss various topics related to the nursing code of ethics and patients' rights.

Including personal development in palliative care education to address death anxiety.

BACKGROUND: Death anxiety may interfere with health care workers' (HCW) relationship with patients and their families. AIMS: Evaluate an intervention to address death anxiety and improve HCW skills dealing with patients/families in palliative and end-of-life care. DESIGN: Quasi-experimental mixed methods approach with a pre-test/post-test design. PARTICIPANTS: 208 HCWs receiving the intervention and working in end-of-life care, in and out of palliative care units, were invited to answer quantitative and qualitative questionnaires. In the end, 150 returned with quantitative answers and of these, 94 with qualitative answers as well. Additionally, out of the 150 participants, 26 were recruited for interview. RESULTS: Pre-and post-test results revealed a significant reduction in levels of death anxiety, an increase in existential wellbeing, and a significant improvement in HCWs' perception of the quality of their helping relationship skills with patients/families. Content analysis provided an understanding of the difficulties experienced by the HCWs and the positive impact of the intervention. CONCLUSION: An intervention to address death anxiety and help relationship skills can reduce the use of avoidance mechanisms and improve HCW self-perceived psycho-existential support to patients/families.

Pediatric heart surgery in Ghana: three ethical questions.

When a group of doctors and nurses from Boston, Massachusetts, provided evaluation and heart surgery to children in Ghana, they encountered three rationing dilemmas: (1) What portion of surgery slots should they reserve for the simplest, most cost-effective surgeries? (2) How much time should be reserved for especially simple, nonsurgical interventions? (3) How much time should be reserved to training local staff to perform such surgeries? This article investigates these three dilemmas.

Ethical issues in practice: a survey of public health nurses in Japan.

OBJECTIVES: The purposes of this study were to identify specific components and frequencies of ethical issues that public health nurses (PHNs) encountered in their practice, relationships between ethical issues and demographic data, and ethics education and workplace environment. DESIGN AND SAMPLE: Cross-sectional survey for PHNs at local governmental agencies in Japan. Usable data were 3,409. MEASURES: Public health nurses completed the frequency of ethical issues, experience of ethics education, workplace environment, and demographics. RESULTS: Item and exploratory factor analysis for the frequency of encountering ethical issues revealed: (1) discrepancy of intention between client and his/her family on treatment or care; (2) differences in views between PHNs and their organization's administrators regarding providing services; and (3) discrepancy of caretaking views between PHNs and various professionals. All factors were related to work experience and one factor was specifically related to the type of local government employing PHNs. Only 11.1% of PHNs received ethics education via continuing education programs. PHNs reported that programmed continuing education systems were not sufficiently available. CONCLUSIONS: Systematic continuing ethics education programs for PHNs need developing, tailored to the specific characteristics associated with PHNs' ethical concerns, such as nurses' working experience and the type of employing local government.

Empowering nurses to participate in ethical decision-making at the bedside.

Nurses at the bedside have widely varied educational backgrounds. Most bedside nurses have insufficient knowledge in the area of ethical decision-making to feel confident in their ability to participate in ethical decision-making along with the health care team. Continuing education programs for staff nurses should focus on ethical decision-making to empower bedside nurses to participate. The effect of a successful continuing education program in ethics could lead to improved relationships among health care professionals, improved communication with patients and families, and reduced stress-related burnout caused by ethical dilemmas. This article describes a successful continuing education program designed to improve knowledge of ethics and confidence in ethical decision-making that can be adapted for any nursing specialty.

Mentoring overseas nurses: barriers to effective and non-discriminatory mentoring practices.

In this article it is argued that there are barriers to effective and non-discriminatory practice when mentoring overseas nurses within the National Health Service (NHS) and the care home sector. These include a lack of awareness about how cultural differences affect mentoring and learning for overseas nurses during their period of supervised practice prior to registration with the UK Nursing and Midwifery Council. These barriers may demonstrate a lack of effective teaching of ethical practice in the context of cultural diversity in health care. This argument is supported by empirical data from a national study. Interviews were undertaken with 93 overseas nurses and 24 national and 13 local managers and mentors from six research sites involving UK health care employers in the NHS and independent sectors in different regions of the UK. The data collected showed that overseas nurses are discriminated against in their learning by poor mentoring practices; equally, from these data, it appears that mentors are ill-equipped by existing mentor preparation programmes to mentor overseas-trained nurses from culturally diverse backgrounds. Recommendations are made for improving mentoring programmes to address mentors' ability to facilitate learning in a culturally diverse workplace and thereby improve overseas nurses' experiences of their supervised practice.

Keeping the center of nursing alive: a framework for preceptor discernment and accountability.

This research served to explicate the profile of the nurse preceptor and illuminate the knowledge that nurse preceptors accrue while teaching students in the final clinical practicum. The analysis of the descriptive survey, sent to approximately 770 preceptors, along with the interpretive analysis of 16 focus groups and 5 interviews, revealed understandings of discovering, learning, and engaging as central to the relational elements of professional discernment and accountability. Preceptor discernment is essential to ensuring competent nursing practice for student nurses preparing for entry-level practice. Dissemination of the findings is suggested through the creation of an educational framework reflective of, relevant to, and used by nurse preceptors that may be used in both practice and academic settings.

Code of ethics and conduct for European nursing.

A main identifying factor of professions is professionals' willingness to comply with ethical and professional standards, often defined in a code of ethics and conduct. In a period of intense nursing mobility, if the public are aware that health professionals have committed themselves to the drawing up of a code of ethics and conduct, they will have more trust in the health professional they choose, especially if this person comes from another European Member State. The Code of Ethics and Conduct for European Nursing is a programmatic document for the nursing profession constructed by the FEPI (European Federation of Nursing Regulators) according to Directive 2005/36/EC On recognition of professional qualifications , and Directive 2006/123/EC On services in the internal market, set out by the European Commission. This article describes the construction of the Code and gives an overview of some specific areas of importance. The main text of the Code is reproduced in Appendix 1.

Lets Do Lunch? The ethics of accepting gifts from the pharmaceutical industry.

When nurses think of ethical issues, debates on assisted suicide or maternal versus fetal rights often come to mind. A less obvious but undoubtedly more common ethical issue is whether or not sponsored lunches, educational events and other forms of gift giving should be accepted from pharmaceutical companies. The authors review the nature of pharmaceutical marketing and gift giving and examine some of the potential ethical issues that arise when nurses accept these gifts.

High tech cheating.

The use of technology has enhanced the convenience, flexibility, and efficiency of both preparatory and continuing education. Unfortunately, academic dishonesty, including plagiarism, has shown a positive correlation with the increased use of technology in education. A review of the literature related to unintended outcomes of the use of technology in nursing education and continuing education was conducted to determine the ethical implications for the nursing profession. Although nursing research dealing with academic and professional misconduct is sparse, evidence suggests that academic dishonesty is a predictor of workplace dishonesty. Given this correlation between unethical classroom behavior and unethical clinical behavior, efforts to staunch academic dishonesty may help allay professional misconduct. A combination of high tech and low tech methods may be used to minimize unethical behaviors among students and practicing professional nurses in order to maintain the integrity of the profession.

[Encouragement and training of ethical competence in geriatric nursing. A pre-condition of high quality in professional caring process]. / Vermittlung und Förderung ethischer Kompetenz in der Altenpflege. Grundlage für qualitativ überzeugende professionelle Pflege.

The article makes a case for the necessity of more intensive training in the ethics of geriatric care. It confronts the bias against too much ethical behaviour in daily practice, while also arguing for the liberating and enriching aspects of giving ethical care to the aged. Based on a differentiation between morals and ethics, the essay recognizes the endeavors to achieve moral behaviour in geriatric care, but questions whether in every case the caregivers have sufficient ethical core competence to determine either the appropriateness or the righteousness of their moral actions. The essay discusses what should be understood under "ethical competence" and how ethical competence can be acquired and advanced by schooling.