A Conflict of Values: Nurses' Willingness to Work Under Threatening Conditions.

PURPOSE: The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work. DESIGN: This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units. METHODS: A questionnaire designed by the investigators was administered to registered nurses while on duty. The questionnaire consisted of three sections: personal characteristics, perceived level of personal threat from five situations (caring for a patient with a dangerous infection, terror attack, war, radiation or chemical disaster, or natural disaster), and perceived personal and peer willingness to work under these threats. FINDINGS: A convenience sample of 249 registered nurses from four hospitals responded. The highest level of perceived threat was a natural disaster (earthquake; M = 2.15, SD = 0.9). Terror (M = 0.83, SD = 0.6) and war (M = 1.01, SD = 0.6) received the lowest mean perceived threat scores. Most respondents were not willing to work during a natural disaster but were willing to care for patients with dangerous infections and during times of war. Weak positive statistically significant correlations were found between the level of perceived threat and willingness to work for all of the threats, except for terror (Spearman rank correlation = .16-.35). CONCLUSIONS: Local culture, perceptions of the level of threat, and perceived peer responsiveness are associated with registered nurses' willingness to work under threat. CLINICAL RELEVANCE: When faced with a threat to personal safety or security, many registered nurses might not be willing to work as usual. What is perceived as threatening is influenced by the local culture and environment. Therefore, managers should be aware of potential cultural and peer influences on this possible conflict of values.

Student nurses' care of terrorists and their victims.

Nurses are increasingly having to face the dilemma of nursing not only the victims of terrorist attacks but also the terrorist attackers. This study investigated the declared practical intentions of Israeli nursing students regarding their care of both victims and attackers and tried to identify which variables predicted the different intentions.A total of 306 students on a BA nursing program responded to the Priorities in Care Questionnaire, which asked for their responses to five vignettes in which the patient featuring in each vignette was either the victim of a terrorist attack, a terrorist, a criminal or a regular patient. With regard to patients in life-threatening situations, the students displayed no disparity of attitude. By contrast, when the patient was a terrorist and the condition was not life threatening, the students were likely to transfer care to a colleague or postpone their care. The variables found to predict intentions were sex,stage of training, work experience, religion, religiosity and political tendency.

Urinary incontinence in women under 65: quality of life, stress related to incontinence and patterns of seeking health care.

OBJECTIVE: We sought to describe quality of life, psychological stress and patterns of seeking health care (PSHC) among young and middle-aged women experiencing urinary stress incontinence (USI). Reasons and variables associated with delay in seeking care were also investigated. METHODS: A sample of 131 patients, aged 22-65, filled out a questionnaire consisted of: SF-36, stress related to incontinence, patterns of seeking health care questionnaires and a 10 cm visual analogue scale (VAS) measuring perceived suffering from USI (0 indicating absence of suffering while 10 indicating most severe suffering). RESULTS: Scores on eight domains of SF-36 were lower, compared to 405 Israeli healthy women (p < 0.001). Forty-one percent reported impairment in performing work and other activities. Mean scores on the VAS was 5.04 (SD: 2.59), 30% marked 7 cm and higher and 12.6% reported most severe suffering due to USI (scored 10 cm). Psychological stress related to incontinence was higher among the younger women and those with severe impairment to sexual activity. The majority of the sample (74%) delayed seeking help for at least a year, 46% delayed it for 3 years. Common reasons for delay were lack of time (36.3%), shame (15.7%) and fear of surgery (14.7%). Age, psychological stress, perceived suffering and social functioning (SF) were associated with patterns of seeking care. CONCLUSIONS: USI causes suffering and impaired quality of life among young women. Reluctance to seek help highlights the need to promote women's knowledge of treatment options and cure prospects.

Patients voice issues of dress and address.

Establishing a positive patient care environment is one of the most basic concepts of health care professional practice. Dress and personal address are aspects of this environment that are influenced by culture and express mutual respect within the patient-provider relationship. The Patient Sensitivity Questionnaire was administered to determine how 76 Israeli inpatients perceived forms of address and dress in their health care environment. Patients preferred that their health care providers wear formal dress and be addressed by their formal titles. Respondents did not object to being addressed by their first names. Based on these results, it would seem that this Israeli sample preferred to retain the traditional provider-patient environment.