Nursing the tropics: nurses as agents of imperial hygiene.

BACKGROUND: Mrs Francis Piggott proposed the Colonial Nursing Association in 1895 as a means of supplying Britain's colonies and dominions with trained professional nurses, who would support the health of white colonists abroad. Over 8400 nurses were placed between 1896 and the Association's end in 1966. Despite the burgeoning of scholarship on gender and empire over the last few decades, there is still more research to be done examining nurses as professional, working women, who present a fascinating variation on the figure of the woman traveler. METHODS: This essay focuses on 1896-1927, exploring how nurses were prepared for their labor abroad and how these skills were challenged and adapted within a foreign environment. We contextualize this discussion with examples from literary tales of exploration and adventure and discourses of empire. RESULTS/CONCLUSIONS: Though the sources of disease against which nurses fought changed during this period, we assert that the underlying role of the nurse continued the same: she was meant to use the tools of personal as well as public 'hygiene' to create both physical and cultural boundaries around her white patients and herself, setting colonists apart from their colonial setting.

Nurses' reports on hospital care in five countries.

The current nursing shortage, high hospital nurse job dissatisfaction, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physicians appear satisfactory, core problems in work design and workforce management threaten the provision of care. Resolving these issues, which are amenable to managerial intervention, is essential to preserving patient safety and care of consistently high quality.

Are teamwork and professional autonomy compatible, and do they result in improved hospital care?

A postal questionnaire survey of 10 022 staff nurses in 32 hospitals in England was undertaken to explore the relationship between interdisciplinary teamwork and nurse autonomy on patient and nurse outcomes and nurse assessed quality of care. The key variables of nursing autonomy, control over resources, relationship with doctors, emotional exhaustion, and decision making were found to correlate with one another as well as having a relationship with nurse assessed quality of care and nurse satisfaction. Nursing autonomy was positively correlated with better perceptions of the quality of care delivered and higher levels of job satisfaction. Analysis of team working by job characteristics showed a small but significant difference in the level of teamwork between full time and part time nurses. No significant differences were found by type of contract (permanent v short term), speciality of ward/unit, shift length, or job title. Nurses with higher teamwork scores were significantly more likely to be satisfied with their jobs, planned to stay in them, and had lower burnout scores. Higher teamwork scores were associated with higher levels of nurse assessed quality of care, perceived quality improvement over the last year, and confidence that patients could manage their care when discharged. Nurses with higher teamwork scores also exhibited higher levels of autonomy and were more involved in decision making. A strong association was found between teamwork and autonomy; this interaction suggests synergy rather than conflict. Organisations should therefore be encouraged to promote nurse autonomy without fearing that it might undermine teamwork.

Nurse education in an international context: the contribution of contingency.

Attempts to reform nurse education in the U.K. have met with limited success. A brief examination of similar moves in other countries reveals a similar situation. Placing experiences in this country in the context of global reform, it is possible to suggest that three sets of conditions need to be satisfied for change to follow: these relate to context, convergence and contingency. Context refers to the creation of a positive climate of opinion or a case and pressure for change. Convergence refers to the fortuitous fusion of professional and government agendas. Contingency provides the unforeseen consequence, the spark that ignites a policy change. The implications for further educational reform in this country are briefly discussed.

Research revealed.

AIM: The objective of this study was to investigate nursing research, including topics, funding and publication. METHOD: A database of published biomedical research set up by the Wellcome Trust was analysed for nursing research. RESULTS: Topics covered in nursing research were found to be diverse, with mental health nursing and nurse education the major areas. Multi-authorship is lower than in biomedical research generally. The most prolific areas of publication are London SE postcodes and Manchester. Only about a third of nursing research appears to be funded. CONCLUSION: Nursing research was found to be the fastest growing field of biomedical research during the period analysed (1988-1995).