Agency and addiction in a harm reduction paradigm: French nurses' perspectives.

French psychiatric nurses' perspectives on individuals addicted to drugs and their treatments are influenced by French socio-cultural norms. In this study, steps of the ethnographic method were used to elicit the intertwining of French professional and cultural perspectives on drug addiction. Emergent themes from nurses' interviews and cultural participant-observations suggest that drug addiction management in France's harm reduction paradigm challenges nurses' beliefs about addicted individuals' agency and conformity to treatment goals, and is influenced by European Union membership, changes in health care, drugs and demographics. Novel nursing strategies emergent from these themes might be applicable in other cultural contexts.

Habits, rituals, and addiction: an inquiry into substance abuse in older persons.

Older people enter the final phases of their lives with well-established habits and rituals, some of which might be or become substance abuse. This inquiry focused on the relationship between habits, rituals, and the compulsive addictive behaviours evident in older persons' substance abuse. Habits and rituals, examined as adaptive and limiting functions in older persons, revealed changes in autonomy, social inclusion, and emotional responses to such changes as older persons experience declining energy reserves and physical debilities. Older persons' ebbing sense of control and passionate responses to change illustrate the perennial struggle between the will and emotions when habits and rituals transform to compulsive addictive behaviours. Two concepts, germane to this struggle both in older persons' addictive behaviours and nurses' response, emerged from this inquiry: temperance, a balance between the will's freely chosen actions and passionate desire, and discipline, the means to achieve such balance. The focused attention demanded in discipline can be realized in spiritual exercises and daily care of the soul. Disciplined actions engage the older persons' imaginative capacities to manage and abandon the self in goals consistent with end-of-life issues: meaningful fulfillment of human potential and the need for daily joy and pleasure in living the final years.

What does an innovative teaching assignment strategy mean to nursing students?

The concept of innovation in nursing education has been addressed in published literature on faculty-defined and faculty-created teaching strategies and instructional methods. In this project, innovation is defined as "using knowledge to create ways and services that are new (or perceived as new) in order to transform systems" (Pardue, Tagliareni, Valiga, Davison-Price, & Orchowsky, 2005). Studies on nursing student perceptions of innovation are limited, and it is unclear how undergraduate and graduate students conceptualize innovative learning experiences. This project explored students' perceptions of their experiences with instructor-defined, innovative teaching/learning strategies in four types of nursing education programs. Issues nurse educators should consider as they apply new techniques to their teaching are discussed.

Philosophical inquiry in nursing: an argument for radical empiricism as a philosophical framework for the phenomenology of addiction.

Philosophical inquiry involves examination of the meaning of a phenomenon within the larger framework of the human condition and a particular view of reality. Argumentation is the method. In this study, the author argues that the metaphysics of radical empiricism enhances the understanding of the immediate subjective experience or phenomenology of addiction. When applied to subjective narratives of the addiction experience from literature, this metaphysics confers meaning to the changes in consciousness that occur in the immediate subjective experience of addiction. Conclusions revealed from the application of this perspective highlight novel feelings, the will and changing sense of self, and the human values of belonging and freedom. This study also revealed the value of the philosophical method of inquiry: to temporize our moral judgments and enrich our perspective of the human values within the addiction phenomenon. These values support and clarify the belief system of nursing.

Research odyssey: the evolution of a research partnership between baccalaureate nursing students and practicing nurses.

This longitudinal descriptive study evaluates the implementation of an innovative teaching strategy: a research partnership between baccalaureate nursing students and nurses in two acute care hospitals. The impetus for this partnership was to introduce a concrete, clinical dimension to a junior level introductory nursing research course. Formative analysis was used to evaluate the success and weaknesses of this innovative strategy over 3 years. Following each year, an evaluation by students and nursing unit managers led to refinement of the partnership goals and logistics for the following year. The third year culminates in a comparison between student responses to the partnership in the small community hospital and those assigned to a larger magnet status hospital. Conclusions, based on content and descriptive analysis indicate the partnership's educational benefits for students and a few logistical concerns. Future directions for this educational strategy are presented.

Nursing leaders' experiences with the ethical dimensions of nursing education.

This pilot study explores four nursing leaders' experiences with the ethical dimensions of leadership in education. Gathering and interpreting such data of experience fosters greater understanding of the nature of moral leadership as it is lived in nursing education. A phenomenological approach was used to collect and analyze the data. The results revealed four major themes: integrity, justice, wrestling with decisions in the light of consequences, and the power of information. These themes clarify the values that direct these leaders' actions as they mediate community needs common to educational and health care institutions.

The shifting sands of self: a framework for the experience of self in addiction.

The self is a common yet unclear theme in addiction studies. William James's model of self provides a framework to explore the experience of self. His model details the subjective and objective constituents, the sense of self-continuity through time, and the ephemeral and plural nature of the changing self. This exploration yields insights into the self that can be usefully applied to subjective experiences with psychoactive drugs of addiction. Results of this application add depth to the common understanding of self in addiction, acknowledge the importance of feelings and choice in the sense of self created in addiction experiences, and affirm the values salient to these interior experiences in addiction. These results suggest meaning derived from those values, and provide important background knowledge for the nurse interacting with these clients.

Feelings of relation in the fringe of consciousness: implications for the subjective experience of addiction and the nurse-client relationship.

Individuals who compulsively abuse psychoactive drugs experience alterations in consciousness. Little is known about the value of these alterations in the spectrum of human experience. William James's concept of the fringe of consciousness describes a function of knowing that emphasizes direct sensory experience. This experience encompasses feelings of relation between an individual's sense of self and idea of self, between self and world, and between self and sense of future possibilities. These feelings can be shown in written narratives of some individuals addicted to psychoactive drugs. Access to the feeling of relation in the fringe suggests meaning for the individual and implications for the nurse-client relationship.