Telling their story: A qualitative descriptive study of the lived experience of expatriate palliative care nurses in the United Arab Emirates.

PURPOSE: To explore the experiences of expatriate nurses caring for Muslim patients near end-of-life in a palliative care unit in the United Arab Emirates. METHODS: A qualitative descriptive study, with data collected through semi structured individual interviews with nine expatriate nurses working in a palliative care unit in one hospital in the United Arab Emirates. Thematic analysis of the data transcripts used a structured inductive approach. RESULTS: Analysis of the interview transcripts yielded three themes. First, language was a significant barrier in end-of-life care but was transcended when nurses practiced authentically, using presence, empathetic touch and spiritual care. Secondly, relationships between nurses, patients and families were strengthened over time, which was not always possible due to late presentation in the palliative care unit. Finally, nurses were continually in discussions with physicians, families and other nurses, co-creating the meaning of new information and experiences within the hospital policy context. CONCLUSION: For expatriate nurses, palliative nursing in a Muslim middle eastern country is complex, requiring nurses to be creative in their communication to co-create meaning in an emotionally intensive environment. Like other palliative care settings, time can strengthen relationships with patients and their families, but local cultural norms often meant that patients came to palliative care late in their disease trajectory. Preparing expatriate nurses for work in specialist palliative care settings requires skill development in advanced communication and spiritual practices, as well as principles of palliative care and tenets of Muslim culture.

Brazilian and North-American nursing in the HOPE Project (1972): approximations and gaps / La enfermería brasileña y norteamericana del Proyecto HOPE (1972): aproximaciones y distanciamientos / Enfermagem brasileira e norte-americana do Projeto HOPE (1972): aproximações e distanciamentos

ABSTRACT Objective: Understand the structuring and operation of the Nursing Service on the hospital ship HOPE and the relations between Nursing from North America and from Rio Grande do Norte. Method: Qualitative, sociohistorical research, developed by consulting documentary and oral sources. Results: The analysis revealed the categories: The HOPE Project: impressions of its nurses and Nursing on the hospital ship SS HOPE: Brazilian impressions. These categories revealed a Nursing Service similar to that of a general hospital, ordered by scales and which functioned uninterruptedly in the three shifts. Final considerations: The Nursing Service consisted exclusively of nurses; followed a hierarchical system; with accumulation of administrative and care functions; strict, precise and technical execution of the work. The language and cultural barriers do not seem to have compromised the Exchange and the work system in counterparts.

RESUMEN Objetivo: Comprender la estructuración, el funcionamiento del Servicio de Enfermería del buque hospital SS HOPE y las relaciones entre la Enfermería norteamericana y la norte-rio-grandense. Método: Investigación cualitativa, socio-histórica, realizada a partir de consultas a fuentes documentales y orales. Resultados: El análisis llegó a las categorías: El Proyecto HOPE - impresiones de sus enfermeras y La Enfermería del buque hospital SS HOPE - impresiones brasileñas. Estas categorías revelaron un Servicio de Enfermería similar al de un hospital general, ordenado por escalas y que funcionaba ininterrumpidamente en los tres turnos. Consideraciones finales: El Servicio de Enfermería estaba compuesto exclusivamente de enfermeras, obedecía a un sistema de jerarquía con acumulación de funciones administrativas y asistenciales, la ejecución del trabajo se realizaba de manera rígida, precisa y técnica, y las barreras idiomáticas y culturales parecen no haber comprometido el intercambio y el sistema de trabajo en contrapartes.

RESUMO Objetivo: Compreender a estruturação, o funcionamento do Serviço de Enfermagem do navio-hospital SS HOPE e as relações entre a Enfermagem norte-americana e a norte-rio-grandense. Método: Pesquisa qualitativa, sócio-histórica, realizada a partir de consultas a fontes documentais e orais. Resultados: A análise chegou às categorias: O Projeto HOPE: impressões de suas enfermeiras e A Enfermagem do navio-hospital SS HOPE: impressões brasileiras. Essas categorias revelaram um Serviço de Enfermagem similar ao de um hospital geral, ordenado por escalas e que funcionava, ininterruptamente, nos três turnos. Considerações finais: O Serviço de Enfermagem era composto, exclusivamente, de enfermeiras, obedecia a um sistema de hierarquia com acúmulo de funções administrativas e assistenciais, a execução do trabalho era realizada de maneira rígida, precisa e técnica, e as barreiras idiomáticas e culturais parecem não ter comprometido o intercâmbio e o sistema de trabalho em contrapartes.

Project HOPE: American nurses in Brazil (1973) / Proyecto HOPE: actuación de enfermeras norteamericanas en Brasil (1973) / Projeto HOPE: atuação de enfermeiras norte-americanas no Brasil (1973)

ABSTRACT Objective: to describe the reality of nurses of Project HOPE and discuss the repercussion of their performance in relation to the reconfiguration of nursing in Alagoas State. Method: social-historical study, whose primary sources were documents filed in the Laboratory of Documentation and Research in History of Nursing, granted by this project; oral testimonies resulting from the transcription of interviews of US nurses and the VeNeta Masson's'logbook, coordinator nurse of the ship. The discussion of the data was based on Pierre Bourdieu's theory. The project was submitted to the Ethics Committee and approved by it. Results: The actions of the American nurses exposed the shortage of this type of professional in the area, as well as the precarious health conditions in the region. Conclusion: the symbolic capital of these nurses has contributed to the reconfiguration of the nursing field in Alagoas State.

RESUMEN Objetivo: describir las circunstancias de actuación de las enfermeras del proyecto HOPE y discutir las repercusiones de la actuación de esas enfermeras en relación a la reconfiguración de la enfermería del estado de Alagoas, Brasil. Método: el estudio histórico-social, cuyas fuentes primarias fueron documentos archivados en el Laboratorio de Documentación e Investigación en Historia de la Enfermería, documentos cedidos por el proyecto HOPE, testimonios orales resultantes de la transcripción de entrevistas de enfermeras norteamericanas y el diario de a bordo de la enfermera VeNeta Masson, coordinadora de enfermería del buque. La discusión de los datos tuvo como referencia la teoría de Pierre Bourdieu. El proyecto fue sometido al Comité de Ética y fue aprobado. Resultados: las acciones de las enfermeras norteamericanas expusieron la escasez de ese tipo de profesional en el área, así como las precarias condiciones de salud en la región. Conclusión: el capital simbólico de esas enfermeras contribuyó a la reconfiguración del campo de la enfermería en Alagoas.

RESUMO Objetivo: descrever as circusntâncias de atuação das enfermeiras do projeto HOPE e discutir as repercussões da atuação dessas enfermeiras em relação à reconfiguração da enfermagem alagoana. Método: estudo histórico-social, cujas fontes primárias foram documentos arquivados no Laboratório de Documentação e Pesquisa em História da Enfermagem, documentos cedidos pelo projeto HOPE, depoimentos orais resultantes da transcrição de entrevistas de enfermeiras norte-americanas e o diário de bordo da enfermeira VeNeta Masson, coordenadora de enfermagem do navio. A discussão dos dados teve como referencial a teoria de Pierre Bourdieu. O projeto foi submetido ao Comitê de Ética e foi aprovado. Resultados: as ações das enfermeiras norte-americanas expuseram a escassez desse tipo de profissional na área, bem como as precárias condições de saúde na região. Conclusão: o capital simbólico dessas enfermeiras contribuiu para a reconfiguração do campo da enfermagem em Alagoas.

Nursing international student mobility in the University of São Paulo / Movilidad internacional estudiantil de Enfermería de la Universidad de São Paulo / Mobilidade internacional estudantil de Enfermagem da Universidade de São Paulo

ABSTRACT Objective: To characterize the experiences of undergraduate students of the School of Nursing of the University of São Paulo (EEUSP) who participated in international mobility programs between January 2011 and July 2017. Method: Exploratory, descriptive study with quantitative approach. Of 68 reports, only 38 (56%) were considered valid and were submitted to descriptive statistical analysis. Data were categorized in general, institutional, academic and cultural aspects and cost of living. Results: The main destination was Portugal and the years with most participation were 2012 and 2013. The mean stay was six months and the students took a mean of three to four courses. The main funder was the university of origin. Conclusion: Academic activities were limited to theoretical and practical courses, with little insertion in research. There is a need to increase investment in learning other languages and to expand partnerships with larger centers of foreign education and research.

RESUMEN Objetivo: Caracterizar las experiencias de los estudiantes de graduación de la Escuela de Enfermería de la Universidad de São Paulo (EEUSP), participantes de los programas de movilidad internacional, entre enero de 2011 y julio de 2017. Método: Se trata de un estudio exploratorio, descriptivo de abordaje cuantitativo, de 68 reportes. De estos, solamente 38 (56%) se consideraron válidos y se sometieron al análisis estadístico descriptivo. Los datos se recogieron según los aspectos generales de la experiencia: institucionales, académicos, culturales y costo de vida. Resultados: El destino principal fue Portugal, entre los años 2012 y 2013, con permanencia media de seis meses y cursando, promedio, de tres a cuatro disciplinas. La principal financiadora fue la universidad de origen. Conclusión: Las actividades académicas se limitaron a disciplinas teórico-prácticas, sin involucrarse mucho en la investigación. Existe la necesidad de aumentar las inversiones para el aprendizaje de otros idiomas y aumentar los convenios con los grandes centros de enseñanza e investigación extranjeros.

RESUMO Objetivo: Caracterizar as experiências dos estudantes de graduação da Escola de Enfermagem da Universidade de São Paulo (EEUSP), participantes dos programas de mobilidade internacional, entre janeiro de 2011 e julho de 2017. Método: Estudo exploratório, descritivo de abordagem quantitativa, de 68 relatórios. Desses, apenas 38 (56%) foram considerados válidos e submetidos à análise estatística descritiva. Os dados foram apreendidos em aspectos gerais da experiência, institucionais, acadêmicos, culturais e custo de vida. Resultados: O principal destino foi Portugal, entre os anos de 2012 e 2013, com permanência média de seis meses, cursando em média três a quatro disciplinas. O principal financiador foi a universidade de origem. Conclusão: As atividades acadêmicas limitaram-se a disciplinas teórico-práticas, com pouca inserção na pesquisa. Há necessidade de aumentar o investimento na aprendizagem de outros idiomas e ampliar parcerias com grandes centros de ensino e de pesquisa estrangeiros.

Experiencias de la "Misión Niño Jesús" durante el cumplimiento de misión Internacionalista en Venezuela / Experience of the "Mission Niño Jesus" during the fulfillment of the internationalist mission in Venezuela

Introducción: la colaboración internacional en el área de la salud ha constituido para Cuba un principio. La enfermera tiene la misión de brindar servicios con respeto a la dignidad humana, amor, dedicación, sacrificio y entrega, con ética, respeto y equidad al tratar a pacientes, familiares y comunidad. Objetivo: exponer experiencias de la "Misión Niño Jesús" en Venezuela. Métodos: estudio descriptivo de corte transversal en el Centro Diagnóstico Integral "San José de la Sierrita", Municipio Mara, Región Guajira del Estado Zulia, desde junio de 2011 hasta agosto de 2013. El universo de estudio quedó constituido por 269 embarazadas atendidas en el centro. Se utilizó el método observacional documental de carnets obstétricos, las variables estudiadas fueron año de ocurrencia, asistencia y tipo de Parto. Se analizó la información con distribuciones de frecuencias absolutas y porcentajes, se calculó el coeficiente de correlación de Pearson para demostrar incremento o no de los partos, se prefijó un intervalo de confianza del 95 por ciento. Resultados: el 34,57 por ciento las mujeres atendidas en el Centro Diagnóstico Integral parieron en el mismo y tuvieron resultados satisfactorios durante el parto, alumbramiento y puerperio al igual que sus bebés. Se comprobó que de manera creciente las embarazadas se realizaron el control prenatal en los módulos de misión médica cubana. Conclusiones: la experiencia de la "Misión Niño Jesús" durante el cumplimiento de la misión Internacionalista en la República Bolivariana de Venezuela logró resultados positivos en el cumplimiento de los indicadores materno-infantiles de la comunidad atendida(AU)

Introduction: International health collaboration has constituted a principle for Cuba. The nurse has the mission of providing services with respect to human dignity, love, dedication, sacrifice and self-giving, with ethics, respect and equity in dealing with patients, families and the community. Objective: To present experiences of the "Mission Niño Jesús" in Venezuela. Methods: A cross-sectional descriptive study at San José de la Sierrita Comprehensive Diagnostic Center, Mara Municipality, Guajira Region of Zulia State, from June 2011 to August 2013. The study universe consisted of 269 pregnant women treated in the Center. The observational documentary method of obstetrical cards was used, the variables studied were year of occurrence, attendance and delivery type. Data were analyzed with absolute frequency distributions and percentages, the Pearson correlation coefficient was calculated to show whether or not births were increased, a 95 percent confidence interval was set. Results: 34.57 percent of the women attended at the Comprehensive Diagnostic Center gave birth and had satisfactory results during labor, delivery and puerperium, as did their babies. It was verified that the pregnant women increasingly received prenatal control in the modules of Cuban medical mission. Conclusions: The experience of the "Mission Niño Jesús" during the fulfillment of the Internationalist mission in the Bolivarian Republic of Venezuela attained positive results in the fulfillment of maternal and child indicators of the served community(AU)

Recognition of foreign nurses degree in Germany ­ procedure, quantity, distribution and decision of applications / Anerkennung ausländischer Pflegeabschlüsse in Deutschland - Verfahren, Anzahl, Verteilung und Entscheidung der Anträge

Background: Qualified foreign nurses are entering the German nursing-care system. Aim: How has the migration of nurses been developing in recent years? Method: Evaluation of official statistics on recognition of qualifications. Results: There is a growing demand for recognition of nursing qualifications acquired abroad; this demand is concentrated on densely populated regions. Conclusions: Migration of care workers is increasing and needs to be analysed by nursing sciences.

Nursing the critically ill surgical patient in Zambia.

Critical illness in the developing world is a substantial burden for individuals, families, communities and healthcare services. The management of these patients will depend on the resources available. Simple conditions such as a fractured leg or a strangulated hernia can have devastating effects on individuals, families and communities. The recent Lancet Commission on Global Surgery and the World Health Organization promise to strengthen emergency and essential care will increase the focus on surgical services within the developing world. This article provides an overview of nursing the critically ill surgical patient in Zambia, a lower middle income country (LMIC) in sub-Saharan Africa.

Acculturation and health behaviors among international students: A qualitative approach.

The process of acculturation often results in changes in the health behavior of international students. This study employed an open-ended, qualitative approach in an attempt to gain an in-depth understanding of the acculturation process for physical activity, diet, and drinking behavior among international students. Eighteen undergraduate international students (average age 19.20, standard deviation 1.21) were interviewed for 45-60 min. Most of the international students became more physically active after they arrived in the United States. Facilitators included accessibility, weight management, free time, and role modeling. Most international students were unsatisfied with the food on campus. Their strategies for adjusting to this included ordering food from restaurants, visiting supermarkets, and moving off campus. Most international students felt uncomfortable with the drinking culture in the United States, although some of them felt drinking was a good way to socialize with Americans and explore American culture. Colleges and universities should adopt strategies to better help their international students build lifelong healthy behaviors.

Migrant nurses in Brazil: demographic characteristics, migration flow and relationship with the training process / Enfermeiros migrantes no Brasil: características demográficas, fluxos migratórios e relação com o processo de formação / Enfermeros migrantes en Brasil: características demográficas, flujos migratorios y relación con el proceso de formación

Objective to analyze the migration of nurses in Brazil, describe the demographic characteristics of migrant nurses, the main migration flows, and establish relationships with the training process. Method a descriptive, exploratory study, based on 2010 Census data. The data were analyzed using descriptive statistics. Result there were 355,383 nurses in Brazil in 2010. Of these, 36,479 (10.3%) reported having moved compared to the year 2005: 18,073 (5.1%) for intrastate migration, 17,525 (4.8%) interstate migration, and 871 (0.2%) international migration. Females (86.3%), Caucasians (65.2%), and unmarried (48.3%) nurses prevailed in the population, without considerable variation between groups according to migration situation. The findings indicate that the migration flows are driven by the training process for states that concentrate a greater number of courses and positions in undergraduate and graduate studies, and the motivation of employment opportunity in regions of economic expansion in the country. Conclusion it is necessary to deepen the discussion on the movement of nurses in Brazil, their motivations, and international migration.

Objetivo analisar a migração de enfermeiros no Brasil, descrevendo as características demográficas dos enfermeiros migrantes, os principais fluxos migratórios, estabelecendo relações com o processo formativo. Método estudo descritivo exploratório, a partir dos dados do Censo Demográfico do ano 2010. Os dados foram tratados pela estatística descritiva. Resultado havia 355.383 enfermeiros residentes no Brasil no ano 2010. Desses, 36.479 (10,3%) relataram movimentação na comparação com o ano 2005, sendo 18.073 (5,1%) por migração intraestadual, 17.525 (4,8%) por migração interestadual e 871 (0,2%) por migração internacional. Predominou, na população de enfermeiros, o sexo feminino (86,3%), a raça/cor da pele branca (65,2%) e o estado civil solteiro (48,3%), sem variações consideráveis entre os grupos, segundo a situação de migração. Os achados indicam fluxos de migração orientados pelo processo de formação para Estados que concentram número de cursos e vagas na graduação e pós-graduação stricto sensu e a motivação por oportunidade de empregos em regiões de expansão econômica do país. Conclusão é necessário aprofundar a discussão sobre a movimentação de enfermeiros no Brasil, suas motivações e fluxos migratórios internacionais.

Objetivo analizar la migración de enfermeros en Brasil, describiendo las características demográficas de los enfermeros migrantes, los principales flujos migratorios, estableciendo relaciones con el proceso de formación. Método estudio descriptivo exploratorio, a partir de los datos del Censo Demográfico del año 2010. Los datos se analizaron utilizando la estadística descriptiva. Resultado había 355,383 enfermeros residentes en Brasil en el año 2010. De esos, 36,479 (10.3%) reportaron movimiento en comparación con el año 2005, de los cuales 18,073 (5.1%) fue por migración dentro del estado, 17,525 (4.8%) por migración entre los estado y 871 (0.2%) por migración internacional. Ha predominado, en la población de enfermeros, el sexo femenino (86.3%), la raza/color de la piel blanca (65.2%) y el estado civil soltero (48.3%), sin variaciones considerables entre los grupos, según la situación de migración. Los hallazgos indican flujos de migración motivados por el proceso de formación para Estados que concentra un número de cursos y lugares en a nivel licenciatura y postgrado stricto sensu y la motivación por oportunidad de empleos en regiones de expansión económica del país. Conclusión es necesario profundizar la discusión sobre el movimiento de enfermeros en Brasil, sus motivaciones y flujos migratorios internacionales.

Strangers in a strange land: work experiences of foreign nurses in Parma's territory.

PURPOSE: The purpose of this research is to explore, investigate and describe experiences and points of view of foreign nurses working in the area of Parma. We focalize particularly on two areas of interest: negativities and positivities in experiences related to the process of integration into the new working environment. BACKGROUND: The literature search has revealed that the phenomenon of "nursing immigration" is numerically significant in Italy and more particularly in Emilia Romagna. From studies conducted in other countries (UK, USA, Canada, Australia and Iceland) there are two categories of factors which influence the process of integration of foreign nurses in the new working environment, facilitators and barriers. METHOD: For this study we followed the phenomenological method . A total of twelve foreign nurses were interviewed in the months of October and November 2013 in the territory of Parma working in various professional fields (medicine, critical care and surgery). We did not impose any structure to interviews so that respondents were free to express their lived experiences spontaneously. All interviews were recorded, transcribed verbatim and analyzed by the method of Giorgi (1970). RESULTS: Results obtained from the analysis of interviews revealed seven themes, divided in positivities and negativities. Positivities are psycho-social support (Italian colleagues, fellow countrymen, patients), opportunities of cultural enrichment, positive work ethic. negativities are difficulty of language and communication, and inequalities racial prejudice, differences in care practices and inadequate opportunities for professional growth related to the Italian working environment. CONCLUSIONS: The study concludes by pointing out the importance of the role that foreign nurses can play in our health care system and how the results of this search can help all professionals in the health sector to have a greater understanding of their experiences. This knowledge can make a contribution to the development of new quantitative research in the same area and then to the formation of new strategies for hospitality and support.

[Clinical nursing practice, some elements of clarification in the French context]. / La filière clinique en soins infirmiers, éléments de clarification dans le contexte français.

In France, certified nurse clinicians have been working in various fields of activity for a number of years. Recent political decisions aim to create the role of nurse clinician specialised in oncology as well as advanced nursing practice. In this context, an explanation of the terminology and the history of this domain is necessary in order to shed light on the ongoing discussion process.

Comunicación acerca de la Red Internacional de Enfermería en Salud Infantil (RED ENSI) / Communication about the International Child Health Nursing (RED ENSI)

La Red de enfermeras de salud infantil en las Américas fue lanzada en 2006 sobre la base de anteriores colaboraciones de un grupo de enfermeras en Latinoamérica para estudiar las necesidades de fortalecimiento de los programas de enfermería de pediatría en la región. Esta red proporciona un modelo para promover la colaboración y comunicación entre las enfermeras de los diferentes países para mejorar la práctica de la enfermería pediátrica. Los objetivos iniciales de la Red fueron elaborados para compartir conocimientos y experiencias relacionadas con la enfermería de salud infantil en las Américas y promover la incorporación de las directrices relacionadas con la Estrategia de la Atención Integrada de las Enfermedades Prevalentes de la infancia (AIEPI) en los programas de enfermería en toda la región. Esta red de colaboración demuestra el poder de la enfermería que trabaja en forma concertada para aprovechar sus puntos fuertes y aumentar la capacidad de las enfermeras y los trabajadores de la salud para abordar las prioridades sanitarias mundiales relacionadas con la salud de los niños(AU)

The Network of Child Health Nurses in the Americas was launched in 2006 building on earlier collaboration of a group of nurses in Latin America to study the needs for strengthening pediatric nursing curricula in the region. This Network provides a model for promoting collaboration and communication between nurses of different countries to improve pediatric nursing practice. The initial goals of the Network are to share knowledge and experience related to child health nursing in the Americas and to promote incorporation of guidelines related to the Integrated Management of Childhood Illnesses (IMCI) in nursing curricula throughout the region. This collaborative network demonstrates the power of nursing working in a concerted way to build on its strengths and increase the capacity of nurses and health care workers to address global health priorities related to children's health care(AU)