Cultivating Praxis Through Chinn and Kramer's Emancipatory Knowing.

Nursing actions in support of equitable health and social relations have always been central to the work of our discipline. The mandate for social justice advocacy is identified in many of our professional and ethical frameworks, with systems-level advocacy situated as a core competency for advanced practice nurses. And yet, the sociopolitical processes that generate health inequities are not always readily understood by nurses. Emancipatory knowing provides an accessible lens to reveal how social injustice occurs while delineating a practical structure through which reflective action can be undertaken toward social change, otherwise known as nursing praxis.

Nursing research on religion and spirituality through a social justice lens.

Critical theories such as postcolonial feminism and intersectionality can provide new and vital perspectives on the interplay between social justice, religion, spirituality, health, and nursing. Criticality prompts us to examine taken-for-granted assumptions, such as the neutrality and universality of spirituality, while analyzing social relations of power, including the racialization of religion and religious patriarchy, that may result in oppressive conditions and social exclusion. The argument is made that when refracted through critical, intersectional lenses, religious and spiritual traditions can be rich sources of theoretical foundations and practical services that could inform nursing's recent re/turn toward social justice.

Apreciación de los pacientes y personal de salud respecto a la atención de enfermería brindada por el personal masculino en el Hospital Clínico Viedma, primer trimestre 2012 / Assessment of patients and health personnel regarding the nursing care provided by male staff at the Hospital Viedma, first quarter 2012

La enfermería ha sido fundamentalmente un trabajo de mujeres. El incremento en la incorporación de hombres a la enfermería hace reflexionar en torno a la cuestión de si existen diferentes formas de expresar y practicar una profesión en relación con el género. La investigación que se realizó con un enfoque cuantitativo de tipo descriptivo, explicativo, prospectivo y transversal. Con una muestra de 25 Licenciadas en Enfermería, 25 médicos, 4 Licenciados en Enfermería y 25 pacientes, utilizando como instrumentos una guía de entrevista estructurada que permitió profundizar el estudio de las variables. Los resultados demuestran que todavía existe poca incursión del género masculino en la profesión de enfermería; sin embargo, con el tiempo se ve el aumento gradual de varones a esta profesión, antes vista como una profesión sólo para mujeres. Según la apreciación de los profesionales en salud de la Institución, el desempeño es adecuado en una mayoría de los enfermeros, que tienen más ventajas que desventajas; según la apreciación de los pacientes se tiene que la incursión de los hombres a la profesión de enfermería es innovadora, pero todavía tiene mayor relevancia la enfermera, ya que son precursoras de esta profesión y los varones enfermeros tienen todavía ciertos limitantes y obstáculos en la atención

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.

A Chinese version of the revised Nurses Professional Values Scale: reliability and validity assessment.

UNLABELLED: The purpose of this study was to assess the reliability and validity of a Chinese version of the revised nurses professional values scale (NPVS-R). The convenient sampling method, including senior undergraduate nursing students (n=110) and clinical nurses (n=223), was applied to recruit appropriate samples from southern Taiwan. The revised nurses professional values scale (NPVS-R) was used in this study. Content validity, construct validity, internal consistency, and reliability were assessed. The final sample consisted of 286 subjects. FINDINGS: three factors were detected in the results, accounting for 60.12% of the explained variance. The first factor was titled professionalism, and included 13 items. The second factor was named caring, and consisted of seven items. Activism was the third factor, which included six items. Overall Cronbach's alpha coefficient was 0.90, taken from values for each of the three factors of 0.88, 0.90, and 0.81, respectively. The Chinese version of the NPVS-R can be considered a reliable and valid scale for assigning values that can mark professionalism in Taiwanese nurses.

The Japanese value of harmony and nursing ethics.

Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses' perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses' harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for all. Because of the unique link between harmony and the location of interaction, the ideal 'workplace harmony' threatened some nurses' professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged.

Differentiating between rights-based and relational ethical approaches.

When forced treatment in mental health care is under consideration, two approaches guide clinicians in their actions: the dominant rights-based approach and the relational ethical approach. We hypothesized that nurses with bachelor's degrees differentiate better between the two approaches than nurses without a degree. To test this hypothesis a survey was performed in major Slovenian health institutions. We found that nurses emphasize the importance of ethics and personal values, but 55.4% of all the nurse participants confused the two approaches. The results confirmed our hypothesis and indicate the importance of nurses' formal education, especially when caring for patients with mental illness.

Giving voice: incorporating the wisdom of Hispanic RNs into practice.

This study used Heideggerian phenomenology to: 1) explore professional practice values and ethical concerns of Hispanic nurses practicing in the Pacific Northwest; and 2) describe values conflicts experienced by Hispanic nurses in clinical practice. Twenty-seven Hispanic nurses were interviewed about nursing practice experiences. Themes included: obligation to serve the Hispanic community; correct cultural mistakes; teach about racism and discrimination; protect professional relationships; act as interpreter and cultural broker; balance additional workload; and represent all Hispanic nurses. Recommendations are included for creating an inclusive work environment that values the wisdom of diverse communities of nurses consistent with ICN Code of Ethics.

Development and psychometric evaluation of the Nurses Professional Values Scale--Revised.

The Nurses Professional Values Scale--Revised (NPVS-R) is an instrument derived from the American Nurses Association Code of Ethics for Nurses designed to measure nurses' professional values. The purpose of this study was to examine the psychometric properties of the NPVS-R in a random sample of baccalaureate and master's students and practicing nurses. The NPVS-R, a 26-item Likert-scale format instrument, was tested on 782 subjects. Responses to the NPVS-R were subjected to exploratory and confirmatory factor analysis. Principal components analysis with varimax rotation and Kaiser normalization resulted in a five-factor solution explaining 56.7% of the common variance. Findings supported internal consistency reliability of five factors with alpha coefficients from .70 to .85 and a total scale alpha coefficient of .92. Construct validity was supported with an overall factor loading range of .46 to .79 across the five factors labeled Caring, Activism, Trust, Professionalism, and Justice. The NPVS-R is a psychometrically sound instrument for measuring professional nurses' values and enhancing professional socialization.

Norwegian nurses' thoughts and feelings regarding the ethics of palliative sedation.

The purpose of this descriptive study was to explore whether or not nurses viewed deep palliative sedation as an ethical problem; and, if so, why they felt it posed a problem for them. An exploratory descriptive design with quantitative and qualitative sections was used. A questionnaire, consisting of open- and closed-ended questions, was answered by a sample of 73 nurses employed in three settings in Norway. The results were analyzed using descriptive statistics and content analysis. The findings indicated that 88% of the respondents had provided care for patients with great suffering; 78% had provided care for patients who received palliative sedation; and 63% felt that deep palliative sedation posed ethical problems. The respondents felt it was ethically difficult when patients were not involved in the decision, when families had continued needs to communicate with their loved ones, and when nurses felt uncertain about the relief of symptoms due to patients' inability to communicate.

Maintenance of patients' integrity in long-term institutional care.

This study aimed to describe and compare the views of nurses and older patients' relatives on factors restricting the maintenance of patient integrity in long-term care. The purposive sample comprised 222 nurses and 213 relatives of older patients in four Finnish long-term care institutions. The data were collected using a self-developed questionnaire addressing five sets of factors relating to patients, relatives, nurses, the organization and society. The maintenance of patient integrity was restricted by: (1) social factors, including lack of respect for long-term geriatric care and lack of adequate resources; (2) patient factors relating to forgetfulness; and (3) factors relating to nurses and relatives in maintaining patient integrity. Better maintenance of patient integrity requires that more consideration is paid to issues of social respect and to the availability of adequate resources. Closer attention must be given to patients who are forgetful and unable to take part in decision making.