Using spatial video geonarratives to improve nursing care for people who use drugs and experience homelessness: A methodology for nurses.

BACKGROUND: People who are insecurely housed and use drugs are disproportionately affected by drug poisonings. Nurses are uniquely positioned to utilize harm reduction strategies to address the needs of the whole person. Needle debris encompasses drug paraphernalia discarded in public spaces. Studying needle debris provides a strategic opportunity to identify where drugs are being used and target public health strategies accordingly. AIM: Our aim in this article is to illustrate how spatial video geonarratives (SVG) combined GPS technology interviews, and videos of locations with needle debris, can elicit valuable data for nursing research. METHODS: Using SVG required knowledge of how to collect data wearing cameras and practice sessions were necessary. A Miufly camera worn at waist height on a belt provided the stability to walk while interviewing stakeholders. We wore the cameras and conducted go-along interviews with outreach workers, while filming the built environment. Upon completion of data collection, both the interview and GPS information were analysed using Wordmapper software. CONCLUSIONS: This methodology resulted in data presented uniquely in both a visual map and narrative. These data were richer than if a single modality had been used. These data highlighted specific contextual factors that were related to the location of needle debris, which created opportunities for nursing interventions to support people experiencing vulnerability.

A grounded theory of clinical nurses' process of coping during COVID-19.

AIMS AND OBJECTIVES: To explore clinical nurses' process of coping during COVID-19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster. BACKGROUND: The COVID-19 pandemic has provoked widespread disruption to clinical nurses' work. It is important to understand clinical nurses' processes of coping during disasters to support the nursing workforce during events such as global pandemics. DESIGN: We employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ). METHODS: Data collection entailed semi-structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses' coping processes inductively building concepts around these points. RESULTS: The predictor of nurses' outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID-a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses' confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing. CONCLUSIONS: Understanding clinical nurses' experience of coping during COVID-19 is essential to maintain the nursing workforce during similar disasters. RELEVANCE TO CLINICAL PRACTICE: Nurse leaders can target areas that support nurses' confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.

What are nurses' roles in modern healthcare? A qualitative interview study using interpretive description.

Aim: Nursing work has historically been difficult to specify. This has led to difficulties in determining safe staffing requirements and adequately supporting safe patient care. The aim of this qualitative interview study was to explore how nurses understand their work. Design: Qualitative interview study, using the interpretive description methodology. Methods: Twenty registered nurses and nursing students completed semi-structured interviews about their work. The researcher drew on the interpretive description methodology to analyse interview data and create a model that interprets participants' experiences of their nursing work. Results: Nurses understand their work by its role in the healthcare system, rather than by the tasks or activities they complete. This understanding is significant because nurses adapt their work constantly, and rigid definitions of working would not support safe adaptation. Nurses report working across three broad roles: clinical work, which is patient-facing; managing work, which sustains the care environment; and enabling work, which provides supports like research and education that make nursing a profession. Conclusions: Clinical, managing and enabling work have different aims, but all serve the purpose of supporting safe patient care and sustaining healthcare systems. Adaptation is a constant feature of each of these roles. This model may be useful for nurses in structuring and explaining their work and informing nursing workforce policy.