An Analysis of the Current Situation and Influence Factors of Narrative Competence Among Nurses in VIP Ward.

Objective: This study aimed to explore the proficiency level in medical narrative ability among nurses in VIP wards and identify the influencing factors. The objective was to provide valuable insights for enhancing the training and development of medical narrative skills among nurses in VIP wards, with the ultimate goal of promoting narrative nursing in clinical practice. Methods: A survey was conducted of 94 nurses working in VIP wards at a grade-A tertiary hospital in Zhongshan City, using the Narrative Competence Scale. Results: The findings revealed that nurses' overall medical narrative ability in VIP wards was relatively low, with a total score of (135.31±16.50). The primary factors identified as influential were professional titles and familiarity with narrative medicine or narrative nursing, which played significant roles. Specifically, nurses with higher professional titles demonstrated greater proficiency in medical storytelling. Moreover, nurses more familiar with narrative medicine or narrative nursing tended to exhibit higher levels of medical narrative ability. Conclusion: The results of this study highlight the significant opportunity for enhancing the medical narrative ability of nurses in VIP wards. To address this issue, it is recommended that training programs incorporate knowledge and skills related to narrative medicine and narrative nursing into the core competency development of VIP nurses. Additionally, there is a need to introduce narrative nursing practices gradually into clinical care. These measures will empower nurses to enhance their narrative abilities, providing superior nursing services to patients. Ultimately, such efforts will strengthen nurses' sense of professional value and increase the social benefits of nursing care.

Exploring yarigai: The meaning of working as a physician in teaching medical professionalism.

INTRODUCTION: The shift in medical professionalism now considers the well-being of physicians, given the prevalence of burnout and the importance of work-life balance. To reconsider the question 'Why do doctors work for the patient?' and explore the meaning of working as a physician, this study adopts the concept of 'yarigai,' which represents fulfillment and motivation in meaningful work. The authors' research questions are: How do doctors recount experiences of yarigai in caring for patients? What kind of values are embodied in their stories about yarigai? METHOD: They adopted narrative inquiry as the methodology for this study. They interviewed 15 doctors who were recognized by their colleagues for their commitment to patient-centered care or had demonstrated yarigai in caring for patients. The semi-structured interviews were conducted face-to-face with each participant by the Japanese researchers, yielding 51 cases of patient-doctor interactions. After grouping the interview data, they translated the cases into English and identified four representative cases to present based on the set criteria. RESULTS: From the 51 case studies, they constructed four representative narratives about the yarigai as a physician. Each of them spoke of (1) finding positive meaning in difficult situations, (2) receiving gifts embodying ikigai, (3) witnessing strength in a seemingly powerless human being, and (4) cultivating relationships that transcend temporal boundaries, as being rewarding in working as a physician. The main results of the study, which are the narratives, are described in the main body of the paper. CONCLUSION: The stories on yarigai gave intrinsic meanings to their occupational lives, which can be informative for students, residents, and young physicians when contemplating the meaning of their work as doctors. Rather than demanding selfless dedication from physicians towards patients, they believe it more important to foster yarigai, derived from the contribution to the well-being of others through patient care.

MAiD as human connection: Stories and metaphors of physician providers' existential lived experience.

Being the one who provides an assisted death is complex and profound, and yet the lived experience of this novel act is little understood in Canada. In this article, we highlight the methodological issue of how one might peer behind emergent threads that addressed us in the data. A narrative-hermeneutic approach revealed that for the eight providers we interviewed, this is an embodied existential experience. The act of providing MAiD fostered embodied feelings of conviction, courage, compassion, and intimacy. We ultimately find that the experience of providing MAiD is human connection. The experience holds a dimension of the existential and provides a way to get closer to the unsayable profoundness that occurs in the space of providing death for a suffering other. This is important if not crucial in medicine and health care, as shared experiences connect us to what it is to be human, especially at end of life.

"Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey.

AIMS: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. METHODS: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. RESULTS: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes. CONCLUSIONS: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.

Moral learning through caring stories of nursing staff.

BACKGROUND: Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff's stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. OBJECTIVE: This study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. RESEARCH DESIGN: In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff's perceptions of working with their caring stories and the impact on PCC. ETHICAL CONSIDERATIONS: Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. FINDINGS: Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. DISCUSSION: Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff's narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. CONCLUSION: Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC.

Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents.

Background: Providing end-of-life (EOL) care to pediatric patients and their families is challenging. Newly licensed nurses, especially those working with the hematology/oncology population, have little to no experience providing the specialized care needed for the dying child. An evidence-based continuing professional development activity provided a novel approach to improve the knowledge, attitudes, and comfort levels of nurse residents related to pediatric EOL care. Method: A high-fidelity simulation module of a pediatric oncology patient at the EOL was embedded into a 12-month nurse residency program. The module employed several teaching strategies including a storytelling approach. Results: Thirteen pediatric nurse residents participated in the program. While the evidence-based intervention increased participants' EOL care knowledge, their overall attitudes, and comfort levels remained unchanged. Discussion: EOL simulation with a storytelling approach is a highly valuable method of teaching new nurses how to care for a dying patient. Additional studies are needed to explore how to increase the comfort levels of new nurses in the delicate population of pediatric hematology/oncology.

"A verdade é essa... Você se acostumando com a qualidade de vida ruim": médicos cearenses e o trabalho em mutação / "The truth is this ... You get used to poor quality of life": Ceará doctors and work in mutation

OBJETIVO: O artigo desenvolve uma reflexão acerca do trabalho de médicos cearenses no diálogo com as suas experiências a partir de narrativas que revelam diferentes formas de ser e viver, num campo de tensões e conflitos, ao desempenharem seu ofício de forma precarizada em instituições públicas e privadas. MÉTODO: Esta precarização se revela não só por problemas materiais do próprio sistema, tais como falta de equipamentos de saúde, superlotação de unidades, alta demanda de consultas e atendimentos, baixa remuneração dos profissionais, mas também por outras dimensões que compõem a vida de seus profissionais, como elevada carga de trabalho, os deslocamentos inter e intrarregionais, estresse devido ao ritmo de vida, multiemprego, ausência de lazer, etc. CONCLUSÃO: Por meio de pesquisas documentais e entrevistas, é possível perceber que a flexibilização e precarização do trabalho afetam os profissionais da área de Medicina, tornando-os trabalhadores assalariados que em suas trajetórias e itinerâncias sonham com bons salários e qualidade de vida.