Violence against nurses by patients and visitors in the emergency department: An integrative review.

AIM: This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. DESIGN: Integrative review. DATA SOURCES: Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. REVIEW METHODS: 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. RESULTS: This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. CONCLUSION: The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. IMPACT: This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses. NO PATIENT OR PUBLIC CONTRIBUTION: This project was an integrative review of the literature therefore no patient or public contribution was necessary. WHAT ALREADY IS KNOWN: Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. WHAT THIS PAPER ADDS: This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. IMPLICATIONS FOR PRACTICE/POLICY: The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.

A commentary on the challenges for nurses in identifying and responding to intimate partner violence amongst gay and bisexual men.

AIM: This commentary elucidates the challenges for nurses in effectively identifying and supporting gay and bisexual men who experience intimate partner violence and offers guidance for education, training and practice to nurses when responding to patients who may be experiencing intimate partner violence. DESIGN: The commentary highlights issues raised by Callan et al.'s (2020) scoping review, translating the experiences of male sexual minorities undergoing abuse to a nursing context, in particular, issues such as homophobic remarks and heteronormative practices in health care and nursing-led environments militate against the identification of individuals who may be experiencing coerced sexual risk-taking, homophobia and sexual orientation outing. RESULTS: Intimate partner violence is a widespread issue that permeates across heterosexual and LGBTQ+ communities, while impressing on the everyday realities of nurses. The potential for discrimination against sexual minority patients may be offset by improving training, education and offering recommendations for nurses in how to identify IPV and how to assess risk. CONCLUSIONS: Nurses possess essential training and transferable skills such as empathy, adaptability, active listening and diplomacy and are ideally placed to facilitate disclosure of intimate partner violence. Gaps in knowledge, training and organizational support for nurses may be effectively addressed through drawing on extant research and international best practice guidelines. IMPACT: Suggestions for research, education and practice to identify gay and bisexual male survivors, intervene appropriately and avoid missed disclosure opportunities are made. We conclude with a table of recommendations with a view to enhancing the essential response of nurses in addressing intimate partner violence in marginalized communities.

Violence against nurses by patients and visitors in the emergency department: A concept analysis.

AIM: This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. BACKGROUND: Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. METHODS: This study employed Walker and Avant's concept analysis technique. RESULTS: The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. CONCLUSION: A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.

Narrative in nursing research: an overview of three approaches.

AIM: The aim of this paper is to present and discuss three popular narrative research approaches which have been successfully used by the authors in nursing research. Examples of each approach are offered to illustrate potential application in healthcare contexts. BACKGROUND: The creation, function and interpretation of narratives are of increasing interest to nurse researchers worldwide. Currently a variety of narrative research approaches are used to explore how people make sense of experience. While this diversity adds to the richness and scope of the methodology, practitioners new to narrative research may struggle in determining which approach best suits their research purposes and contexts. DESIGN: This discussion paper presents the philosophical basis, methodology, strengths and challenges of the following three commonly used narrative approaches: Murray's Narrative Framework, the Biographical Narrative Interpretive Method and Arts-Based Narrative Methods. DATA SOURCES: Data sources dating from 1934-2014 were used. These included seminal texts and articles from nursing and social science journals on narrative and narrative research found in the CINAHL, Medline and PsycInfo databases. IMPLICATIONS FOR NURSING: This discussion offers clarity and guidance to nurse researchers who are considering/ using narrative research methods to enquire into the storied nature of human experience and sense making processes. CONCLUSIONS: Employing a specific narrative research approach requires close attention to the 'fit' of the research question/context with the particular method under consideration. While sharing some narrative commonalities, each of these three methods enables the emergence of unique analytic and interpretive perspectives about stories relevant to nursing practice.

An introduction to the biographical narrative interpretive method.

AIM: To introduce the biographical narrative interpretive method (BNIM) to nurse researchers in search of a new methodology and method. BACKGROUND: Listening to and interpreting the narratives of patients is a core feature of nursing. Research methodologies and methods frequently do not fully take into account the historical, psycho-social and biographical dynamics of people's lives. DATA SOURCES: This paper draws from the experiences of both authors who have previously utilised the BNIM method, as well as sourcing relevant literature. REVIEW METHODS: This is a methodology paper that reviews the historical context of BNIM and provides an overview of its potential application for nursing research. Discussion The core assumptions and analytic strategy of BNIM focus on three inter-related facets: the person's whole life history or story (biography), how they tell it (narrative) and the social interpretation (interpretive). BNIM uses a unique interviewing technique to elicit an uninterrupted story from participants. The BNIM analytic tool is formulaic and uses nine stages to analyse individual cases. A tenth stage helps with analysis across cases. CONCLUSION: BNIM methodology and methods empower participants to articulate the vicissitudes of their life and experiences of illness while also providing the researcher with a framework for data analysis and interpretation to give meaning to individuals' life stories. IMPLICATIONS FOR RESEARCH/PRACTICE: The BNIM interview technique and analytic framework are useful tools to help with an in-depth qualitative exploration of life stories in context.

A Scoping Review of Intimate Partner Violence as It Relates to the Experiences of Gay and Bisexual Men.

Intimate partner violence (IPV) is a global health issue that encroaches beyond parameters of age, gender, sexual orientation and is the subject of extensive scholarly inquiry. Research on IPV in heterosexual couples, in particular on heterosexual women, has been prolific. However, there is a dearth of literature to document the distinct experiences of gay and bisexual men, despite the evidence of prevalence of IPV as reported equal or higher to heterosexual women. Studies have found that one in four gay men and four in 10 bisexual men have experienced IPV in their lifetime. This scoping review examines studies between 1931 and 2019 that had a predominant focus on violence among gay and bisexual men. Four electronic databases were searched in 2019. Arksey and O'Malley's framework was utilized to extract 28 studies using a range of research designs that represented 13,224 sexual minority male participants. Across studies, gay and bisexual men were observed to experience IPV similarly to heterosexual couples involving psychological, physical, and sexual violence. However, as a marginalized and sexual minority group, they experience distinctive features of violence including sexual orientation outing, unprotected sexual intercourse, homophobia, internalized homophobia, and difficulties accessing minority men-focused services. Minority stress theory is posited as a useful lens in understanding the above features. In keeping with previous scholarship, a paucity of knowledge on gay and bisexual men's experience of IPV was observed, and additional research is recommended.

An exploratory study of the conditions important in facilitating the empowerment of midwives.

OBJECTIVE: to explore the conditions important in facilitating the empowerment of midwives, as judged by practising midwives. DESIGN: a cross-sectional, descriptive, national survey of nurses and midwives practising in Ireland was undertaken in 2002. The questionnaire used in the survey included the 'Understanding of Empowerment Scale'. PARTICIPANTS: the data come from a larger national study of empowerment among nurses and midwives carried out by the authors in 2001/2 (Scott et al., 2003). A random sample of 4050 nurses and midwives in Ireland was obtained from the Live Register of An Bord Altranais (Irish Nursing Board). There was an overall response rate of 46% (n = 1781). Of these, 1340 people completed questionnaires, as 441 of those who replied were not in practice at the time. Of those who completed the questionnaire, 7% (n = 95) were practising midwives. Their findings are reported in this paper. MEASUREMENTS AND FINDINGS: factor analysis using the Principal Axis Factoring method of extraction and an oblique (Direct Oblimin) rotation was carried out on the Understanding of Empowerment Scale. This suggested four factors or conditions important for the empowerment of midwives: control, support, recognition and skills. KEY CONCLUSIONS: these findings relating to the conditions that facilitate empowerment in midwifery reflect the professional distinctiveness of midwifery and take into account the specific role and working environment of the midwife. IMPLICATIONS FOR PRACTICE: the identification of the important conditions to facilitate empowerment in midwifery provides a framework with which to explore ways of building on strengths and addressing weaknesses within the current situation for midwives in Ireland and elsewhere. These suggestive findings offer an opportunity to further develop a tool to measure levels of these conditions necessary to facilitate empowerment in midwifery.

Accessible yet not accessed? A literature review exploring factors which may prevent patients taking over the counter analgesia prior to attending Accident and Emergency.

Over the counter (OTC) analgesics are products which are widely available and publicly accessible. Contemporary healthcare policy encourages patients to take greater control over their health care and recovery [Department of Health and Children 2001. Quality and Fairness - A Health System for You, Health Strategy. Dublin, Stationery Office.]. Over the counter medication offers injured patients a degree of control over their pain experience, preventing unnecessary pain on transit to an Accident and Emergency (A&E) department. In terms of availability, the range and variety of analgesics available is ever increasing, as more and more ingredients are downgraded from prescription only medicine (POM) to OTC status. However, despite the increase in the availability of OTC analgesia and an emphasis on patient empowerment, the majority of patients continue to present to A&E without taking any prior analgesia. In a study of 391 patients, 81% of patients took no analgesia prior to attending the A&E department [Emergency Nurse 9 (2002) 36]. Pain, as Cooper [Cooper, A., 1994. Pain Assessment in accident and Emergency. Accident and Emergency Nursing 2(1) (1994) 103] has noted, prompts people to make a rational decision to attend the A&E department. This literature review explores possible explanations as to why patients do not take OTC analgesia as a first line step in pain management.

Transition to blended learning: experiences from the first year of our blended learning Bachelor of Nursing Studies programme.

BACKGROUND: The School of Nursing at Dublin City University offered a new blended learning Bachelor of Nursing Studies programme in the academic year 2011. AIM: To document the experiences of the academic team making the transition from a face-to-face classroom-delivered programme to the new blended learning format. METHOD: Academics who delivered the programme were asked to describe their experiences of developing the new programme via two focus groups. RESULTS: Five dominant themes were identified: Staff Readiness; Student Readiness; Programme Delivery and Student Engagement; Assessment of Module Learning Outcomes and Feedback; and Reflecting on the First Year and Thinking of the Future. Face-to-face tutorials were identified as very important to both academics and students. Reservations about whether migrating the programme to an online format encouraged students to engage in additional practices of plagiarism were expressed by some. Student ability/readiness to engage with technology-enhanced learning was an important determinant of their own success academically. DISCUSSION: In the field of nursing blended learning is a relatively new and emerging field which will require huge cultural shifts for staff and students alike.

Accounting for Intimate Partner Violence: A Biographical Analysis of Narrative Strategies Used by Men Experiencing IPV From Their Female Partners.

Intimate partner violence (IPV) is a serious social issue which affects the medium- and long-term health outcomes of many individuals worldwide. The cost of IPV on the physical and psychological well-being of individuals, in addition to its wider economic costs in responding to abused persons, is significant. Presently, there is a lack of understanding about the nature of female-initiated IPV and how men account for their experiences of it. This study examined male victims' life stories of their IPV experiences from their intimate partners. Using the biographical narrative interpretive method, three cases were analyzed from a social constructionist perspective to examine what narrative strategies men used to account for their experiences of being abused by their female partners. Three dominant narrative strategies were used by respondents: the fatherhood narrative, the good husband narrative, and the abuse narrative. The abuse narrative had a unique narrative form, which reflected respondents' disassociation between their identities as men and also as abused persons. Dominant conflicting discourses of masculinity and intimate partner abuse disadvantaged men in identifying IPV and secondly in responding appropriately. This study found that men prefer to use dominant discursive identities as legitimate means from which to disclose IPV experiences. The findings from this study illustrate that broad questioning by professionals regarding fatherhood may be most helpful in promoting disclosures of IPV if this is suspected.

Irish nurses' and midwives' understanding and experiences of empowerment.

AIM: This study explored conceptualizations of empowerment among Irish nurses and midwives. BACKGROUND: Current literature on the meaning of empowerment lacks consensus. As a result there is a likelihood that empowerment will be conceptualized differently between managers and subordinates. METHOD: In order to get a sense of how Irish practitioners viewed empowerment, 10 focus groups were held in locations throughout Ireland (n = 93). A national distribution of participants was obtained. RESULTS: Twenty-one different responses emerged representing what nurses and midwives understood by the term empowerment. In relation to experiences of empowerment, six themes were found to impact on empowerment experiences. Three themes emerged as central to empowerment. One theme (education for practice) was identified as an antecedent to empowerment. CONCLUSION: Empowerment is a complex concept and its meaning is contextually determined. Managers play a key role in impacting on the empowerment perceptions of Irish nurses and midwives.

Considering video production? Lessons learned from the production of a blood pressure measurement video.

It is important that innovative tools that are created to enhance student learning are efficient and effective. Satisfying both criteria presents many challenges to contemporary nurse educators who wish to embark on creating alternative media to augment student nurse education. This paper is based on the author's own experience of producing a teaching video with the assistance of two multimedia students. This project was made possible by a university teaching and learning grant. Some recommendations are made arising from the 'lessons learned' from this project are highlighted. These are broadly categorised into pre-production, production and post-production considerations. In general, a good working relationship within the production team was beneficial in clarifying discrepancies between multimedia perspectives and nurse educator perspectives. It is hoped that this paper will be helpful to prospective nurse educators intending to produce similar video material.