A duty of care to the nurse as well.

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the responsibility employers have to ensure that disciplinary procedures and processes are fit for purpose.

Association between Performance in a Maintenance of Certification Program and Disciplinary Actions against the Medical Licenses of Anesthesiologists.

WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: In 2000, the American Board of Anesthesiology (Raleigh, North Carolina) began issuing time-limited certificates requiring renewal every 10 yr through a maintenance of certification program. This study investigated the association between performance in this program and disciplinary actions against medical licenses. METHODS: The incidence of postcertification prejudicial license actions was compared (1) between anesthesiologists certified between 1994 and 1999 (non-time-limited certificates not requiring maintenance of certification) and those certified between 2000 and 2005 (time-limited certificates requiring maintenance of certification); (2) within the non-time-limited cohort, between those who did and did not voluntarily participate in maintenance of certification; and (3) within the time-limited cohort, between those who did and did not complete maintenance of certification requirements within 10 yr. RESULTS: The cumulative incidence of license actions was 3.8% (587 of 15,486). The incidence did not significantly differ after time-limited certificates were introduced (hazard ratio = 1.15; 95% CI, 0.95 to 1.39; for non-time-limited cohort compared with time-limited cohort). In the non-time-limited cohort, 10% (n = 953) voluntarily participated in maintenance of certification. Maintenance of certification participation was associated with a lower incidence of license actions (hazard ratio = 0.60; 95% CI, 0.38 to 0.94). In the time-limited cohort, 90% (n = 5,329) completed maintenance of certification requirements within 10 yr of certificate issuance. Not completing maintenance of certification requirements (n = 588) was associated with a higher incidence of license actions (hazard ratio = 4.61; 95% CI, 3.27 to 6.51). CONCLUSIONS: These findings suggest that meeting maintenance of certification requirements is associated with a lower likelihood of being disciplined by a state licensing agency. The introduction of time-limited certificates in 2000 was not associated with a significant change in the rate of license actions.

Counterproductive work behavior among frontline government employees: Role of personality, emotional intelligence, affectivity, emotional labor, and emotional exhaustion / Comportamiento laboral contraproducente en funcionarios de primera línea:papel de la personalidad, la inteligencia emocional, la afectividad, el trabajoemocional y el agotamiento emocional

The main objective of this research is to study the effect of personality, emotional intelligence (EI), affectivity, emotional labor and emotional exhaustion on counterproductive work behavior (CWB) of front line employees in the government sector. A questionnaire was designed and distributed to 625 front line employees working at service counters in 25 ministries in Malaysia. We received responses from 519employees (response rate = 83%). The data was analyzed using Structural Equation Modeling (SEM). The main findings are: (1) personality factors of employees drive their EI, affectivity, emotional labor, emotional exhaustion, and CWB and (2) EI and affectivity impact emotional labor, emotional exhaustion and CWB. Through the integrated model, we have studied the indirect roles of emotional labor and emotional exhaustion. This is one of the few studies that have effectively integrated the five constructs into a single framework to study their effects on CWB (AU)

El objetivo principal de este trabajo es estudiar el efecto de la personalidad, la inteligencia emocional(IE), la afectividad, el trabajo emocional y el agotamiento emocional en el comportamiento laboral contraproducente de los empleados de primera línea del sector público. Se diseñó un cuestionario, que se distribuyó a 625 funcionarios de primera línea destinados en ventanillas de 25 ministerios de Malasia. Recibimos respuesta de 519 funcionarios (índice de respuesta del 83%). Los datos se analizaron mediante el modelado de ecuaciones estructurales (SEM). Se obtuvieron los siguientes resultados: (1) los factores de personalidad gobiernan su inteligencia emocional, afectividad, trabajo emocional, agotamiento emocional y el comportamiento laboral contraproducente (CLC) y (2) la inteligencia emocional y la afectividad influyen en el trabajo emocional, el agotamiento emocional y el CLC. Mediante el modelo integrado hemos estudiado el papel indirecto del trabajo emocional y del agotamiento emocional. Se trata de uno de los pocos estudios que han integrado eficazmente los cinco constructos en una estructura única para estudiar sus efectos sobre el CLC (AU)

Revisión de aspectos normativos y funcionales del personal de los Cuerpos Facultativo y de Enfermeros de Instituciones Penitenciarias / A review of the regulatory and functional aspects of prison health care and nursing staff

Con relación a los funcionarios sanitarios penitenciarios encuadrados en los Cuerpos Facultativo de Sanidad Penitenciaria y de Enfermeros de Instituciones Penitenciarias, este trabajo tiene dos objetivos. El primero, anotar el régimen jurídico aplicable a los mismos como funcionarios de la Administración General del Estado al servicio de las Instituciones Penitenciarias, destacando las peculiaridades de la regulación normativa aplicable por el hecho de prestar ese servicio. El segundo, con el trasfondo de las normas generales que sobre sanidad penitenciaria contiene la Ley Orgánica 1/1979, de 26 de septiembre, General Penitenciaria y su Reglamento de desarrollo, aprobado por Real Decreto 190/1996, de 9 de febrero, efectuar un análisis crítico del cuadro obligacional y funcional del personal facultativo y de enfermería establecido en el viejo Reglamento Penitenciario de 1981, para determinar si, desde un punto de vista jurídico, puede erigirse en obstáculo o freno para que la Administración Penitenciaria proceda al desarrollo y ejecución de las funciones que tiene atribuidas en materia de planificación, organización y dirección de las actividades tendentes al mantenimiento y mejora de la higiene y de la salud en el medio penitenciario (AU)

The aim of this study of prison health care staff in Prison Health Care and Nursing Units is twofold. The first one is to consider those aspects of the legal system applicable to them as government employees of the General State Administration at the service of Prisons, highlighting the peculiarities of the legal regulations that can be applied as a result of providing said service. The second, based on the general regulations on prison health contained in Organic Law 1/1979, of 26 September, General Penitentiary Law and the implementing regulations thereof, approved by Royal Decree 190/1966, of 9 February, sets out to provide a critical analysis of the obligatory and functional framework for health care and nursing staff established in the old Penitentiary Regulations of 1981, to determine from a legal perspective if it is possible to impede or brake so that the Prison Administration may develop or carry out the functions for which it is responsible in terms of planning, organization and management of activities geared towards maintaining and improving hygiene and health in the prison environment (AU)

Salud, entorno y enfermería. Fundamentos filosóficos y teóricos para el desarrollo y la validación de una terminología enfermera de interfase (III) / Fundamentos filosóficos y teóricos para el desarrollo y la validación de una terminología enfermera de interfase (III)

INTRODUCCIÓN: este manuscrito es el tercero de una tríada de artículos en los que se exponen las bases filosóficas y teóricas que sustenta el desarrollo y la validación de una terminología enfermera de interfase como vocabulario normalizado para facilitar la entrada de datos en los sistemas de información, producir información y generar conocimiento enfermero. OBJETIVO: presentar las bases filosóficas y teóricas en las que se sustenta el desarrollo de una nueva terminología enfermera de interfase denominada ATIC®. MÉTODO: revisión, análisis y discusión de las principales corrientes filosóficas, de las teorías de alto y medio rango y de la producción científica enfermera mediante la conceptualización interpretativa del conceptos metaparadigmáticos «salud», «entorno» y «enfermería». RESULTADOS: en los dos primeros artículos se presenta ATIC® y su fundamentación filosófica en el pragmatismo, el holismo, el postpositivismo y el constructivismo, así como la construcción del significado del concepto «persona». En este tercer artículo se conceptualiza la «salud» como un estado de equilibrio multidimensional y se exponen los conceptos de «estado de salud relativa», de «enfermedad» y del «estar enfermo». El análisis de las teorías sobre el «entorno» permite su conceptualización como un conjunto de variables con potencialidad para afectar los estados de salud. En esta línea, la Enfermería se interpreta como la disciplina científica que se ocupa de los estados de salud en el entorno y la experiencia particular del individuo o la comunidad. CONCLUSIONES: la terminología ATIC® se sustenta en una fundamentación filosófico-teórica ecléctica, lo que le permite, a priori, ser empleada desde múltiples tendencias dentro del paradigma de la totalidad (AU)

INTRODUCTION: this manuscript is the third of a triad of papers introducing the philosophical and theoretical approaches that support the development and validation of a nursing interface terminology as a standard vocabulary designed to ease data entry into electronic health records, to produce information and to generate knowledge. GOALS: to analyze the philosophical and theoretical approaches considered in the development of a new nursing interface terminology called ATIC®. METHOD: review, analysis and discussion of the main philosophical orientations, high and mid-range theories and nursing scientific literature to develop an interpretative conceptualization of the metaparadigm concepts «Health», «Environment» and «Nursing». RESULTS: in the 2 previous papers the ATIC® terminology, its foundation on pragmatism, holism, post-positivism and constructivism and the construction of the meaning for the concept «Individual» is discussed. In this third paper, Health is conceptualized as a multidimensional balance state and the concepts of Partial health status, Disease and Being ill are explored within. The analysis of the Environment theories drives its conceptualization as a group of variables that has the potential to affect health status. In this orientation, Nursing is understood as the scientific discipline focused on the study of health status in the particular environment and experience of the individuals, groups, communities or societies (AU)

Reactions toward affirmative action measures for women / Reacciones a las Medidas de Acción Afirmativa para las Mujeres

Este trabajo examina si existen diferencias entre mujeres y hombres en sus reacciones hacia diferentes tipos de medidas de acción afirmativa (MAAs) para mujeres, para lo que 192 mujeres y 128 hombres ocupantes de diferentes puestos respondieron a un cuestionario. Los resultados muestran que las mujeres reaccionan de manera más positiva que los hombres hacia las MAAs, aunque las reacciones de ambos varían en función del tipo de medida de acción afirmativa. Las reacciones son más positivas cuando las decisiones de personal se basan en el mérito y se vuelven más negativas cuando las decisiones están basadas principalmente en el género. También encontramos que las reacciones hacia las MAAs se relacionan con las variables “percepción de injusticia” y “percepción de amenaza para los hombres”, y especialmente con la primera. Otro resultado es que las reacciones hacia el concepto genérico de acción afirmativa son más positivas que hacia medidas específicas de AA. Por último, comentamos las implicaciones de estos resultados para la investigación y la práctica(AU)

This paper examines whether there are differences between women and men in their reactions towards different types of specific affirmative action measures (AAMs) for women. 192 women and 128 men from a variety of jobs responded to a survey. We conclude that women react more positively than men towards AAMs, although the reactions of both men and women vary depending on the type of AAM. Thus, reactions become increasingly positive when personnel decisions were made on the basis of merit and increasingly negative when decisions were made on the basis of gender. We also found that reactions towards AAMs are related to the variables “unfairness perception” and “threat perceived to men”, and especially to the former. Also, reactions towards the generic concept of affirmative action are more positive than towards specific AA measures. Implications of these results for research and practice are discussed(AU)

Developing a modern standard to define and assess professionalism in trainees.

OBJECTIVE: Assessing professionalism in medical education poses many challenges. The authors discuss common themes and principles in managing professionalism in medical education. METHODS: The authors review the development of standards of professionalism in medical education. They define educational goals for professionalism and also discuss the practical problems with assessing professionalism and addressing it with the trainees. Strategies for remediation of unprofessional conduct are outlined. RESULTS: Given the importance of role models in the development of professional behavior, maintaining an environment that fosters professionalism is an implicit feature of teaching professionalism. Professionalism should be a part of the objectives for each course and clinical rotation, using clearly defined goals and objectives. Assessment of professionalism should begin early and be conducted frequently, giving trainees the opportunity to change. A formal mentoring system can be an effective mechanism to develop role models and teach professionalism. CONCLUSION: Teaching professionalism through formal curricula is paramount in helping develop new generations of compassionate and responsible physicians. Additional strategies such as consistent role modeling of professional behaviors are also needed to encourage the development of professional physicians.