Collegial relationship breakdown: A qualitative exploration of nurses in acute care settings

Nurses' collegiality: An evolutionary concept analysis

Collegiality is one of the fundamental values of the nursing profession. During the nursing history, collegiality has been described as part of a nurse's relationship with their peers and it influences the quality of care they provide and job satisfaction and commitment to their work. Despite earlier definitions, the concept of collegiality in nursing has remained unclear. The aim of this study was to clarify the concept of collegiality in the nursing profession, using Rodger's evolutionary concept analysis. We carried out electronic searches using the CINAHL, PubMed, Scopus, Web of Science, SocINDEX, PsycINFO and Eric databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers published in English language from the inception of database to November 2022. This identified 25 papers. Based on our analysis, the attributes of the concept of collegiality were achieving mutual goals together with equality, reciprocity, trusted advocacy, powerful self-regulation and engaged belongingness. Antecedents of the concept included existing professional group, connection between professionals and professional self-esteem. The consequences were strengthening nurses' professional status, job satisfaction and their ability to provide the best possible patient care. We found that nurses' collegiality was a value-based concept, with a unique character based on professional connections. The concept brought together ethical and pragmatic strategies to achieve the best possible results for the nursing profession. Provided knowledge can be applied for further development of the concept and applying it in clinical research and practice. The concept of nurses' collegiality should also be studied in the future because both the profession and their working environment are constantly changing.

Instructional Video of a Standardized Interprofessional Postsimulation Facilitator-guided Debriefing of a Fatality in Plastic Surgery

Background

Postsimulation facilitator-guided debriefing (PSFGD) is the process of intentional discussion of thoughts, actions, and events that took place during simulation amongst the facilitator(s) and trainees. Despite the significance of delivering high-quality debriefings, there is a lack of evidence-based guidelines. Our study aimed to provide an instructional video demonstration of a PSFGD of a fatality.

Methods

Fifty surgical interns participated in a burn simulation scenario in two groups. Group 1 (control, or "no exposure," n = 25) consisted of residents who received oral postsimulation debriefing from an independent faculty member who had no exposure to our instructional video on how to debrief effectively. Group 2 (intervention, or "exposure," n = 25) consisted of interns who were debriefed by the second faculty member who did watch our instructional video before the simulation and learned about "advocacy and inquiry" techniques. The outcome measures were the Debriefing Assessment for Simulation in Healthcare score and the postdebrief multiple-choice question (MCQ) quiz scores to assess debriefers' performance and interns' knowledge consolidation, respectively.

Results

The "exposure" group presented statistically significantly higher values for the Debriefing Assessment for Simulation in Healthcare score (P < 0.001) and MCQ score (P < 0.001) compared with the "no exposure" group.

Conclusions

Debriefers who followed the methodology as demonstrated in our instructional video were considered more competent, and the residents achieved higher MCQ scores. The quality of the debriefing ensures improved critical thinking and problem-solving skills. Safer practice and better patient outcomes are achieved by developing debriefing programs for educators.

Nursing team communication in a medical ward

ABSTRACT Objective: To describe the essential elements that make the nursing team communication process effective, and to analyze such elements in the light of two main theorists, Berlo and King. Method: This is a qualitative study of assistant convergent research approach. The data production technique was the semi-structured interview, with 25 nursing professionals from a public hospital. Data were analyzed with thematic content techniques. Results: The main element of consolidation of the communication process and interpersonal relationship, with consequent interaction, is the dialogue, which is guided by emotions, feelings, and team integration. Conclusion: The communication process and the interpersonal relationship reach their objectives and the reciprocal understanding expected when there is effective dialogue, validated by the source and receiver of the processes, with consequent interaction.

Nurses' perception of the strategies to gaining professional power: A qualitative study

Background

Power in nursing is a broad concept that has a determining effect on the achievement of professional goals. Gaining power is essential for promoting the roles of nurses, improving their professional image and the consistent improvement of healthcare systems.

Objectives

This study was conducted to identify and clarify strategies for gaining power in the nursing profession through the experiences of Iranian nurses.

Methods

The present qualitative grounded theory study was conducted on fifteen participants selected through purposive sampling. Data were collected through individual, in-depth, semi-structured interviews. The data obtained were analyzed using the guidelines provided by Corbin and Strauss, (2008 edition). This study was carried out in Qazvin city of Iran and lasted fourteen months (2015–2016).

Results

The analysis of the data were classified under the main theme of gaining human-professional power based on individual and organizational capacities, divided into four main categories, including respecting human values and ethical principles (with two subcategories, keeping the human symbols of power and commitment to moral obligations of power), promoting professional interactions (with two subcategories, paying attention to intraprofessional communication and paying attention to interprofessional communication), attempting professional endurance (with two subcategories, raising self-confidence and having professional commitment), and valuing potential capacities (with two subcategories, regard for individual capacities and regard for organizational capacities).

Conclusion

The findings obtained suggest that success in gaining power in nursing, requires a cumulative focus on human, ethical, professional, individual and organizational capacities.

A national study of paramedic and nursing students' readiness for interprofessional learning (IPL): Results from nine universities

BACKGROUND

The development of successful and functional interprofessional practice is best achieved through interprofessional learning (IPL). Given that many paramedic programmes still take an isolative uni-professional educational approach to their undergraduate courses, it is unclear on their preparedness for students' IPL. Therefore, the objective of this study was to assess the attitudes of undergraduate paramedic and nursing/paramedic students from nine Australian universities towards IPL over a two year period.

METHODS

Using a convenience sample of paramedic and nursing/paramedic students-attitudes towards IPL was measured using the Readiness for Interprofessional Learning Scale (RIPLS) 5-point Likert-scale (1=strongly disagree and 5=strongly agree).

RESULTS

A total of 1264 students participated (n=303 in 2011 and n=961 in 2012) in this study, consistent with a 43% response rate. Surveyed students were predominantly first year n=506 (40.03%), female n=748 (59.2%) and undertaking single paramedic degrees n=948 (75.0%). Nursing/paramedic students demonstrated significantly lower Negative Professional Identity (M=6.26, p=0.004) and Roles and Responsibilities means (M=6.87, p<0.0001) and higher Positive Professional Identity means (M=15.68, p=0.011) compared with paramedic students.

CONCLUSIONS

The impact of nursing/paramedic education was shown to significantly enhance student attitudes towards interprofessionalism and the individual universities involved in this study generated students at varying stages of IPL preparedness. Students' year level appeared to influence IPL readiness, yet there are compelling paradoxical arguments for both earlier and later inclusion of IPL within curricula.

Organizing safe transitions from intensive care

Background. Organizing and performing patient transfers in the continuum of care is part of the work of nurses and other staff of a multiprofessional healthcare team. An understanding of discharge practices is needed in order to ultimate patients' transfers from high technological intensive care units (ICU) to general wards. Aim. To describe, as experienced by intensive care and general ward staff, what strategies could be used when organizing patient's care before, during, and after transfer from intensive care. Method. Interviews of 15 participants were conducted, audio-taped, transcribed verbatim, and analyzed using qualitative content analysis. Results. The results showed that the categories secure, encourage, and collaborate are strategies used in the three phases of the ICU transitional care process. The main category; a safe, interactive rehabilitation process, illustrated how all strategies were characterized by an intention to create and maintain safety during the process. A three-way interaction was described: between staff and patient/families, between team members and involved units, and between patient/family and environment. Discussion/Conclusions. The findings highlight that ICU transitional care implies critical care rehabilitation. Discharge procedures need to be safe and structured and involve collaboration, encouraging support, optimal timing, early mobilization, and a multidiscipline approach.