Nursing professional attire: probing patient preferences to inform implementation

What motivates young Arab Muslim women to choose nursing as a profession: A cross-sectional study

AIM

This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications.

BACKGROUND

The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions.

METHODS

A cross-sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20-30 in Israel. The study adhered to the EQUATOR checklist for cross-sectional studies.

RESULTS

Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing.

DISCUSSION

The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society.

CONCLUSION

Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession.

IMPLICATIONS FOR POLICY

Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women.

A scoping review exploring people's perceptions of healthcare uniforms

BACKGROUND

Healthcare staff uniforms are a subject of debate in the UK, and this is particularly true in the case of less understood roles such as advanced nurse practitioners. Aim: This review explores what is known about people's perceptions of health professionals' uniforms.

METHOD

A mixed methods scoping review following the Joanna Briggs Institute (JBI) methodology. Five databases (CINAHL, ASSIA, PsycINFO, and EMBASE) and several search engines were searched. Eligible reports were peer-reviewed English-language studies using any methodology to explore people's perceptions of different uniforms for health professionals.

FINDINGS

Forty-six studies (mainly from North America) were included, presenting a variety of perspectives on the uniforms worn by doctors, nurses and other health professionals.

CONCLUSION

Culture and context likely influence how uniforms are understood. Practitioners should consider how this may affect communication with both patients and colleagues. What health professionals wear matters, particularly in relation to less well understood roles.

Effective communication between nursing professionals and patients after the implementation of mask-wearing requirements in the clinical setting: A cross-sectional study

This study aimed to evaluate staff nurses' perspectives on the use of face masks in effective communication and relationship management skills with patients in the hospital setting. The study surveyed registered nurses (RNs) who work with adult patients in different hospital units. An online survey was completed by RNs who were selected by convenience sampling. RNs' communication with patients was perceived as moderately affected by the use of face masks. Statistically significant differences were found when comparing communication with years of professional experience. Participants who had over 10 years of experience reported having greater difficulty in their communication with patients when using face masks. The effect of provider-patient relationship on effective nurse-patient face-mask communication was statistically significant and negative. This study shows that some participants found face masks used in the clinical setting may affect nurse-patient communication, as well as the nurses' ability to manage their relationships with patients. The findings of this study support the need for targeted research into effective communication strategies when face mask use is needed in the healthcare setting.

Understanding Experience of Patients With Highly Infectious Diseases During Extended Isolation: A Design Perspective

OBJECTIVES

This study aimed to develop a better understanding of the unique needs of patients with highly infectious diseases and their perceptions of being placed in isolation. We explore the subjective experiences of patients treated for Ebola in a biocontainment unit (BCU) and the healthcare personnel who cared for them.

BACKGROUND

The 2014 Ebola outbreak and the COVID-19 pandemic have brought to focus some major challenges of caring for patients with serious infectious diseases. Previous studies on BCU design have looked at ways to prevent self- and cross-contamination, but very few have examined how the built environment can support an improved patient experience.

METHOD

A qualitative study was conducted with four patients treated for Ebola and two critical care nurses who provided direct care to them at a single BCU in the U.S. Data were collected through in-depth semi-structured interviews to capture the actual patients' perception and experience of isolation. The interviews were analyzed using the thematic analysis approach.

RESULTS

The Ebola patients placed in source isolation perceived the BCU as an artificial environment where they lacked control, agency, autonomy, and independence. The physical separation from other patients, visitor restrictions, and staff wearing PPE contributed to feelings of social and emotional isolation, and loneliness.

CONCLUSIONS

The isolation can take a toll on physiological and psychological well-being. A thoughtful design of isolation units may improve patients' experience by supporting human and social interactions, empowering patients through space flexibility and personalization of space, and supporting a more holistic approach to isolation care.

An Integrative Review of Body Art in Nursing

BACKGROUND

Schools of nursing and health care facilities frequently have policies prohibiting the visibility of body art (tattoos and piercings). The authors sought to understand literature specific to nursing regarding such policies.

PURPOSE

This integrative review examined literature regarding body art in nursing.

METHODS

A systematic electronic database search was conducted for publications between 2010 and 2021. Thematic analysis of both empirical studies and nonresearch articles was completed.

RESULTS

Thirty articles were analyzed, revealing 3 themes and 8 subthemes related to body art in nursing practice: level of acceptability (subthemes were positive perception, stigmatizing, and personal meaning); professional image (subthemes were appearance matters, policy, and trust and confidence); and infection concern (subthemes were hygiene and contamination).

CONCLUSIONS

Current understanding from literature regarding body art in nursing was summarized.

A new therapeutic communication model "TAGEET" to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19

AIM

To design and present a new communication model "TAGEET" to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19.

BACKGROUND

COVID-19 is a highly contagious disease that brings with it fear and anxiety for all involved inclusive of nurses and patients. New guidelines for nurses to follow such as attention to physical distance coupled with the wearing of defined personal protective equipment, gloves, long-sleeved disposable gown, FFP2 face mask and eye protection place additional strain on nurses to engage therapeutically with patients. Evidence suggests that the wearing of face masks and personal protective equipment acts as barriers to effective therapeutic engagement with patients. We found an absence of communication models to help nurses engage therapeutically with patients.

DESIGN

This is a position paper that draws on previous research to inform the design of a new model for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19.

METHOD

We reviewed the literature on caring for patients in isolation, the barriers to therapeutic communication and the psychological impact of infectious diseases on nurses and patients.

CONCLUSION

Remaining emotionally present to self, whilst being present to others can be challenging for nurses in a pandemic environment. We believe that the "TAGEET" model (T-Tune-in, A-Approach and introduce, G-Ground self, E-Engage and respond, E-End encounter, T-Tune-out), although devised for nurses to engage therapeutically with patients suspected of or confirmed with COVID-19 could be used by all healthcare professionals in any challenging clinical environment.

RELEVANCE TO CLINICAL PRACTICE

This new therapeutic communication model will provide support for nurses with how to manage self in the context of caring for others in a COVID-19 environment.

The stigmatisation of source isolation: a literature review

Background

Isolation precautions in patients with multi-drug-resistant bacteria and other communicable infectious agents can be associated with adverse effects. Patients' perspectives of isolation suggest that the imposed environment and procedures create barriers to their physical, social and emotional needs.

Aims

The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that stigma is a significant characteristic of the experience of source isolation in healthcare settings.

Methods

The methodological framework of Arksey and O'Malley was applied to this review. A total of 14 papers identified from 189 abstracts screened were included in the review.

Results

The research reviewed suggests a clear association between stigmatisation and isolation in which stigma does have a direct negative effect on patients placed in hospital isolation. None of the studies found evidence to the contrary.

Conclusions

The implications of this literature review for policy-makers and healthcare professionals suggest that when isolation or other forms of constraint are implemented and in use, patients must be provided with strengthened forms of support, including social and emotional support, and given access to healthcare of optimal quality to prevent the associated adverse effects of isolation as much as possible.

Professional Image and the Nursing Uniform

BACKGROUND

Traditional nursing uniforms have evolved and influenced nursing image, but professional image in nursing is unique and unclear. Institutional policies dictate uniform and appearance standards that portray professionalism in health care environments.

METHOD

Nurses were questioned using three structured open-ended questions about the nursing uniform and its effects on patients' perceptions of professionalism. Qualitative line-by-line analyses of transcribed data were conducted to identify emerging themes using van Manen's phenomenology.

RESULTS

Participants wore varying uniforms while in nursing school. The influences of uniform evolution on patients' perceptions of professionalism were acknowledged along with current challenges in maintaining a professional image in nursing.

CONCLUSION

Findings will be used for future exploration of the concept of professional image to improve educational practices that promote a professional work environment and professional image for the discipline. [J Contin Educ Nurs. 2018;49(12):555-557.].

The Impact of Nurses' Uniforms on Nurse-Patient Interactions: Patients' Perspectives

OBJECTIVES

The aim of this study was to explore patients' perceptions toward the nursing uniforms used in a hospital in Singapore and how different uniforms impact nurse-patient interactions.

BACKGROUND

Nursing uniforms act as a form of nonverbal communication. However, implications of the increasing variety of nursing uniforms on patients' perceptions of nurses and nurse-patient interactions are unexplored.

METHODS

An exploratory qualitative study design using semistructured interviews was adopted for the study. Twenty-one patients agreed to be interviewed. An audio recorder was used during data collection. The thematic analysis method was used for data analysis.

RESULTS

Four major themes were identified: identity, subjectivity, suitability, and inconsequential. Nurses' uniform was regarded as a representation of identity. Suitability of the uniform for nurses was a main concern for patients. However, nurses' uniforms were inconsequential to nurse-patient interactions.

CONCLUSION

Patients' perceptions of nurses' uniforms were highly subjective and have no substantial impact on nurse-patient interactions.

Pilot evaluation of isolation patients' perceptions on ability to identify types of health care workers when wearing isolation gowns

In a survey research study, perceptions of 50 hospitalized patients on contact isolation were evaluated regarding their ability to identify health care worker (HCW) type in isolation gowns with no hospital badge under or on the gown, in isolation gowns with the hospital badge partially visible through the gown, and in isolation gowns with a preprinted large font Registered Nurse and Nursing Technician sticker badge on the outside of the gown. Patients ranked their ability to identify HCWs when entering their hospital room as important (average ranking, 8.0, where 0 was not at all important and 10 was very important); 28 patients (56%) specified all HCWs entering their hospital room should wear a preprinted large font sticker badge on the outside of their isolation gowns. Patients found little difficulty identifying HCW type with the large font preprinted sticker badge (average difficulty ranking, 1.0, where 0 is not at all difficult and 10 is very difficult), a simplistic method to improve HCW type identification.

Role and Image of Nursing in Children's Literature: A Qualitative Media Analysis

Nurses' role and image as portrayed in young children's literature were described and analyzed.

DESIGN AND METHODS

A total of 30 children's books (pre-kindergarten through grade two audience) written in English were chosen using progressive theoretical sampling. Included were books, both fiction and non-fiction and with varying years of publication, that mentioned nurses and/or were about general healthcare topics. The books were analyzed using the method of qualitative media analysis which is derived from the theoretical framework of symbolic interactionism.

RESULTS

Nurses were generally portrayed positively but simply and inaccurately in this sample of children's literature. The seven themes discovered were labeled as nurse characters using traits evident in the sample: nurse unlikely, nurse minimal, nurse caring, nurse subordination, nurse skillful, nurse diversity, and nurse obvious.

CONCLUSION

The image of nursing is socially and culturally constructed, and accurate portrayals of nurses and their roles are necessary in all media. Thus, better representation of nurses in children's books is needed as young children's literature is an important first exposure to the art and science of nursing.

PRACTICE IMPLICATIONS

Future children's books authored by nurses may more closely reflect accurate contemporary nursing practice and contribute to an improved image of the nursing profession.

Increasing Staff Pride and Patient Connection

This column is presented by a nurse educator at the Princess Alexandra Hospital. The author reinforces the value of our professional identity as nurses. The project described in this article focused on the presence of a visible name tag and a professional introduction of the nurse to the patient to promote the development of trust.

Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis

This article uses a Bourdieusian framework to understand the importance of clothing norms for symbolizing and reproducing social, as well as professional, hierarchy in hospitals. Using data from participant observation, it examines how a complex yet informal dress code has emerged at a community hospital in the Northeastern United States, in a setting where very few formal guidelines exist on how to dress. By conceptualizing professionals as holders of various types of capital (economic, cultural, and symbolic), this article expands previous research which considered clothing only as a marker of professional identity. The findings demonstrate (1) how clothing norms are used in subtle, but purposeful, ways to reflect varying degrees of cultural and economic capital and (2) how these complex norms also reflect professional boundaries in medical authority (symbolic capital), which is important during critical moments where clothing can quickly signal who can take control. The discussion borrows Bourdieu's concepts of habitus and field to explain why subordinates subscribe to these clothing norms, in the absence of a formal organizational dress code.