The development of nurses' foundational values

Factors influencing the development of nursing professionalism: a descriptive qualitative study

BACKGROUND

The shortage of nurses threatens the entire healthcare system, and nursing professionalism can improve nurse retention and enhance the quality of care. However, nursing professionalism is dynamic, and the factors influencing its development are not fully understood.

METHODS

A qualitative descriptive study was conducted. Using maximum variation and purposive sampling, 14 southern and northern China participants were recruited. Semi-structured interviews were conducted from May 2022 to August 2023 in face-to-face conversations in offices in the workplace or via voice calls. The interviews were transcribed verbatim and analyzed via thematic analysis.

RESULTS

Three main themes emerged: (1) nourishment factors: promoting early sprouting; (2) growth factors: the power of self-activation and overcoming challenges; and (3) rootedness factors: stability and upward momentum. Participants described the early acquisition of nursing professionalism as derived from personality traits, family upbringing, and school professional education, promoting the growth of nursing professionalism through self-activation and overcoming challenges, and maintaining the stable and upward development of nursing professionalism through an upward atmosphere and external motivation.

CONCLUSION

We revealed the dynamic factors that influence the development of nursing professionalism, including "nourishment factors", "growth factors", and "rootedness factors". Our findings provide a foundation for future development of nursing professionalism cultivation strategies. Nursing administrators can guide the development of nurses' professionalism from many angles according to the stage they are in, and the development of professionalism deserves more attention. In the future, we can no longer consider the development of nursing professionalism solely as the responsibility of individual nurses; the power of families, organizations, and society is indispensable to jointly promoting nursing professionalism among nurses.

Professional values education for undergraduate nursing students: developing a framework based on the professional values growth theory

BACKGROUND

Education has been recognised as necessary in forming and internalising professional values. The system and instructors' content in existing educational institutions focus on developing students' knowledge, skills and practices. Still, the development of values has yet to achieve significant effects, leading to a crisis in students' professional identity.

AIMS

To construct a professional values growth theory for undergraduate nursing students and develop a corresponding education framework.

METHODS

Through the review, some databases(PubMed、CINAHL、Web of Science、Wiley and Google Scholars)were searched using a systematic search strategy to collect relevant literature on professional values education. Based on the nursing professional values growth theory (Li and Li, Nursing Ethics In press, 2022), a theory of professional values growth of nursing undergraduates was developed using the method of theory derivation. Two rounds of expert meetings were conducted to review and revise an education framework of professional values of nursing undergraduates derived from that theory.

FINDINGS

A total of 10 studies were included. The contents of two themes were analysed: theories and models and the current status of the professional values development of nursing students. The resulting professional values growth theory for undergraduate nursing students consists of five parts: key aspects, decisive opportunities, drivers, embodiment (humanistic sentiments, moral emotions), and outcomes. A total of five experts in the relevant fields were invited to this study. After two rounds of expert meetings, an education framework for undergraduate nursing students was finally developed, which consists of four parts: education objectives, education process and content, environment and conditions, and evaluation.

CONCLUSION

The education framework developed in this study has practical implications for the development of professional values of undergraduate nursing students, providing educational strategies and methods for the growth and internalisation of professional values of undergraduate nursing students.

Promoting activity and mobility in long-term care environments: A photo-elicitation study with older adults and nurses

AIM(S)

The aim of this research study is to collaboratively generate insights in the current institutional long-term care environment for activity and mobility of older adults, and of solutions that could be used to increase the activity and improve the mobility of the older adults.

DESIGN

This research constitutes a qualitative study with a critical approach.

METHODS

Data were collected using photo-elicitation in four long-term care units in Finland during the spring of 2022. Older adults participated in individual data collection sessions which combined photographing and discussion. Staff members individually took photographs and later participated in a group discussion based on the photographs. Reflexive thematic analysis was used to analyse all data together.

RESULTS

Ten older adults and 12 staff members participated in the research study. Four themes were identified: (1) facilities should be designed and equipped for their users, (2) moving in the institutional environment, (3) passivity as a norm, and (4) nurses should act differently and have the resources to do so.

CONCLUSION

To increase the activity and improve the mobility of older adults, improvements are needed in terms of the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Increased attention to the support of activity and mobility could benefit older adults in institutional long-term care. Physical activity promotion should be incorporated as an integral part of nursing practice.

PATIENT OR PUBLIC CONTRIBUTION

Directors of units were consulted when planning the study. Older adults and nurses contributed to the data collection and interpretation of data.

IMPACT

(ADDRESSING): What problem did the study address? ○Older adults have recurrently been reported as living inactive lives in institutional long-term care. ○There is evidence of the relationship between the environment and the activity and mobility of older adults, but there seems to be a research-practice gap in terms of implementing activity- and mobility-promoting environments. ○Older adults and staff members are important in developing practice and change-oriented knowledge that can be used to increase the activity and improve the mobility of older adults in institutional long-term care. What were the main findings? ○Various environmental improvements are recommended to increase the activity and improve the mobility of older adults in institutional long-term care settings. ○Improvements for the design of facilities, opportunities for freedom of movement, outdoor activity, daily life activities, exercise, nurses' role in activating older adults and resources for activity support would benefit older adults' activity and mobility. Where and on whom will the research have an impact? ○Increasing the activity of older adults requires better activity promotion and mobility support by nurses in institutional care. Sufficient education and resources should be organized for activity promotion, in addition to a care and organizational culture that values activity. ○Environmental aspects to promote activity and mobility need to be considered already at the planning, building and renovating phases of facilities. ○Policymakers and care organizers should consider evidence of the harms and benefits of different institutional living environments when making decisions on organizing care.

REPORTING METHOD

The study is reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Compassion, emotions and cognition: Implications for nursing education

Compassion is often understood as central to nursing and as important to ensure quality nursing and healthcare. In recent years, there has been a focus on strategies in nursing education to ensure compassionate nurses. However, it is not always clear how the concept of compassion is understood. Theoretical conceptualisations that lie behind various understandings of compassion have consequences for how we approach compassion in nursing education. We present some ways in which compassion is often understood, their philosophical underpinnings and the consequences these understandings can have for nursing education. We argue that it is useful for nursing education to understand compassion as a cognitive emotion and discuss how such an understanding can inform educational approaches to compassion.

Sharing the Same Reality, Healthy Relations Between Colleagues at Work: A Meta-Synthesis

Introduction

Good relations are important at work, leading to well-being among coworkers. Since the latest research in nursing is mostly about bullying, and lateral violence, it was important to study what healthy relations mean.

Objectives

The aim was to identify and synthesize qualitative studies that describe healthy relations, creating health and well-being between colleagues at work.

Methods

A meta-synthesis approach, inspired by Sherwood's steps of analysis, was chosen for this study. Ten articles from three continents, comprising 230 participants, were included.

Results

Two themes were identified as follows: (a) creating a mutual bond on a personal level and a permissive atmosphere through the human warmth; and (b) sharing togetherness in a greater whole, offering unconditional help and devoting themselves to taking care of each other. An overarching metaphor implicating the home/homeness was abstracted from the two themes: "Healthy relations between colleagues at work constitute the community as a common world, containing feelings of being at home, implying acting in an expression of the ethos and dignity, a culture created that makes the ideal form of healthy relations visible."

Conclusion

Nurses find their meaning when they work in a permissive environment, and when they are allowed to be themselves. Such meaning can be found through their engagement with one another, by offering each other unconditional help. Good relationships lead to a place they call their home, where there is trust and friendship.

Factors affecting nurses' professional values: A comprehensive integrative review

OBJECTIVES

Values should inform the care every nurse provides. Professional values equally affect patient care and organizational outcomes. In addition, they aid in forming a basis for moral judgments. The aim of this review is to elucidate the whole spectrum of factors affecting the development of nurses' professional values.

DESIGN

An integrative review approach was chosen.

DATA SOURCE

The review included searches in four databases - MEDLINE Complete, CINAHL Plus, ERIC, and Scopus - from January 2015 to November 2021, 572 articles were screened resulting in 35 quantitative and qualitative articles that met the inclusion criteria and passed the critical appraisal.

RESULT

Five major themes and subthemes emerged from the review: Individual determinants was the first theme. Education was the second theme. Experience was the third theme. The fourth theme was nurses' values perceptions. The final theme dealt with the impact of role models.

CONCLUSION

Understanding the power of nursing values as an effective influencer of nursing practice is important because nurses' values can ensure high-quality care and strengthen the professional brand.

Paradoxes, nurses' roles and Medical Assistance in Dying: A grounded theory

BACKGROUND

In June 2016, the Parliament of Canada passed federal legislation allowing eligible adults to request Medical Assistance in Dying (MAID). Since its implementation, there likely exists a degree of hesitancy among some healthcare providers due to the law being inconsistent with personal beliefs and values. It is imperative to explore how nurses in Quebec experience the shift from accompanying palliative clients through "a natural death" to participating in "a premeditated death."

RESEARCH QUESTION/AIM/OBJECTIVES

This study aims to explore how Quebec nurses personally and professionally face the new practice of MAID and their role evolution.

RESEARCH DESIGN

A grounded theory design was used.

PARTICIPANTS AND RESEARCH CONTEXT

We recruited 37 nurses who participated in or coordinated at least one MAID. Semi-structured interviews and focus groups were conducted and audiotaped. Data collection and analysis followed Strauss and Corbin steps.

ETHICAL CONSIDERATIONS

Ethics approval was received from the investigator's affiliated University. Participants were informed regarding the research goal, signed a written consent, and were assigned pseudonyms.

FINDINGS/RESULTS

Results show that nurses experienced the wide range of paradoxe during MAID centering around the following eight elements: 1) confrontation abouth death, 2) choice, 3) time of death, 4) emotional load, 5) new Bill, 6) relationship with the person, 7) communication skills, and 8) healthcare setting. The shifting of views and values in this new role is presented by the contradiction of opposites.

CONCLUSIONS

A better understanding of the paradox experienced by nurses involved with MAID paves the way for the development of interventions.

Addressing the Lack of Professional Values and Behaviors among New Nurses

Professionalism and safety in patient care are concepts nurses are expected to exhibit in practice. High fidelity simulation was explored to assist in teaching students the behaviors needed to succeed in nursing. Nursing leaders identified areas in which graduates struggle, including critical thinking, skills acquisition, time management, role responsibilities, delegation, and effective communication. The project's purpose was to analyze students' perceptions regarding professional nursing values, identify gaps in knowledge concerning professional behavior, and determine perception change of professional values. A pretest post-test simulation intervention was chosen. Improvement in communication and autonomy was noted with statistically significant findings.