Preparing RNs for Primary Care: Value Added

The U.S. health care system needs a fundamental redesign, as the current model of care is not meeting the needs of the population for primary care. Factors affecting the primary care workforce include a decrease in primary care providers, an increase in the aging population with limited health insurance, and a decrease in health care access. With the current emphasis for primary care redesign and team-based care, RNs practicing with an expanded role are in a unique position to address the primary care crisis. However, limited data exist on the academic and clinical preparation of RNs to practice in an outpatient or primary care setting. This article describes an educational program for RNs hired to work in an expanded role in a primary care setting. [J Contin Educ Nurs. 2021;52(2):100-104.].

Critical care nurses' critical thinking and decision making related to pain management

OBJECTIVES

The current study aimed to examine nurses' critical thinking and decision-making skills related to pain management and their association with nurses' characteristics.

RESEARCH METHODOLOGY/DESIGN

This descriptive correlational study used a convenience sample of 115 critical care nurses working in a university hospital in Jordan. Data were collected using a pain-related vignette and validated questionnaires.

MAIN OUTCOME MEASURES

The Critical Thinking Self-Assessment Scale and the Nursing Decision-Making Instrument were used to measure the nurses' critical thinking and decision-making skills, respectively. As a secondary outcome measure, data regarding the sociodemographic/professional characteristics of the participants, including gender, marital status, experience, education and work environment, were collected.

RESULT

The participating nurses reported poor critical thinking and intuitive decision-making skills related to pain management. Nurses with more clinical experience and higher levels of education reported significantly better critical thinking and intuitive decision-making skills than less experienced and less educated nurses. Nurses with intuitive decision-making modes reported significantly better levels of critical thinking than nurses with analytical or flexible analytical-intuitive decision-making modes.

CONCLUSION

Critical care nurses were found to have ineffective critical thinking and intuitive decision-making skills related to pain management, which may lead to poor patient outcomes. Gaining more in-depth understanding of nurses' critical thinking and decision-making skills and their associated factors is crucial for achieving effective pain management in critical care settings.

Burns pain management: The role of nurse-patient communication

BACKGROUND

Nursing is an embodiment of knowledge, clinical work, and interpersonal communication. Effective nursing care has a distinct influence on the overall satisfaction and experience of the patient. Communication is said to be indispensable in the delivery of quality healthcare. Effective communication between nurses and patients has proven to yield better results with pain control and improved psychological status of patients.

OBJECTIVES

The aim of the study is to explore nurses' perceptions on the role of communication in the management of burns pain.

METHODS

A qualitative design with purposive sampling was carried out to recruit 11 registered nurses from a Reconstructive Plastic Surgery and Burns Center in Ghana. To identify the participants' perception on the role of nurse-patient communication in the management of burns pain, a face to face semi-structured interviews were conducted using an interview guide to collect data.

RESULTS

Thematic analysis was done with various themes emerging. Helping patients manage pain, early detection of patient's distress, improved patient participation in their care were some of the positive effects of nurse-patient communication whiles reduced level of cooperation during caregiving, and endurance of pain by the patient were the results of poor nurse-patient communication. Language and time factor were the barriers that were identified to hinder effective communication between nurses and patients.

CONCLUSIONS

Due to the subjective nature of pain, the current study highlights the need for increased communication for an effective assessment and management of pain among patients with burns. It is, therefore, imperative that nurses be well trained in communication with an emphasis on patient-centered communication.