Learning opportunities in case studies for becoming a reflective nurse practitioner

Empathy in nurses: Spanish adaptation of the Jefferson scale of empathy (JSE) on nurses

Background: Empathy is a key skill for nurses for providing high-quality care. Aims: To adapt and explore the psychometric properties of the Jefferson Scale of Empathy (JSE) for nursing students in a sample of Spanish nurses, to analyse the empathy levels and to provide some percentiles for interpreting empathy levels. Methods: Factor structure was evaluated with exploratory and confirmatory factor analysis (EFA, CFA), and reliability was evaluated with Cronbach's alpha, composite reliability (CR), and average variance extracted (AVE) in a convenience sample of 500 Spanish nurses. Results: The definitive model composed of 15 items grouped into three factors presented good psychometric properties. Levels of empathy in the sample can be considered high. Conclusion: The study provides a reliable and valid instrument to measure levels of empathy in nurses in the Spanish context. Impact Statement: The instrument is suitable for assessing educational needs, and evaluating the effectiveness of training programmes.

Mental health nurses and mental health peer workers: Self-perceptions of role-related clinical competences

In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.

RN-BS Students' Reports of Their Self-Care and Health-Promotion Practices in a Holistic Nursing Course

PURPOSE

This study explored RN-BS students' self-care and health-promotion (SCHP) practices in a semester-long holistic nursing course with emphasis on the utility of self-reflection through journal writing.

DESIGN

A qualitative single case study blended in practical action research.

METHOD

Fifteen RN-BS students enrolled in the holistic nursing course completed (a) three reflective journal entries (beginning, midterm, and conclusion); (b) two IHWA-short form surveys (beginning and conclusion); and (c) one demographic form (beginning) of the course.

FINDINGS

Three reflective journals indicated that students' understanding of their SCHP practices progressed from novice, to advanced, and finally to competent from the beginning, middle, and at the conclusion of the course. Four findings emerged in relation to reports of their SCHP practices: (a) new awareness of self, (b) application of SCHP practices knowledge, (c) role modeling, and (d) dedication to SCHP practices beyond the semester. Four findings emerged in relation to participation in the reflective journaling about reports of their SCHP practices: (a) self-discovery, (b) retrospective self-evaluation, (c) useful intervention for SCHP, and (d) beneficial learning tool in academic environment.

CONCLUSIONS

Reflective journaling enhanced students' SCHP practices and was recognized as useful instructional strategy to improve learning in the classroom.

Learning to attain an advanced level of professional responsibility

BACKGROUND

After graduation, nurse practitioner students are expected to be capable of providing complex, evidence-based nursing care independently, combined with standardized medical care. The students who follow work-study programs have to develop their competencies in a healthcare environment dominated by efficiency policies.

OBJECTIVE

This study aims to explore nurse practitioner students' perceptions of their professional responsibility for patient care.

METHOD

This qualitative interpretative study entails a content analysis of 46 reflective case studies written by nurse practitioner students.

FINDINGS

The students felt responsible for the monitoring of patients' health status, attending to psychosocial problems, emphasizing compliance, and optimizing the family's role as informal caregivers. At the same time, students struggled to understand the complexities of their patients' needs, and they had difficulty applying their knowledge and skills to complex medical, psychological, and social problems.

CONCLUSION

The students' perceptions of their new responsibility were characterized by a strong focus on curative care, while psychosocial components of health and illness concerns were often overlooked. The students experienced difficulties in meeting the criteria of advanced practice nursing described in the Dutch competency framework.

Learning transitions-a descriptive study of nurses' experiences during advanced level nursing education

Background

Building capacity in a changing health care system is a challenge for advanced nursing education programs. Master-level nursing education is increasingly becoming the required education level for specialist nurses, and additional studies are needed to learn more about students’ experiences and learning transitions while undertaking such education. This study aimed to explore nursing students’ experience of their learning transitions while undertaking advanced nursing education and to describe how they translated the new knowledge and competence they gained into clinical practice.

Methods

We used a qualitative research design with narrative self-reported reflections. 34 nurses (95 % women) from both urban and rural areas working with children, with adults in outpatient and inpatient endocrinology clinics in hospitals or with adults, including older people, attending primary health care services participated in the study. We collected data at two time points 15 months apart. Time one was the first week of the advanced nursing education, and time two was the completion of the education program. We used Malterud’s modification of Giorgi’s phenomenological analysis, otherwise known as systematic text condensation, to analyze the data.

Results

Two core themes captured the participants’ experiences. The first theme was “assessing the situation of people with diabetes from a different perspective”, with the subthemes “an expanded perspective of practice and higher level of reflection”, “applying critical thinking in practice” and “changing patient-nurse relationships in diabetes care”. The second core theme was “a change in participants’ perception of their professional position”, with the subthemes “a greater knowledge base enhancing professional confidence” and “a more equal position within the professional team”.

Conclusions

The study provides in-depth information about transition into advanced nursing education and can inform curriculum developers, nurse educators, policy-makers and nursing managers about how nursing education broadened participants’ perspectives of nursing and enhanced their confidence and professional position.