Progressing toward specialty certification as the National Standard for Nursing

Nursing specialty certification is an objective measure that assures the public that nurses demonstrate the highest level of professional knowledge in their field. Many nurses do not seek specialty certification, as evidenced by low certification rates. In this creative controversy article, we build a case that progressing toward nursing specialty certification as a national standard will increase overall nursing professionalism while better preparing nurses to meet the needs of their specialty patient populations and the changing health care system.

Current State of Pain Resource Nurse (PRN) Programs and Experiences of PRNs in China

BACKGROUND

Since the 2010s, the Pain Resource Nurse (PRN) program and similar programs have been introduced in Chinese hospitals. However, the status of the PRN program and nurses' experiences in these programs remain unclear.

AIMS

The aim of the study was to identify the factors related to PRN programs and explore PRNs' experiences being part of the program.

DESIGN

A combination of descriptive cross-sectional and qualitative methods was used in the study.

SETTINGS

Thirty-two hospitals in the eastern, central, and western regions of China.

PARTICIPANTS/SUBJECTS

Twenty-four PRNs who had been PRNs for 6 months or more.

METHODS

A purposive sample of 32 hospitals from eastern, central, and western regions of China carried out a PRN or similar program for more than 1 year with at least five bedside nurses from different nursing units were enrolled in the descriptive cross-sectional study. The questionnaire was designed by Brown's advanced nursing practice framework theory. A total of 24 PRNs who had been PRNs for 6 months or more participated in the interview by convenience and purposive sampling.

RESULTS

The mean number of PRNs in a program was 30.12 ± 17.93 (range 5-74). The role of the PRN was broader compared with that of bedside nurses, and it included pain management, training, and education. The most common reason for hospitals to establish PRN programs was to improve the quality of pain management (n = 28, 87.5%). Administrative support (n = 28, 87.5%) was a major supportive factor for PRN programs and lack of physician support (n = 28, 87.5%) was a barrier. Although all hospitals provided training, those with knowledge assessments after training indicated a significant improvement in the desired PRN functions compared with those that did not (p < .05). Personal interviews revealed that the reasons for becoming a PRN varied and included considering PRN as a career opportunity, personal interest, passively accepting the designation, and being a PRN temporarily. The positive professional experiences of being a PRN included an increased sense of self-worth and accomplishment and growth in a specialty, whereas the negative experiences included frustration with the work environment and resignation because of extra workload.

CONCLUSIONS

The hospital survey results indicated that the PRN program in China is still in the early development stage. The PRN interviews suggest that being a PRN involves both positive and negative experiences.

Reflections on nurse education: past, present and future

Janet Scammell, Associate Professor (Nursing), Bournemouth University, reflects on the changes in nursing that she has seen since beginning her nursing career 40 years ago.

Acute oncology: a developing sub-specialty

Patients with cancer frequently present to hospital as an emergency admission acutely unwell. Patients can suffer from complications of the cancer itself, or significant adverse effects/toxicities related to their cancer therapy. Alternatively, the initial presentation of the malignancy may be through a hospital admission, and the cancer can frequently be widespread and with a poorer prognosis. Patients are often admitted under general physicians, away from their comprehensive cancer care centre or oncologists. Without specialist input or staff adhering to most appropriate pathways, the management of these complicated conditions may be difficult, with patients sometimes having unnecessary and painful investigations and prolonged hospital stays. To address these issues the concept of an acute oncology service has recently evolved. This is a developing sub-specialty that aims to improve the care of cancer patients presenting acutely to hospital at a devastating time in their lives. This article will explore the literature to describe the recent development of the acute oncology model, and consider different methods for the delivery of this service.

Evidence-based practice readiness of ASORN members

Due to the importance of evidence-based practice and its impact on patient outcomes, a research study was conducted in early 2013 soliciting participation of ASORN members. Findings indicate the collegiality and curiosity of nurses, who identify a gap in practice due to lack of knowledge/skills and organizational barriers. Since nurses value EBP and research, as noted in study findings and ASORN Board of Directors support, efforts to advance the art and science of ophthalmic nursing will continue in the future.

Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives

Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice.

Developing clinical research nurses

Clinical research nurses have a unique role in developing and contributing to high-quality care. This article discusses key policy recommendations on their support and development, and outlines a local project exploring the issues that research nurses face. It also makes recommendations to improve these nurses' training and profile.

Specialist nursing training in Poland: applications for neuroscience nursing

BACKGROUND

Nurses have a pivotal role in providing facilitating, advocating and promoting the best possible care and outcome for the client. To ensure decisions and actions are based on current standards of practice, nurses must be accountable for participation in ongoing education in their area of practice.

AIM

To present a description of the current state of Polish nursing education and specialized model for neurological and neurosurgical nursing that can be utilized for both undergraduate and postgraduate continuing education in Poland.

DATA SOURCES

The model of postgraduate training introduced in Poland in 2000 was taken into consideration in developing the framework for neuroscience nursing postgraduate continuing education presented here. The framework for neurological continuing education is also based on a review of the literature and is consistent with Poland's legally binding professional nursing regulations (normative and implementing regulations).

CONCLUSION

The model demonstrates the need for the content of pre- and post-undergraduate degree education in neurological nursing to be graduated, based on the frameworks for undergraduate education (acquiring the knowledge and basic skills for performing the work of nurses) and postgraduate education (acquiring knowledge and specialist skills necessary for providing advanced nursing care including medical acts on patients with nervous system diseases).

IMPLICATIONS FOR NURSING

New and advanced skills gained in specialization training can be applied to complex functions, roles and professional tasks undertaken by nurses in relation to care of patients with neurological dysfunctions.

A survey evaluating the current role of the nurse practitioner in urology

The role of the nurse practitioner (NP) continues to expand into the care of specialty populations. This article presents results of a survey that allowed NPs who self-identified as working specifically with people diagnosed with urologic conditions to describe their clinical role. The purpose of identifying NP-specific clinical tasks was to provide evidence to be used in revising the urology specialty certification examination for NPs.

Every nurse needs to know about learning disabilities

Professor Alan Glasper says the Royal College of Nursing's position paper on learning disability nursing will remain aspirational; the number of these nurses is declining and is set to fall further. These patients present in all settings, so all nursing courses should cover meeting their needs.