Differentiated nursing practice

This study's purpose was to explore, through a descriptive method, the registered nurses' experience of being assisted in practice by multiskilled personnel for the provision of direct patient care. The multiskilled personnel were unlicensed, functioned in an assistive role to the nurse, and were trained at the hospital to perform technical direct patient care tasks. Data sources included interviews with three registered nurses. Study findings supported the existence of a caring nurse-multiskilled assistant relationship that was characterized by the concepts of communication, task responsibility, reciprocal helping, respect, commitment to a shared goal, and nurse leadership. Through a dialectical process, where the thesis was the nurse-patient relationship as identified in the study and the antithesis was the multiskilled assistant-patient relationship, the nurse-multiskilled assistant-patient relationship was synthesized. The study findings in relationship to previous studies, team theory, and Nursing as Caring theory were discussed.

The purpose of this study was to explore, through a descriptive method, views of registered nurses and unlicensed assistive personnel about their roles. Data sources included interviews with three registered nurses and three unlicensed assistive workers practicing in partnership on an acute patient care unit. Study findings supported role theory assertions that role strain and stress, manifested as role ambiguity, role confusion, role overlapping, and role overload occur when the role transition process and role expectations are not clarified or nurtured among role partners. Implications for nursing practice include the following: (1) Nurses in clinical and administrative practice need to be sensitized to the importance of nurses and ancillary personnel being active participants in the work redesign process, and must support the value of caring that transpires in the nurse-patient relationship. (2) Role theory can be utilized to understand dynamics that occur in work settings of nurses and assistive partners.