Nursing services

The purpose of this study was to identify nursing values from lived experiences of six nurses during interactions with patients. Nurses employed by nursing agencies were asked: "describe an interaction you have experienced with a patient that best represents your nursing values". Giorgi's method of interpretation for phenomenological studies was used to analyze the stories. From each participant's specific values a general description of the structure of all participants' values was generated. Caring was the predominant value that emerged and encompasses nursing practice and the compassionate action it teaches. Concepts emerging from the study are living and learning of values, unpretentious presence, and caring as the ascendent value in nursing practice. Recommendations for future study include exploration of these concepts toward development of a value based nursing practice to increase job satisfaction and self-esteem for nurses recognizing their values.

Within the current context of the healthcare environment, the charge nurse role has become very important for safety and positive outcomes. There is little known about the role from the perspective of the charge nurse. This qualitative descriptive exploratory study examined the experience of being a charge nurse in acute care practice, and describes how charge nurses live caring in their support of nurses and patients. Ray's (1989, 2006) theory of Bureaucratic Caring, Swanson's (2008) caring attributes and leadership, and Boykin and Schoenhofer's (2001) theory of Nursing as Caring provided the theoretical lenses through which study findings were viewed. Semi-structured interviews were conducted with 20 charge nurses in 4 acute care facilities. Eight themes emerged from an inductive analysis of the data describing the experience of being a charge nurse in acute care practice: Creating a Safety Net, Monitoring for Quality, Showing the Way, Completing the Puzzle, Managing the Flow, Mak ing a Difference, Putting Out Fires, and Keeping Patients Happy. Participants also were asked questions about how they provide support to staff nurses and patients. Themes that reflected how charge nurses live caring in their support of staff and patients were: Jumping in the Trenches, Nurturing Staff Growth, Offering Authentic Presence, and Looking after Nurses. Additionally, the researcher used methods of narrative inquiry to get the participants to share stories of how they lived caring in their support of nurses and patients. Recommendations included the need to elevate the visibility of the charge nurse role and its importance to the organization, and provide support for leadership development. Job descriptions and competencies for charge nurses must reflect the complexity of the environment.

The purpose of this study was to explore what keeps nurses in nursing by examining the impact of the relational experiences between the nurse and her or his patient in the context of the nursing situation. Heideggerian hermeneutic phenomenology grounded the study and was the method used to interpret the registered nurse participants' meaning of their everydayness. The nurses' first hand perspectives elicited implications for nursing practice. This qualitative research study examined what keeps nurses in nursing. The eight registered nurse participants provided rich descriptive data from which four relational themes emerged: Practicing from Inner Core Beliefs, Understanding the Other from Within, Making a Difference, and Nursing as an Evolving Process. The hermeneutical interpretative process guided the researcher to synthesize the themes into a constitutive pattern of meaning which the researcher named Intentional Compassion Energy. In intentional caring consciousness, the nurse intentionally knows the nursed as whole. Compassion energy is the intersubjective gift of compassion that gives nurses the opportunity to be with the nursed. Compassion energy is composed of compassionate presence, patterned nurturance and intentionally knowing the nursed and self as whole. Thus, intentional compassion energy is defined as the regeneration of nurses' capacity to foster interconnectedness when the nurse activates the intent to nurse. Intentional compassion energy was discovered in the meaning of the nurse participants being in their everydayness of practice. The participants described the intention to care compassionately as the grounding of their practice, striving to understand the other, to make a difference while living their nursing as an evolving process. Hermeneutic phenomenology provided the opening to discover what keeps nurses in nursing.

A new role has been developed in nursing named the Clinical Nurse LeaderSM (CNL®). This new role positions the masters prepared nurse at the patient's bedside to oversee care coordination and serve as a resource for the clinical nursing team, and to bridge the gaps in health care delivery to better meet the needs of patients in all health care delivery settings. Since this is a new role, there is a paucity of research that has been conducted surrounding these nurses. A phenomenological investigation examined the lived experiences of CNLs® to gain understanding about the meaning of leadership at the point of care and to discover the unique expressions of living caring that CNLs® experience as they embark upon this new role in the acute care hospital setting. Ten CNL® participants were interviewed for this study. Their stories about patient situations and relationships with other disciplines were shared with rich description and emotion. Hermeneutic analysis of the text revealed six essential themes. Six essential themes emerged revealing the essence of leading at the bedside and living caring in the CNL® role: navigating safe passage, pride in making a difference, bringing the bedside point of view, knowing the patient as person, helping nurses to grow, and CNLs® needing to be known, understood and affirmed. Taken as a whole through a synthesis of the themes, the understanding of the meaning of leading to CNLs® includes keeping their patients safe, being proud of their accomplishments and the respect gained from others, as well as being a helper and advocate for other nurses.

Professional competence is expected of all nurses in practice. Although new nurses have met the competency requirement for practice legally, opinions vary among new nurses and nurse administrators as to whether new nurses are indeed competent to practice nursing. The purpose of this phenomenological research study was to learn what new nurses think about professional competence. The research question guiding this study was, "What is professional competence from the perspective of newly licensed registered nurses?"