Warner, Marguerite

The purpose of this research was to explore and describe nurses' perceptions of their ability to interact with families under a variety of circumstances in the intensive care unit. Bandura's theory of self-efficacy (1986) provided a framework for the study. Twenty-six critical care nurses ranked their experiences and perceived self-efficacy on a list of twenty situations of family-nurse interaction. Information about years of experience in critical care nursing, personal experience of family illness, and family nursing courses was also gathered. The results of this study suggest that nurses' sense of self-efficacy varies with the circumstances of family-nurse interaction. Level of self-efficacy was also significantly related to nursing experience with families and to previous family course work. This study has implications for nursing administration, education, and practice. Suggestions for further research are also made.

The purpose of this study was to describe the practice of nursing and the factors that influence nursing practice in one patient care setting where the Director is not a nurse. A qualitative design employing the methods of grounded theory was utilized. Reaching for Completeness was the core concept that emerged from the analysis. Reaching for Completeness describes the directionality of nursing practice in this setting. It includes: coming to Know the Client, Responding to the Immediate Needs of the Client, and Pulling it All Together. Factors that appeared to influence the practice of nursing in this setting were the management styles of the director and nurse manager, shared expectations of professionalism, and a shared sense of satisfaction in what the patients and staff accomplished together each day. The results of this study suggest that the main factor affecting the development of nursing practice in a patient care setting may not be whether the director is a nurse, but rather, whether nursing retains ownership of the practice of nursing.