Winland-Brown, Jill

Rapid social and economic changes are modifying health care delivery systems and health care financing. These changes require that primary care physicians develop new collaborative approaches to patient care, including a reassessment of relationships with other primary care providers, particularly nurse practitioners. The purpose of this research was to explore and define what constitutes a successful collaborative practice. Open-ended, interactive interviews were conducted with three dyads of physician - nurse practitioner in the ambulatory care setting. Data analysis using the grounded theory method revealed six key elements associated with effective collaborative practice: Communication, competence, autonomy, coordination, trust and personality. This research contributes to clarification of the barriers that hinder a collaborative practice and suggests many benefits derived from such a practice. The findings of the study may inspire other health care providers to enter a collaborative practice to achieve excellence in patient care. Ethical decisions cannot be achieved by a single care provider, but rather require the expertise and unique abilities of both physician and nurse practitioner.

This study presents information on the effect an organ procurement coordinator had on referral rates made by emergency room nurses. Retrospective data were analyzed after a period of eight months of data collection. These data included a pre-test/post-test which was given to emergency room nursing staff in southeast Florida. Inservice education was given by an organ procurement coordinator during an eight month period. The number of referrals were analyzed at the beginning and end of this period. There was a positive correlation between the increased knowledge of the emergency room nursing staff and the increase in referral rates. This information gives support to the significance of the organ procurement coordinator's role as educator to emergency room nurses. By increasing knowledge regarding the organ donation process, referral rates were increased, providing more opportunity for potential organ donors. This information can be useful for future programs to increase referral rates made by emergency room nurses. Further implications for practice, education, and research are discussed.

This research study, utilizing Colaizzi's phenomenological method, examined the clients' perspective of a caring interaction between a nurse and client during cardiac catheterization. Eight participants described their experience of a caring interaction with a nurse during cardiac catheterization. Formulated meanings were derived from their significant statements and then grouped into themes. Three common themes emerged to form the essence of caring. The ingredients for a caring interaction included connecting through genuine presence, being there through technical competence, and caring as a way of seeing through verbal communication. By providing an understanding of the clients' perspective, this study will benefit the nursing profession and contribute to the foundation of a theory based practice for the care of the client who has experienced cardiac catheterization. This practice will be grounded in the caring philosophy.

This study explored the lived experience of choosing a healthier lifestyle. Using van Manen's methodology for researching lived experience, five participants described their experiences of the phenomenon. Four essential thematic structures were identified: (a) Conscious Choice; (b) Self Discovery; (c) Goals, Expectations, and Benefits; and (d) Validation and Motivation. Three incidental thematic structures were identified: (a) Resources, (b) Events, and (c) Addiction. A descriptive paragraph was written from the significant statements and a metatheme emerged for the phenomenon. The metatheme for the experience of choosing a healthier lifestyle was written as the phenomenological statement: The lived experience of choosing a healthier lifestyle is a conscious choosing of how to be in the world, and the actions taken to fulfill and sustain that desire.

This research study addresses the personal, professional and organizational values held by nurse administrators, utilizing the phenomenological method of Paul Colaizzi (1978). The study investigates the values of eight nurse administrators in two acute care hospitals. Based on the significant statements which were formulated into clusters of themes and the formulation of essential values and themes, three common values emerged: communication, education, and honesty. A better understanding of these values will help guide nurse administrators in their current roles.

This study describes the experiences of nursing students with disabilities through interviews, observations, and document analysis. The sample included five current students and five graduate nurses with physical or auditory impairments and 61 nursing faculty members, staff members, patients, and fellow students. The Colaizzi (1978) method of data analysis was modified to include additional information from interviews, observations, and documents. The findings revealed important concerns related to potentially unsafe nursing practice. The findings should assist nursing faculty with admission and retention decisions and development of reasonable accommodations. Recommendations for nursing programs to develop enforceable guidelines for admission and state regulatory boards of nursing to consider licensure with practice limitations are included.