While spirituality is widely used in alternative medicine today and in some cases careful studies proved their benefits, it has been neglected in the nursing practice. Since the claimed philosophy of practice today is holistic, without the spiritual component the holistic practice will be fragmented.
In a study dedicated to spiritual practice in psychiatry the following was sited:
“Practicing nurses today are continually confronted with issues of cultural and spiritual diversity. Although nurses claim to use a holistic approach to patient assessment, the spiritual aspect is often forgotten (Saudia, Kinney, Brown, & Young-ward,1991). Taylor, Amenta, and Highfield (1995) emphasized that “lack of time, a focus on physical needs, low nurse/patient staffing ratios, and high patient acuity also may interfere with the provision of spiritual care” (p.31). Many of the problems noted by Taylor et al. (1995) could be decreased, if the spiritual aspect of care were viewed by the administration of psychiatric facilities as essential to the well-being of the client.
Despite the fact that primary care replaced team nursing in 1960s, the choice between the two modes needs further research since the practice of the profession has changed considerably with the advances of technology.”(McRoberts et al, downloaded on 10 October 2006 from: http://www.graduateresearch.com/mcroberts.htm)
In my research I am going to investigate the feasibility of using spirituality in patient care and identify the best approach to integrating the spiritual practice in the holistic approach to patient care. It will also be one of the objectives of this research to identify the training needs of the nursing staff when spiritual practice is implemented.
My methodology for this research will be a move from literature review to empirical research applied in the workplace. It might be necessary to experiment in more than one site. However, this will be decided at the research design stage considering practical issues including number of RNs and LPNs and patients in different wards to be involved in the study. Experimentation will be carried out in different wards using experiment group of patients and control groups who do not receive the spiritual care.
The patient’s perception of the nursing image of professionalism, based on the clothing worn by the nurse
The uniform worn by nurses is intended to play a number of roles. Firstly it is an identification for the nurse, not only for the patient but for any member of the public who comes to the hospital. In the UK for example people who need to be in the hospital can easily identify the nurses, the sister, the student nurse etc. from the uniforms style, colour etc.
The uniform also creates a professional first impression, convey trust and credibility. Moreover it has “an underlying psychological effect acknowledging that a dress does not have a gender, but denotes attributes of feminity, nurturing and caring, akin to nursing. In the same sense, it enhances and reinforces this image to the public, and in return the public fully support their nurses, a trait often called upon in industrial disputes.” (David and Dee, 2002)
Today, may be with the influence of TV programmes, tunics and scrubs are noticeably increasing and are justified by the claim that they are more practical. There is no doubt about the importance of a uniform for the profession of nursing. However, what needs to be studied and investigated is the perception of patients. How are they affected by the uniform and is care influenced by the uniform.
In this research I am going to study the perception of the patients about the uniform and how they relate this to the care provided by the nurse, trust in her professionalism and respect of her decisions.
The questions to be answered are: a) Does the dress make me distinct from nurses working in other units? b) Does the patient accept me as the trusted caregiver when I am in uniform or without though he can identify me personally? c) Does the uniform cover me from accidental or incidental physical exposure and protect me from avoidable embarrassment? d) Does this dress augment my professional disposition? etc.
Methodology of the research will be literature review and empirical research in the work place. Data to be analyzed will be collected by interviews, questionnaires and observation.
Practice in Intensive Care Unit and Hospital Wards: Does the differences in Job descriptions justify a difference in working hours?
Professional practice for nurses in intensive care units are thought to be more challenging and demanding than in other wards of the hospital. Because of the critical conditions of the patients the nurse on duty in the ICU is always alert and on the run. More importantly decision making in the ICU may be more difficult and stressful. The patient himself is also more demanding (when conscious) and requires special psychological handling.
This environment of practice added to the caution needed to avoid lawsuits make the professional practice in the ICU unusual and different to that of the classical wards in the hospital. Therefore, a working schedule of, for example, 8 hours in both places is thought to be unfair.
However, all these are observations and personal opinions of people involved. Therefore, it is necessary to carry out empirical research in order to confirm or rule out the hypotheses:
Working in the ICU is more stressful and puts a lot of pressure on the nurse that she should not work the usual shift hours.
Working in the ICU is almost similar to working in the traditional hospital wards and should not justify a change in the number of hours covered in one shift in the ICU?
My methodology will be a literature review followed by empirical research experiments on nurses working in the ICU and those who work in the traditional wards. How to obtain the data to be analysed will be detailed at the design stage.