Dissertations / Theses on the topic 'Nurse communication'

The process of how nurses work in relationships to accomplish their work is presented in this dissertation. This study has made the relational work process of nurses explicit. While research demonstrates that increased nurse staffing is associated with better patient outcomes and with nurses experiencing less burnout and job dissatisfaction, the process is not explored in the empirical literature. The research question was: “What is the process of relational work of the nurse?” Data collection and analysis conformed to the process of classical grounded theory. Interviews were face to face with 23 registered nurses working as direct care staff nurses on inpatient units. Data analysis (constant comparison) occurred concurrently with data collection.

The core category, Coming Together to Get Through, emerged from the data as how nurses worked collectively to accomplish their work. Without the help from their nursing, and physician, colleagues they could not finish each day’s work completely and do the best for their patients. The ten temporal categories of the process are: Spending Time, Knowing Other Nurses and Doctors, Asserting Authority, Trusting and Respecting, Being Approachable, Relying on One Another, Needing Each Other, Helping Each Other, Getting the Work Done, and Did the Best for Our Patients. This is the first study to empirically discover a basic social process that demonstrates how the nurse works in relationships. The importance of social and relational constructs and their creation in an organization posits relationships as work and the building blocks of work in organizations. Discovery of this substantive theory of relational work allowed for conceptualization of an explicit work process. This empirical knowledge fills a gap in the literature that may affect appropriate staffing levels which in turn impact both patient and professional outcomes. Future research will focus on creation of a scale of the relational work of nurses, the process of interprofessional relational work, and if high levels of relational work are a pathway to decreased levels of moral distress and burnout, as well as improved professional satisfaction, and better patient outcomes.

Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg’s, Vroom’s, Yetton’s, Maslow’s, Benner’s, and Kahn’s motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and engagement elements using structured interviews of 21 ED nurses from three hospitals of varying sizes and capabilities and included three generational cohorts of Baby Boomer, Generation X, and Millennial RN. Interview analysis showed distinct similarities and differences in nurse satisfaction and work engagement with a consistency in job engagement with no distinct differences among generations. Distinct findings included persistent lack of staff resources, poor communication from leaders, and compassion fatigue among staff. Findings reflected strong interpersonal relationships, teamwork, autonomy, and a strong sense of accomplishment among nurses. Findings indicate that satisfied nurses have improved outcomes, produce happier customers, and feel a sense of accomplishment in the job performed. The positive social impact of this study is in providing guidance on retaining ED RN to provide adequate staffing levels for safe, quality healthcare.

This grounded theory study describes how Nurse Practitioners (NPs) provided care to Aboriginal people in British Columbia and proposed a theoretical foundation to guide NPs interactions with Aboriginal people in providing healthcare. This study first explored NPs work with Aboriginal people. Through analysis of interview responses, insight was gained into how NPs provide care to Aboriginal people. Fourteen NPs who worked with Aboriginal people in British Columbia for at least one year during the past five years were interviewed. After each interview data were manually coded for concepts and categories from which to build theory. Memos were written for further clarity and participants were asked to verify whether or not identified concepts and categories worked, fit, and were relevant and modifiable as new data arose. The theory, Engaging Mutually, identified core categories of Initializing Engagement, Sympathetic Mutuality, and Therapeutic Enlightenment as being connected and working together to help provide effective health care. Engaging Mutually was identified as relevant to the theories of oppression, motivational expectancy, social justice, social cognitive, cultural competency, and Watson’s caring theory. The significance of this study was to assist NPs to gain a better understanding of how to work with Aboriginal people to improve their health. This study contributes to research, theory, leadership, and nursing and NP practice. Engaging Mutually may assist NPs and other health care providers to develop appropriate health care practices when working with Aboriginal people and potentially with people from other cultures.

The role of information technology within health care is getting more central and prominent. The purpose of this change is both to make the health care more efficient and to heighten patient safety. This exploratory case study of four care units aims to provide a glimpse into the clinical work of nurses, and to indentify and describe their communication and information needs. The analytical framework used in this study is distributed cognition and the research method used is cognitive ethnography. The study provides a peek into the complex system of health care, and how the central artifacts such as patient records, whiteboards and different alarm systems are used in this context. The result of the study describes the current work practices and information flows in the studied care units. From these results general system design implications are made.

The aim of the study was to investigate nurses’ perception about patients’ participation in medicine treatment and how to make the patient participate. A qualitative method was used and six nurses were interviewed. The nurses’ perceptions of patients’ participation in medicine treatment were characterized especially by patients having good knowledge about their medicines. Therefore, the nurses considered it important to be well-informed about the effect of the medicines. Furthermore, everyone believed that giving information on the basis of the patient’s knowledge-level and answering questions from the patient were important nursing care. The result was considered a less anxiety and more satisfied patient who is compliant to medicine prescription, so that unnecessary hospital admissions could be avoided. However, information is occasionally followed-up. Other measures were to explain and give motivation for treatment. The nurse is available to the patient and notices effects of the treatment that can be drawn to the doctor’s attention. The way to communicate and cooperate with the patient is considered important but dialogue is not common and sometimes the patient’s opinion is not requested. Moreover, it happens that the nurses prove to have a paternalistic attitude. Obstacles that were mentioned were lackof time, dementia, certain diseases and urgent situations. The nurses meant that respect should be shown if patients do not want to participate. Conclusion: The patient participation and influence ought to be strengthening by the nurses’ attitude of the advantage that the patient participates in his own care. Wrong approach by the nurses need to be changed in favour of patients influence. Besides, all leaders at all levels in the healthcare sector, need to be organized in order to facilitate patient participation of the best quality.

Att drabbas av afasi kan innebära att en högst mänsklig förmåga går förlorad, vilket kan begränsa patientens kommunikationsmöjligheter. Därmed ställs högre krav på den icke verbala kommunikationen. Vårdpersonal beskriver svårigheter att skapa förståelse i denna form av kommunikation. Till följd av detta blir samspelet lidande och omvårdnaden kan därför inte anpassas till den unika människan. Syftet med denna litteraturöversikt är att belysa och sammanställa befintlig forskning, som beskriver hur olika icke verbala kommunikationsvägar integreras, i omvårdnaden till patienter som drabbats av stroke med afasi som följd. I metoden genomfördes sökningar i databaserna Cinahl och Medline. De 12 artiklar som inkluderats har kvalitetsgranskats och analyserats enligt Friberg (2006). I resultatet beskrivs hur den talande kroppen, stödet till den unika människan, kroppslig beröring och relationen har betydelse för förståelsen i den icke verbala kommunikationen. Diskussionen kretsar kring hur denna förståelse kommer i samspelet, för att se den unika människan och skapa relationen som ger stöd utifrån människans förutsättningar här och nu. De fyra kategorier som framläggs i denna studie kan öka kunskapen inom det fenomen som studerats och lägga grunden för vidare studier på området.

To suffer from aphasia could mean that a most important ability of human nature is lost and could therefore restrict the patient's communication ability. Therefore a higher standard is of importance in the non-verbal communication. Health professionals describe difficulties in understanding this form of communication. This causes disturbance in the interaction and nursing care cannot be adapted to the unique human being. The purpose of this literature review is to highlight and summarize existing research, describing how the various non-verbal communication channels are integrated, in nursing care to patients affected by stroke and aphasia. In the method of this literature review searches were made from the databases Cinahl and Medline. The 12 articles that were included has been quality examined and analyzed according to Friberg (2006). The results describe how the speaking body, support for the unique human being, bodily contact and relationships are important for the understanding of the nonverbal communication. The discussion revolves around how this understanding is formed in the interaction, to be able to see the unique human being and create relationships that provide external support for the human needs here and now. The four categories that are presented in this study may increase the knowledge of the studied phenomena and could also be the ground for further studies in this area.

Objective: From the patient’s perspective describe communication difficulties, which can arise, and how they are handled in their contact with public health care and illustrate their needs of communication.

Method: A study of literature was carried out to receive a background and an insight in previous research concerning the subject area. Twelve women with hearing loss was asked to complete a questionnaire, with open questions, regarding communication difficulties in health care situations.

Sample: For the literature review, scientific papers were selected via the database, PubMed using relevant keywords. Seven were selected for closer review. For the survey study twelve women were asked to participate which ten of those responded.

Results: The study of literature shows that communication difficulties occur in public health care between patients with hearing loss and the nursing staff. These are mainly due to lack of information, lack of knowledge and comprehension regarding hearing disorders. Also, there is a lack of knowledge about methods in communication and factors regarding environment and surrounding. This affects the patients with a not sufficient quality of the care in comparison with the care for hearing patients. The causes of communication problems above are confirmed by the questionnaire study. Most of the participants experienced insecurity in their contact with public health care due to communication difficulties and they expressed that they often meet unsympathetic nursing staff. This can create dejectedness among the patients. The results from both literature review and the survey shows that education to all nursing staff, regarding communication and meeting of patient with hearing loss, can solve the problems.

Conclusions: Special education efforts to nursing staff regarding communication with patients with hearing loss are needed. That can give conditions to the health care service to achieve the goal about a good and high qualitative care.