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Journal articles on the topic 'Nursing practitioners'

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1

Jomon Joy, Jomon Joy, Sreehari Ravindranath, and Joseph Thomas R. "An Exploration of Stress Coping Strategies Among Nursing Practitioners." International Journal of Scientific Research 2, no. 5 (June 1, 2012): 554–56. http://dx.doi.org/10.15373/22778179/may2013/190.

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2

Woolforde, Launette. "Nursing Professional Development Practitioners." Journal for Nurses in Professional Development 37, no. 5 (September 2021): 257–59. http://dx.doi.org/10.1097/nnd.0000000000000803.

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3

Vaughan, Barbara. "How Experienced Practitioners Gain Knowledge." Creative Nursing 20, no. 1 (2014): 30–36. http://dx.doi.org/10.1891/1078-4535.20.1.30.

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An evolution in nursing in the United Kingdom in the 1970s from rule-bound toward holistic, autonomous practice engendered an examination of nursing’s body of knowledge and how it is incorporated into practice. This article describes Barbara Carper’s (1978) Fundamental Patterns of Knowing in Nursing (empiric, ethical, aesthetic, and personal knowledge), and links it to three major worldviews of the way in which knowledge is sought (positivism, naturalism, and critical social theory). Carper’s model was used in the United Kingdom as the basis for a curriculum of structured reflective practice using workshops, journaling, and clinical supervision. An example from a practitioner’s diary demonstrates how Carper’s model informs reflection on an interaction with a patient with newly diagnosed cancer.
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Johns, Christopher. "Unravelling The Dilemmas Within Everyday Nursing Practice." Nursing Ethics 6, no. 4 (July 1999): 287–98. http://dx.doi.org/10.1177/096973309900600404.

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Each day, nurse practitioners are faced with clinical situations and dilemmas that have no obvious right answers. This article sets out the process of ethical mapping as a reflective device to enable practitioners to reflect on dilemmas of practice in order to learn through the experience and inform future practice. Ethical mapping is illustrated around a single experience that an intensive care practitioner shared in an ongoing guided reflection relationship. Within this process the practitioner draws on ethical principles to inform the particular situation, notably autonomy, doing harm, truth telling and advocacy. Through reflection, ethical principles are transcended and assimilated into knowing in practice, enabling the practitioner to become more ethically sensitive in responding to future situations.
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Wong, Carin, Jenny Martinez, Brenda Fagan, and Natalie E. Leland. "Understanding Communication Between Rehabilitation Practitioners and Nurses: Implications for Post-Acute Care Quality." Journal of Applied Gerontology 39, no. 7 (August 24, 2018): 795–802. http://dx.doi.org/10.1177/0733464818794148.

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Objective: This study examined post-acute care (PAC) rehabilitation practitioner’s perspectives on communication. Method: This is a secondary data analysis of a larger qualitative study, which included PAC rehabilitation provider ( n = 99) focus groups that were held in a purposive sample of 13 skilled nursing facilities (SNFs). Results: Participants emphasized the importance of bidirectional communication between rehabilitation and nursing. Three themes were identified: (a) communication between rehabilitation practitioners and registered nurses or licensed practical nurses, (b) communication between rehabilitation practitioners and certified nursing assistants, and (c) communication between rehabilitation practitioners and nursing leaders. Two subthemes within each of the three themes were further characterized to understand how information was exchanged: (a) static communication and (b) action-oriented communication. Conclusion: Our findings highlight opportunities for better communication in PAC between rehabilitation practitioners and nursing and thus lay a foundation for future efforts to improve care coordination through enhancing interdisciplinary communication.
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Harrison, Penny. "Advanced practitioners in gastrointestinal nursing." Gastrointestinal Nursing 17, no. 9 (November 2, 2019): 82. http://dx.doi.org/10.12968/gasn.2019.17.9.82.

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7

Riley, Jillian, Lyndell Brodie, and Caroline Shuldham. "Cardiac nursing: Achieving Competent Practitioners." European Journal of Cardiovascular Nursing 4, no. 1 (March 2005): 15–21. http://dx.doi.org/10.1016/j.ejcnurse.2005.01.002.

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This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are “fit for purpose”, and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.
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8

Oden, Kristy, and Jenny Dawson. "Transitioning Nurse Practitioners into Assistant Professors." International Journal for Innovation Education and Research 3, no. 1 (January 31, 2015): 69–77. http://dx.doi.org/10.31686/ijier.vol3.iss1.301.

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As the nursing shortage continues to increase, there is a need for qualified nursing faculty. The development of the Doctorate of Nursing Practice, a terminal degree with a focus on clinical practice, has the potential to bridge the gap of nursing faculty. Nurse practitioners are transition into education. Nurse practitioners are experts in various practice areas but novice nursing faculty. Mentoring of new faculty by seasoned faculty is a way to grow excellent nursing faculty and increase retention of employees. Many resources exist to make this transition smooth.
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9

Birkholz, Gloria. "Implications of the National Practitioner Data Bank for Nurse Practitioners." Nurse Practitioner 16, no. 8 (August 1991): 40???46. http://dx.doi.org/10.1097/00006205-199108000-00015.

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10

Karnick, Paula M. "Humanbecoming Theory in Practice." Nursing Science Quarterly 25, no. 2 (March 25, 2012): 147–48. http://dx.doi.org/10.1177/0894318412437957.

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The age-old battle of what to include in nursing education continues. Now this battle extends itself into nurse practitioner education with a slightly different twist. Abandoning nursing theory-guided education for the medical model leaves nurse practitioner education flat. In this author’s academic experience, nursing theory was included in the curriculum. The exemplar presented is testament to the distinction and significance of including nursing theory-guided education. The unique difference between nurse practitioners and physicians is the use of theory in practice.
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Raftery, Chris. "Nurse Practitioners: Remaining True to Nursing." Journal for Nurse Practitioners 12, no. 8 (September 2016): 574. http://dx.doi.org/10.1016/j.nurpra.2016.07.024.

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12

Martin, Kathleen. "Nurse Practitioners' Use of Nursing Diagnosis." International Journal of Nursing Terminologies and Classifications 6, no. 1 (January 1995): 9–15. http://dx.doi.org/10.1111/j.1744-618x.1995.tb00273.x.

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Carison-Catalano, Judy. "Nurse Practitioners' Use of Nursing Diagnoses." International Journal of Nursing Terminologies and Classifications 9, no. 1 (January 1998): 2–4. http://dx.doi.org/10.1111/j.1744-618x.1998.tb00456.x.

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14

Matthews, Francesca. "Educating sustainable practitioners of veterinary nursing." Veterinary Nurse 2, no. 10 (December 2011): 604–10. http://dx.doi.org/10.12968/vetn.2011.2.10.604.

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15

Pate, Joseph Michael. "Nursing Information Systems for Nurse Practitioners." Nurse Practitioner 19, no. 12 (December 1994): 16–17. http://dx.doi.org/10.1097/00006205-199412000-00006.

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16

Woolforde, Launette. "Nursing Professional Development Practitioners on Boards." Journal for Nurses in Professional Development 34, no. 5 (2018): 293–94. http://dx.doi.org/10.1097/nnd.0000000000000475.

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17

Hamilton, Helen. "Nurse practitioners." Collegian 5, no. 2 (January 1998): 5. http://dx.doi.org/10.1016/s1322-7696(08)60275-9.

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Finlayson, Bernice. "Nurse ‘practitioners’." Collegian 5, no. 3 (January 1998): 8. http://dx.doi.org/10.1016/s1322-7696(08)60290-5.

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19

Thibodeau, Janice A., and Joellen W. Hawkins. "Nurse Practitioners." Nurse Practitioner 14, no. 12 (December 1989): 47???51. http://dx.doi.org/10.1097/00006205-198912000-00010.

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&NA;. "Nurse Practitioners." Nurse Practitioner 17, no. 7 (July 1992): 56. http://dx.doi.org/10.1097/00006205-199207000-00015.

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21

Bartol, Tom. "Nurse practitioners." Nurse Practitioner 40, no. 6 (June 2015): 14–16. http://dx.doi.org/10.1097/01.npr.0000465128.80771.ec.

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22

Rhead, Mark, and Frank Strange. "Nursing lecturer/practitioners: can lecturer/practitioners be music to our ears?" Journal of Advanced Nursing 24, no. 6 (December 1996): 1265–72. http://dx.doi.org/10.1111/j.1365-2648.1996.tb01034.x.

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23

Raftery, Chris. "Nurse practitioner succession planning: forward thinking or just an after-thought?" Australian Health Review 37, no. 5 (2013): 585. http://dx.doi.org/10.1071/ah13072.

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This paper examines the concept of backfill and succession planning for an elite speciality nursing group, nurse practitioners. Nurse practitioners work in many public, private, inpatient and outpatient settings across the country. This discussion is relevant to all practicing nurse practitioners, but especially those with their own specific patient group. A nurse practitioner is an elite nursing specialist with specific speciality skills. While present, nurse practitioners can be most effective at holistically managing their patient group. However, if an endorsed nurse practitioner is no longer present, for a short or long interval, their specific skills and abilities cannot be easily substituted or replaced in the short term. This potential compromise in patient care can be detrimental to the developing reputation of the role of the nurse practitioner. In order to address the shortage of specifically skilled nurse practitioners across the country in all specialties, there is a need to forward plan and consider contingencies for succession in the event of short- or long-term absences from the clinical environment. Succession planning is the key to patient safety and the successful implementation of the role of the nurse practitioner. What is known about the topic? While succession planning itself is not a new concept, nurse practitioner role development for the most part has been about advancing innovative nurse-led models of care, as opposed to planning for future needs. What does the paper add? This paper aims to reignite the role development discussion to highlight the need for better alignment of succession planning with the establishment of nurse practitioner roles. What are the implications for the practitioner? Better alignment of succession planning and role development will ensure continuity of nurse practitioner models of care well beyond our pioneering nurse practitioners’ working life.
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24

Butler, Kathy Diane. "Nurse Practitioners and Evidence-Based Nursing Practice." Clinical Scholars Review 4, no. 1 (2011): 53–57. http://dx.doi.org/10.1891/1939-2095.4.1.53.

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The objectives of this study were to assess nurse practitioners’ (NP) beliefs and attitudes about evidence-based nursing practice (EBNP) and their implementation of EBNP. This exploratory descriptive study surveyed NPs in Tennessee. Most of the respondents were White females, 42 years of age, with a master’s degree as a family nurse practitioner (FNP), practicing in primary care for a mean of 7.9 years. The respondents tended to have positive beliefs and attitudes about EBNP, but their implementation of EBNP was not consistent with their beliefs. The findings of this survey emphasize the need for EBNP in NP education curricula and continuing education programs and for NP access to evidence-based information at point of care to improve the care provided to patients.
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25

Kleinpell, Ruth, Michelle L. Cook, and Diane L. Padden. "American Association of Nurse Practitioners National Nurse Practitioner sample survey." Journal of the American Association of Nurse Practitioners 30, no. 3 (March 2018): 140–49. http://dx.doi.org/10.1097/jxx.0000000000000030.

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26

A. Almutairi, Hessa, Kholoud N. Alharbi, Hana K. Alotheimin, Roaa Gassas, Musaad S. Alghamdi, Ayman A. Alamri, Abdulaziz M. Alsufyani, and Adel S. Bashatah. "Nurse Practitioner: Is It Time to Have a Role in Saudi Arabia?" Nursing Reports 10, no. 2 (October 9, 2020): 41–47. http://dx.doi.org/10.3390/nursrep10020007.

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Low recruitment of Saudi nationals into the nursing profession, coupled with a growing population, has led to a severe nursing shortage in Saudi Arabia, particularly of nurses with advanced qualifications in clinical nursing. While the role of nurse practitioner has been successfully integrated into the healthcare systems of the U.S., Canada, the UK and Australia for decades, the advanced practice registered nurse (APRN), which includes nurse practitioners and clinical nursing specialists, is still not being implemented effectively in Saudi Arabia due to a variety of regulatory, institutional and cultural barriers. The author looks at some of those barriers and offers recommendations of how they might be overcome. Given that in many parts of the world, nurse practitioners are considered an essential component to meeting healthcare demands, the author considers the question of whether APRNs can find a role in Saudi Arabia’s healthcare system.
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27

Keane, Anne, and Therese Richmond. "Tertiary Nurse Practitioners." Image: the Journal of Nursing Scholarship 25, no. 4 (December 1993): 281–84. http://dx.doi.org/10.1111/j.1547-5069.1993.tb00260.x.

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28

Jo Gagan, Mary. "Using Vignettes to Study Nurse Practitioners’ Performance in Suspected Domestic Violence Situations." Journal of Nursing Measurement 8, no. 1 (January 2000): 7–22. http://dx.doi.org/10.1891/1061-3749.8.1.7.

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Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.
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Tallo, Donato. "Good nursing requires caring practitioners with knowledge." Nursing Standard 29, no. 29 (March 18, 2015): 33. http://dx.doi.org/10.7748/ns.29.29.33.s39.

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30

Di Giulio, P., L. Saiani, and A. Brugnolli. "Advancing cancer nursing practice: educating advanced practitioners." European Journal of Cancer 35 (September 1999): S38. http://dx.doi.org/10.1016/s0959-8049(99)80566-8.

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31

Adams, Donna, and Barbara K. Miller. "Professionalism in nursing behaviors of nurse practitioners." Journal of Professional Nursing 17, no. 4 (July 2001): 203–10. http://dx.doi.org/10.1053/jpnu.2001.25913.

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32

Harris, Anne, and Maggie Redshaw. "Professional issues facing nurse practitioners and nursing." British Journal of Nursing 7, no. 22 (December 10, 1998): 1381–85. http://dx.doi.org/10.12968/bjon.1998.7.22.5537.

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Bodine, Jennifer L. "Nursing Professional Development Practitioners in Leadership Roles." Journal for Nurses in Professional Development 36, no. 6 (November 2020): 353–54. http://dx.doi.org/10.1097/nnd.0000000000000681.

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34

Warren, Joan Insalaco, and Mary G. Harper. "Transforming Roles of Nursing Professional Development Practitioners." Journal for Nurses in Professional Development 31, no. 1 (2017): 2–12. http://dx.doi.org/10.1097/nnd.0000000000000320.

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Warren, Joan Insalaco. "Nursing Professional Development Practitioners as Proactive Leaders." Journal for Nurses in Professional Development 33, no. 4 (2017): 211–12. http://dx.doi.org/10.1097/nnd.0000000000000361.

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Kiss, Elizabeth, Alison Simpson, and Charlene M. Smith. "Nursing Professional Development Practitioners in Leadership Roles." Journal for Nurses in Professional Development 36, no. 2 (2020): 99–103. http://dx.doi.org/10.1097/nnd.0000000000000605.

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Balmer, Jann T. "Nursing Professional Development Practitioners in Leadership Roles." Journal for Nurses in Professional Development 36, no. 3 (2020): 167–69. http://dx.doi.org/10.1097/nnd.0000000000000626.

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38

Hamlin, Jennifer. "Are we ready for advanced nursing practitioners?" Veterinary Nurse 11, no. 7 (September 2, 2020): 291. http://dx.doi.org/10.12968/vetn.2020.11.7.291.

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39

Williamson, Graham R. "Core Skills for Nurse Practitioners: A Handbook for Nurse Practitioners." Journal of Advanced Nursing 43, no. 5 (August 14, 2003): 536. http://dx.doi.org/10.1046/j.1365-2648.2003.02774_4.x.

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40

Gmeiner, AC. "The view from practitioners." Health SA Gesondheid 1, no. 3 (December 1, 1996): 16. http://dx.doi.org/10.4102/hsag.v1i3.316.

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Ian Hulat is the Programme Manager of the South East Wales Institute of Nursing and Midwifery and a practicing counsellor with the Central School of Councelling Therapy. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
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McCain, Gail. "Yet Another Degree for the Nursing Profession." Neonatal Network 24, no. 4 (July 2005): 7. http://dx.doi.org/10.1891/0730-0832.24.4.7.

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THE AMERICAN ASSOCIATION OF COLLEGES OF NURSING (AACN) issued a position statement on the practice doctorate in nursing in October of 2004.1 It proposes a terminal professional degree, doctor of nursing practice (DNP), to replace the master’s degree in nursing as preparation for advanced practice nursing. Advanced practice nursing refers to certified nurse practitioners (e.g., neonatal nurse practitioners), certified nurse midwives, certified nurse anesthetists, and clinical nurse specialists.
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Shuler, Pamela A., and Roxana Huebscher. "Clarifying Nurse Practitioners' Unique Contributions: Application of The Shuler Nurse Practitioner Practice Model." Journal of the American Academy of Nurse Practitioners 10, no. 11 (November 1998): 491–99. http://dx.doi.org/10.1111/j.1745-7599.1998.tb00478.x.

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43

Hoffman, Leslie A., Mary Beth Happ, Carmella Scharfenberg, Dana DiVirgilio-Thomas, and Frederick J. Tasota. "Perceptions of Physicians, Nurses, and Respiratory Therapists About the Role of Acute Care Nurse Practitioners." American Journal of Critical Care 13, no. 6 (November 1, 2004): 480–88. http://dx.doi.org/10.4037/ajcc2004.13.6.480.

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• Background Information about the contributions of acute care nurse practitioners to medical management teams in critical care settings is limited.• Objective To examine contributions of acute care nurse practitioners to medical management of critically ill patients from the perspectives of 3 disciplines: medicine, respiratory care, and nursing.• Methods Attending physicians, respiratory therapists, and nurses in 2 intensive care units were asked to list 3 advantages and 3 disadvantages of collaborative care provided by acute care nurse practitioners. Qualitative methods (coding/constant comparative analysis) were used to identify common themes and subthemes. Overall response rate was 35% (from 69% for attending physicians to 26% for nurses).• Results Responses were grouped into 4 main themes: accessibility, competence/knowledge, care coordination/communication, and system issues. Acute care nurse practitioners were valued for their accessibility, expertise in routine daily management of patients, and ability to meet patient/family needs, especially for “long-stay” patients. Also, they were respected for their commitment to providing quality care and for their communication skills, exemplified through teaching of nursing staff, patient/family involvement, and fluency in weaning protocols. Physicians valued acute care nurse practitioners’ continuity of care, patient/family focus, and commitment. Nurses valued their accessibility, commitment, and patient/family focus. Respiratory therapists valued their accessibility, commitment, and consistency in implementing weaning protocols.• Conclusion Responses reflected unique advantages of acute care nurse practitioners as members of medical management teams in critical care settings. Despite perceptions of the acute care nurse practitioner’s role as medically oriented, the themes reflect a clear nursing focus.
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Karpa, Jane V., and Wanda M. Chernomas. "Nurse Educators’ Perspectives on Student Development of Reflection for Psychiatric Mental Health Nursing Practice." International Journal of Nursing Education Scholarship 10, no. 1 (August 24, 2013): 185–94. http://dx.doi.org/10.1515/ijnes-2012-0040.

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AbstractPsychiatric nursing, in various parts of the world, including regions of Canada, is recognized as a distinct nursing profession. In psychiatric mental health nursing practice, reflection is considered a foundational skill given the relational nature of nurses’ therapeutic work. Communicating the significance of reflection for practice to students and teaching this intangible skill is challenging for educators. The purpose of this qualitative study was to explore with psychiatric mental health nurse educators their views on how they develop reflective practitioners. Participants’ perspectives and experiences in teaching reflective practice were captured in four themes: building the use of self as an agent of change, building skills of reflection/building the habit of reflection, building a bridge between theory and practice, and building a continuing reflective practice – from student to practitioner. Recommendations include a systematic incorporation of reflection into a curriculum and creating supportive learning environments that facilitate the development of reflective practitioners.
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45

Paynter, Martha, Wendy V. Norman, and Ruth Martin-Misener. "Nurses are Key Members of the Abortion Care Team: Why aren’t Schools of Nursing Teaching Abortion Care?" Witness: The Canadian Journal of Critical Nursing Discourse 1, no. 2 (December 10, 2019): 17–29. http://dx.doi.org/10.25071/2291-5796.30.

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Abortion is a common and safe procedure in Canada, with the Canadian Institute for Health Information reporting approximately 100,000 procedures per year. Yet access remains problematic. As abortion is unrestricted by criminal law in Canada, access is limited by geographic barriers and by a shortage of providers. We present a feminist critical lens to describe how the marginalization of nursing and nurses in abortion care contributes to social stigma and public misunderstanding about abortion access. The roles of registered nurses and nurse practitioners in abortion advocacy, service navigation, counselling, education, support, physiological care and follow up are underutilized and under-researched. In 2015, decades after its availability elsewhere in the world, Health Canada approved mifepristone (a pill for medical abortion). In 2017, provincial regulators began to authorize nurse practitioners to independently provide medical abortion care, as appropriate given the inclusion in nurse practitioner scope of practice to order diagnostic tests, make diagnoses, and treat health conditions. Ensuring nurse practitioners are able to practice medical abortion has the potential to significantly increase abortion access for rural, remote and other marginalized populations. There is also an opportunity to optimize the registered nurse role in abortion care. However, achieving these improvements is challenging as abortion is not routinely taught in Canadian Schools of Nursing. We argue that to destigmatize abortion and improve access, undergraduate nursing and nurse practitioner programs across the country must begin to include abortion and family planning competencies.
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Pesut, Barbara, Sally Thorne, Megan L. Stager, Catharine J. Schiller, Christine Penney, Carolyn Hoffman, Madeleine Greig, and Josette Roussel. "Medical Assistance in Dying: A Review of Canadian Nursing Regulatory Documents." Policy, Politics, & Nursing Practice 20, no. 3 (May 6, 2019): 113–30. http://dx.doi.org/10.1177/1527154419845407.

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Canada's legalization of Medical Assistance in Dying (MAiD) in 2016 has had important implications for nursing regulators. Evidence indicates that registered nurses perform key roles in ensuring high-quality care for patients receiving MAiD. Further, Canada is the first country to recognize nurse practitioners as MAiD assessors and providers. The purpose of this article is to analyze the documents created by Canadian nursing regulatory bodies to support registered nurse and nurse practitioner practice in the political context of MAiD. A search of Canadian provincial and territorial websites retrieved 17 documents that provided regulatory guidance for registered nurses and nurse practitioners related to MAiD. Responsibilities of registered nurses varied across all documents reviewed but included assisting in assessment of patient competency, providing information about MAiD to patients and families, coordinating the MAiD process, preparing equipment and intravenous access for medication delivery, coordinating and informing health care personnel related to the MAiD procedure, documenting nursing care provided, supporting patients and significant others, and providing post death care. Responsibilities of nurse practitioners were identified in relation to existing legislation. Safety concerns cited in these documents related to ensuring that nurses understood their boundaries in relation to counseling versus informing, administering versus aiding, ensuring safeguards were met, obtaining informed consent, and documenting. Guidance related to conscientious objection figured prominently across documents. These findings have important implications for system level support for the nursing role in MAiD including ongoing education and support for nurses' moral decision making.
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47

Bullough, Vern L. "Struggles of Nurse Practitioners." Journal of Nursing Scholarship 36, no. 2 (May 20, 2004): 95. http://dx.doi.org/10.1111/j.1547-5069.2004.4033_1.x.

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48

Setlersten, Lori. "Professionalism of Nurse Practitioners." Journal of the American Academy of Nurse Practitioners 3, no. 4 (October 1991): 145–46. http://dx.doi.org/10.1111/j.1745-7599.1991.tb01093.x.

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49

Facione, Noreen W., and Peter A. Facione. "Acceptance of Nurse Practitioners." Nurse Practitioner 10, no. 1 (January 1985): 54???59. http://dx.doi.org/10.1097/00006205-198501000-00010.

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50

Jones, L. Colette. "In-Patient Nurse Practitioners." Nurse Practitioner 10, no. 5 (May 1985): 48???50. http://dx.doi.org/10.1097/00006205-198505000-00007.

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