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Aims and objectives. The purpose of the study was to explore the meaning(s) that emergency department nurses ascribe to acts of violence from patients, their family and friends and what impact these meaning(s) have upon how they respond to such acts. Background. Violence in the health sector is of international concern. In high acuity areas such as emergency departments, nurses have an increased risk of violence. The literature further suggests that violence towards nurses in emergency departments is under-reported. Design and methods. This study was undertaken in 2005, at a regional Australian Emergency Department with 20 consenting registered nurses. Using an instrumental case study design, both qualitative and quantitative data were generated. Qualitative data were collected using participant observation, semi-structured interviews, informal field interviews and researcher journaling. Quantitative data of violent events were generated using a structured observational guide. Textual data were analysed thematically and numeric data were analysed using frequency counts. Mixed methods and concurrent data analysis contributed to the rigour of this study. Findings. Emergency department nurses made judgments about the meaning of violent events according to three factors: (i) perceived personalization of the violence; (ii) presence of mitigating factors; and (iii) the reason for the presentation. The meanings that were ascribed to individual acts of violence informed the responses that nurses initiated. Conclusions. The findings show that violence towards emergency department nurses is interpreted in a more systematic and complex way than the current definitions of violence make possible. The meanings given to violence were contextually constructed and these ascribed meaning(s) and judgments informed the actions that the nurses took in response to both the act of violence and the agent of violence. Relevance to clinical practice. Understanding the meaning(s) of violence towards nurses contributes to the discussions surrounding why nurses under-report violence. Further, these findings bring insights into how nurses can and do, handle violence in the workplace. [ABSTRACT FROM AUTHOR]

Aim. This paper is the report of a study to explicate the components of observable behaviour that indicate a potential for violence in patients, their family and friends when presenting at an emergency department. Background. Violence towards nurses is a contemporary, multifaceted problem for the healthcare workforce globally. International literature identifies emergency departments as having high levels of violence. Method. A mixed method case study design was adopted, and data were collected by means of 290 hours of participant observation, 16 semi-structured interviews and 13 informal field interviews over a 5-month period in 2005. Thematic analysis of textual data was undertaken using NVivo2. Frequency counts were developed from the numerical data. Findings. Five distinctive elements of observable behaviour indicating potential for violence in patients, their families and friends were identified. These elements can be conceptualized as a potential nursing violence assessment framework and described through the acronym STAMP: Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing. Conclusion. Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing provides a useful, practical nursing violence assessment framework to assist nurses to quickly identify patients, families and friends who have a potential for violence. [ABSTRACT FROM AUTHOR]

Violence against nurses is an on-going issue in healthcare settings, and is regularly documented in the literature. Assessing the potential for violence against nurses in the emergency department is essential to maintain their safety. The aim of this study was to develop a violence assessment tool by refining a list of predictive cues identified from both a previous study and existing literature. Using the Delphi technique, a panel of 1 1 expert nurse academics and clinicians developed a 37-item questionnaire and used three rounds of Delphi to refine the violence assessment questionnaire. The resulting tool comprises 17 cues of potential violence that can be easily observed and requires no prior knowledge of the perpetrators' medical history. [ABSTRACT FROM AUTHOR]

Abstract Increasing numbers of nurses seek to undertake doctoral education as nursing continues to develop as a discrete area of clinical and theoretical scholarship. Effective supervision is a crucial aspect of doctoral education and has been identified as essential to successful completion of doctoral training. Relatively little, however, is written about the relationship aspects of doctoral supervision in nursing. This paper presents some reflections on doctoral education in nursing from the perspective of four people who have established intergenerational supervisory relationships. [ABSTRACT FROM AUTHOR]

Background. Elaboration of the concept of cytokine-induced sickness behaviour in recent years has opened new avenues for understanding brain involvement in sickness and recovery processes. Additionally, this has led to much speculation about the role of the immune system in neuropsychiatric syndromes, including depression and chronic fatigue. However, few studies have examined this phenomenon as it naturally occurs in sick humans, and none has attempted to document the quantitative relationships between cytokine levels and non-specific symptoms. The aim of this research was to examine human sickness behaviour and its immunological correlates in documented Epstein-Barr virus (EBV), Q fever or Ross River virus (RRV) infections. Method. We studied two separate samples. The first consisted of 21 patients with acute Q fever. The second included 48 patients with acute RRV or EBV infection. Psychological and somatic symptom profiles were derived from self-report measures completed at enrolment. Quantification of pro-inflammatory cytokines [interleukin (IL)-1β and IL-6] in sera and supernatants of peripheral blood mononuclear cell (PBMC) cultures was undertaken by specific ELISAs. Results. Levels of IL-1β and IL-6 spontaneously released from PBMC cultures were consistently correlated with reported manifestations of acute sickness behaviour including fever, malaise, pain, fatigue, mood and poor concentration. Conclusions. IL-1β and IL-6 produced as part of the host response represent sensitive markers of sickness behaviour in humans with acute infection. Further work is needed to systematically characterize the spectrum and natural history of sickness behaviour in humans and to elucidate its biological basis. [ABSTRACT FROM AUTHOR]