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Aim: The aim of this study was to gain insight into the perception of nurses about their roles in medical‐surgical units. Background: As a result of ever‐changing work environments, medical‐surgical nurses find it difficult to know and practice according to the full scope of their roles. Design: A qualitative descriptive study. Methods: Semi‐structured individual interviews were conducted with 21 nurses on three campuses of a large tertiary care hospital located in Quebec, Canada. Thematic analysis was used to construe meaning from the interviews. This research adheres to the Standards for Reporting Qualitative Research guidelines and checklist. Results: The data analysis resulted in three main themes: (i) confusion in nurses' roles and scope of practice; (ii) challenges in the continuity of care and (iii) factors affecting the roles of nurses in medical‐surgical units. Conclusion: Attention must be paid to the care continuum as it represents a critical element for surgical patients' quality and safety of care. Relevance to clinical practice: Medical‐surgical nurses should understand their roles and the factors that limit their full scope of practice in order to provide and manage complex care situations. Additionally, an interdisciplinary approach is a strategy that may better respond to patients' clinical needs across the surgical journey. [ABSTRACT FROM AUTHOR]

Copyright of Aequitas: Journal of Human Development, Disability & Social Change / Revue de Développement Humain, Handicap et Changement Social is the property of Reseau international sur le Processus de production du handicap, RIPPH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Primary central nervous system lymphomas (PCNSL) are rare and aggressive CNS tumors. Current management involves high-dose methotrexate (HD-MTX) typically administered intravenously (IV), despite the existence of the blood-brain barrier (BBB), which significantly decreases its bioavailability. Cerebral intra-arterial chemotherapy (CIAC) coupled with osmotic BBB disruption (OBBBD) can theoretically circumvent this issue. Methods: We performed a retrospective analysis of patients with newly diagnosed PCNSL treated with HD-MTX-based CIAC+OBBBD at our center between November 1999 and May 2018. OBBBD was achieved using a 25% mannitol intra-arterial infusion. Patients were followed clinically and radiologically every month until death or remission. Demographics, clinical and outcome data were collected from the medical record. All imaging studies were reviewed for evidence of complication and outcome assessment. Kaplan-Meier analyses were used to compute remission, progression-free survival (PFS) as well as overall survival times. Subgroup analyses were performed using the log rank test. Results: Forty-four patients were included in the cohort. Median follow-up was 38 months. Complete response was achieved in 34 patients (79%) at a median of 7.3 months. Actuarial median survival and PFS were 45 months and 24 months, respectively. Age, ECOG and lesion location did not impact outcome. Complications included thrombocytopenia (39%), neutropenia (20%), anemia (5%), seizures (11%), stroke (2%), and others (20%). Conclusion: CIAC using HD-MTX-based protocols with OBBBD is a safe and well-tolerated procedure for the management of PCNSL. Our data suggests better PFS and survival outcomes compared to IV protocols with less hematologic toxicity and good tolerability, especially in the elderly. [ABSTRACT FROM AUTHOR]

This paper presents findings from a qualitative case study that explored long term integration of internationally educated nurses in an Ontario healthcare facility. Using critical social theory as the philosophical underpinnings for this research, we selected the case based on the hospital's history of employing and supporting internationally educated professionals. Data sources included: documents review, twenty-eight interviews, socio-demographic survey and five focus groups involving IENs and other stakeholders. An overarching theme points to a 'two-way' notion of workplace integration whereby efforts are required on the part of the employer as well as the IENs. An in-depth analysis of the data reveals sub-processes of two-way integration: respecting diversity and difference, adopting inclusive practices and striving to achieve equity. Challenges in achieving two-way integration are discussed. Implications for nursing leaders to tap into IENs' diverse talents for the benefit of their local healthcare systems are highlighted. [ABSTRACT FROM AUTHOR]

Background and Purpose: Violence among nurses and in nursing academia is a significant issue, with attention increasingly focused on damage resulting from psychological violence, such as bullying, harassment, aggression, and incivility. Each workplace’s interpretation of violence will impact individual behavior within the organization. Organizational and environmental factors can contribute to violent behaviors becoming normalized in the workplace. When violent behaviors go unconstrained, they become imbedded within the workplace culture. An increased understanding of workplace culture is required to address workplace violence. The purpose of this article is to demonstrate how the use of this theoretical framework can provide greater understanding of the role of workplace culture in sustaining violent behaviors in nursing academia. Methods: The theoretical perspectives of Gail Mason on interpersonal violence and Michel Foucault on power were utilized to inform the research process and guide data analysis. Results: The framework makes possible the exposure of a dominant discourse perpetuating violence in nursing academia. Power and violence were found to work together to shape knowledge and influence group norms and behaviors. Implications for Practice: The framework is useful in providing greater understanding of how the concepts of power, knowledge, difference, and resistance support the enactment of workplace violence. Investigating the influence of these concepts in the development of accepted practices and discourses may allow greater insight into ways violence and power are used to negotiate and enforce organizational rules and norms. [ABSTRACT FROM AUTHOR]

Background: Global trends in migration accompanied with recent changes to the immigrant selection process may have influenced the demographic and human capital characteristics of internationally educated nurses (IENs) in Canada and in turn the assistance required to facilitate their workforce integration. This study aimed to describe the demographic and human capital profile of IENs in Canada, to explore recent changes to the profile, and to identify predictors of IENs' workforce integration.Methods: A cross-sectional, descriptive, correlational survey design was used. Eligible IENs were immigrants, registered and employed as regulated nurses in Canada. Data were collected in 2014 via online and paper questionnaires. Descriptive statistics were used to examine the data by year of immigration. Logistic regression modeling was employed to identify predictors of IENs' workforce integration measured as passing the licensure exam to acquire professional recertification and securing employment.Results: The sample consisted of 2280 IENs, representative of all Canadian provincial jurisdictions. Since changes to the immigrant selection process in 2002, the IEN population in Canada has become more racially diverse with greater numbers emigrating from developing countries. Recent arrivals (after 2002) had high levels of human capital (knowledge, professional experience, language proficiency). Some, but not all, benefited from the formal and informal assistance available to facilitate their workforce integration. Professional experience and help studying significantly predicted if IENs passed the licensure exam on their first attempt. Bridging program participation and assistance from social networks in Canada were significant predictors if IENs had difficulty securing employment.Conclusions: Nurses will continue to migrate from a wide variety of countries throughout the world that have dissimilar nursing education and health systems. Thus, IENs are not a homogenous group, and a "one size fits all" model may not be effective for facilitating their professional recertification and employment in the destination country. Canada, as well as other countries, could consider using a case management approach to develop and tailor education and forms of assistance to meet the individual needs of IENs. Using technology to reach IENs who have not yet immigrated or have settled outside of urban centers are other potential strategies that may facilitate their timely entrance into the destination countries' nursing workforce. [ABSTRACT FROM AUTHOR]

Nursing managers are identified as playing a central role in workplace aggression management. In effect, employees' decisions to report unacceptable behavior is said to be directly influenced by how a manager will respond to their claims. Using principles from critical nursing ethnography, data were collected from interviews, organizational documents, and observation of physical environment. Twenty-three semistructured interviews were conducted in both a university-affiliated psychiatric hospital and a community hospital located in a large metropolitan city in Ontario. The study aimed at broadening the understanding of how nurse managers respond to intraprofessional and interprofessional workplace aggression. Several strategies were described by managers including coaching individuals so they feel capable of addressing the issue themselves, acting as mediator to allow both sides to openly and respectfully talk about the issue, and disciplining employees whose actions warrant harsh consequences. As part of the study, managers reported that dealing with workplace aggression could be difficult and time consuming and admitted that they sometimes came to doubt their abilities to be able to positively resolve such a widespread problem. Conclusions drawn from the study suggest that aggression management is not solely the responsibility of managers but must involve several actors including the aggressive individual, peers, human resources department, and unions. [ABSTRACT FROM AUTHOR]

The author reflects on her career as a university professor as she tackles issues on aggression and workplace violence. She mentions that health care professionals experience workplace violence 16 times and the nurses are second among those at risk of aggression and violence. She states that aggressions are not reported by victims for they are afraid of ethical dilemma or retaliation. Moreover, the author says that the people in the society have become civil and less tolerant to one another.

Medical Assistance in Dying (MAiD) is a complex process involving the person seeking care and their relatives. MAiD involves physical, psychosocial and spiritual needs, and consequently the involvement of an interdisciplinary team is beneficial. Therefore, updating the knowledge and skills of healthcare and social services professionals is critical. An interdisciplinary team from Laval University (Quebec, Canada) has developed a continuous training program for all health care and social services professionals who could be involved in the care of persons who request MAiD and their loved ones. It is crucial to assess whether the objectives of the continuous training program are being met, especially since this new training addresses several complex issues (legal, ethical, and clinical). Bandura's self-efficacy theory has been widely used to develop scales for assessing the impact of training programs and identifying knowledge gaps. Bandura's theory states that feeling secure in one's self-efficacy leads to self-determined motivation. Although there are various scales intended to measure self-efficacy in palliative care, none include self-efficacy for participating in the process surrounding MAiD. As a result, we aim to create a bilingual (English-French) interdisciplinary scale to assess self-efficacy for participating in the process surrounding MAiD. The scale will allow decision-makers and researchers to identify current knowledge gaps. It will also be useful for assessing the impact of current and future training programs addressing this end-of-life practice. In this work in progress, we briefly introduce the training program and the future steps in the development and validation of the scale., Competing Interests: None to declare., (© 2023 Tapp, Plaisance, Boudreault, St-Pierre, Desbiens, Poitras, Lemay, Urrea, Lapointe, Henry, Bravo; licensee Synergies Partners.)

The purpose of this article is to present a renewed way to theorize intra/inter-professional aggression in nursing. To this end, René Girard's mimetic mechanism and Max Weber's conception of professional closure will be explored. More specifically mimetic mechanism, summarized as a sequence of four distinct but interdependent phases including mimetic desire, mimetic rivalry, mimetic (sacrificial) crisis, and scapegoat, will serve to broaden the understanding ofintra-professional aggression. For its part, professional closure, a strategy designed to limit and control the number of individuals admitted to a specific profession, will provide a fresh perspective to critically examine the issue of inter-professional aggression by drawing attention to hidden practices of dominance and control.

Objectives: To explore the use of policies and procedures as a tool to support the implementation of clinical guidelines and to determine the relationship between organizational support and stability with nurses' perception of policy change., Design: Secondary analysis of qualitative and quantitative data collected in the post-intervention phase of the study entitled Evaluation of the Dissemination and Utilization of Best Practice Guidelines by Registered Nurses in Ontario., Setting: Eleven agencies across Ontario, Canada., Participants: Fifty nursing staff, 32 nurse administrators and 22 clinical resource nurses (90% response) participated in semi-structured interviews. A total of 316 randomly selected nursing staff from 23 participating units in 11 agencies completed questionnaires (65% response)., Methods: Qualitative data from semi-structured interviews were examined to determine whether participants had modified their policies and procedures as part of the implementation of clinical guidelines. Using SPSS 11.0 for Windows, the authors assessed, using independent t-tests, the relationship between the perception of modification of policies and procedures and the perceptions of organizational support an organisational stability., Results: While modifications to policies and procedures were made at each agency as part of the implementation of clinical guidelines, 27% of staff disagreed that modifications had been made. Nursing staff who agreed that changes had been made to policies and procedures were significantly more likely to report positive organizational support for clinical guideline implementation., Conclusion: Findings suggest the need to increase nursing staffs' awareness of changes to policies and procedures during clinical guideline implementation. Furthermore, results indicate that organizational support may have a positive influence on modifications to policies and procedures that are guided by research-based clinical guideline recommendations.