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Aim. The aim of this paper is to discuss six issues influencing the introduction of advanced practice nursing (APN) roles: confusion about APN terminology, failure to define clearly the roles and goals, role emphasis on physician replacement/support, underutilization of all APN role domains, failure to address environmental factors that undermine the roles, and limited use of evidence-based approaches to guide their development, implementation and evaluation.Background. Health care restructuring in many countries has led to substantial increases in the different types and number of APN roles. The extent to which these roles truly reflect advanced nursing practice is often unclear. The misuse of APN terminology, inconsistent titling and educational preparation, and misguided interpretations regarding the purpose of these roles pose barriers to realizing their full potential and impact on health. Role conflict, role overload, and variable stakeholder acceptance are frequently reported problems associated with the introduction of APN roles.Discussion. Challenges associated with the introduction of APN roles suggests that greater attention to and consistent use of the terms of the terms advanced nursing practice, advancement and advanced practice nursing is required. Advanced nursing practice refers to the work or what nurses do in the role and is important for defining the specific nature and goals for introducing new APN roles. The concept of advancement further defines the multi-dimensional scope and mandate of advanced nursing practice and distinguishes differences from other types of nursing roles. Advanced practice nursing refers to the whole field, involving a variety of such roles and the environments in which they exist. Many barriers to realizing the full potential of these roles could be avoided through better planning and efforts to address environmental factors, structures, and resources that are necessary for advanced nursing practice to take place.Conclusions. Recommendations for the future introduction of APN roles can be drawn from this paper. These include the need for a collaborative, systematic and evidence-based process designed to provide data to support the need and goals for a clearly defined APN role, support a nursing orientation to advanced practice, promote full utilization of all the role domains, create environments that support role development, and provide ongoing evaluation of these roles related to predetermined goals. [ABSTRACT FROM AUTHOR]

This paper addresses the place, position and potential of what is characterized as the `Learning Resources Movement' in nurse education. It is based on experiences drawn from 10 years viewing resource use in general and nursing education, and, more recently, on observations arising from a research project looking at the growth within the school of nursing, of organizational structures for their development. It dims that the true potential of the movement has nowhere been fully realized It sees the present position as indeterminate and misconceived It claims that further development of such resources as are and will be available is intricately tied up with the professional development of nursing in a `chicken-and-egg' situation. It argues that the stage has now been reached where the successful development of the one cannot proceed without the successful development of the other. Drawing on a fairy-tale analogy the paper views the Learning Resources Movement as a powerful tool for seeing through the shining surfaces of what to many are new curricular clothes and dealing with the basic truths of the situation underneath. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to illuminate the meaning of caring for people with malodorous exuding ulcers. BACKGROUND: Managing ulcers is complicated and consensus on assessment and treatment difficult to reach. Nurses need knowledge and skills to provide good care. They must stay close and be exposed to contamination and suffering. They must provide care without violating patients and we need to further explore this challenge. METHOD: A convenience sample of ten participants was recruited. Participants had experience of caring for people with malodorous exuding ulcers and were employed in primary health or hospital care in Sweden. Narrative interviews were conducted during late 2002 to early 2005 and interpreted using a phenomenological-hermeneutic method. FINDINGS: Themes were formulated: 'Facing the wound' when nurses reveal what is meant to be concealed and perceive patients' vulnerability; 'Facing one's own defencelessness' when feeling invaded, helpless and ashamed; 'Struggling to shield one's own defencelessness' was achieved by striving to be in control, striving to endure and seeking a way out. 'Struggling to shield patients' vulnerability' was about alleviating patients' additional suffering by striving to spare patients, pushing boundaries, making uncomfortable decisions and sharing togetherness. When failing to shield their own defencelessness and patients' vulnerability, nurses run the risk of experiencing desolation. CONCLUSION: Physical proximity and bodily suffering affect nurses. Caring for people with ulcers calls for improved interprofessional cooperation in order to provide the best treatments and care. Further education for these nurses is needed, as well as support from managements and organizations. [ABSTRACT FROM AUTHOR]

Family carers of people with a severe mental illness play a vital, yet often unrecognized and undervalued role in Australian society. Respite care services can assist these family carers in their role; however, little is known about their access to these services. The paper addresses this knowledge gap. An exploratory field study was conducted throughout the eastern suburbs of Sydney, Australia, to identify and examine the factors influencing the use and provision of respite services for older carers of people with a mental illness. Semistructured, in-depth interviews, and structured self-completed questionnaires were conducted with older family carers, mental health care professionals, and respite care service providers. Additionally, relevant documents (local policies, strategic plans and reports on respite care) were reviewed. It was found that current respite services are problematic for older family carers of Australians with a mental illness, signalling the need for concerted efforts by carers, health professionals, and service providers to improve access. Changes to respite provision and utilization are recommended. [ABSTRACT FROM AUTHOR]

Background: The concept of respite care has been widely accepted and used throughout most developed countries, although primarily in connection with frail elderly, people with dementia, people with developmental disability or children. This paper aims at exploring older family carers’ needs for, access to and use of respite services when caring for people with a mental illness (excluding dementia) in the community. Method: Data were collected through: semi-structured interviews with 26 mental health professionals, 21 family carers aged over 55 years and 25 respite service providers; demographic questionnaires; field notes; and local area, state and national documents relating to respite care services. Demographic data were analysed using descriptive statistics. All 72 interviews, field notes and other documents were analysed using content analysis. Results: Current respite services are not adequate to meet the needs of mentally ill patients and older carers. The unique aspects of respite care for older carers of persons with mental illness are poorly understood. Conclusion: Bringing these issues to light creates the potential to address the unmet needs of older carers, improve provision of respite services, enhance quality of life of those who can benefit from respite services, and assist mental health professionals to work better with carers. [ABSTRACT FROM AUTHOR]

In this paper I explore the possibilities of nursing as safeguarding through a phenomenological description of a small sculpture by the German artist Käthe Kollwitz. My discussion will be grounded in Heidegger's understanding of technicity as a pervasive systematizing and aggressive challenging-out. The method is grounded in Merleau-Ponty's and Heidegger's contention that strong artworks are truth-disclosing and show up our precognitive contact with the world. Bringing nursing concerns to an encounter with single strong artworks can help us cultivate a more receptive openness to our patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heart disease is a severe long-term illness, which often requires lifestyle changes and self-care and affects the life of the whole family. Perceived family health is highly complex. It combines people's values and everyday experiences, such as knowledge about their own health, what they do to promote their health, how their life progresses, and how they feel physically and emotionally. AIM: The aim of this paper is to report a study to describe the perceived health of families of patients with heart disease and to ascertain factors related to family health. METHODS: Data were collected by questionnaire with a convenience sample of 161 family members of patients receiving treatment on two medical wards of a university hospital in southern Finland. Data were analysed using means and medians and tested by parametric and non-parametric tests. A stepwise regression analysis was also used. RESULTS: The most important predictors of family health were family structural factors, effect of illness symptoms on daily life, and family relationships. The strongest predictor was family structural factors. It was found that the better the family structure and relationships, the better the family health. Similarly, the greater the effect of the illness on the patient's daily life, the worse the family health. CONCLUSION: The findings suggest that supporting family functioning in the families of people with heart disease is an important challenge for family nursing. [ABSTRACT FROM AUTHOR]

When concepts and the `paper and pencil' tests used to measure these concepts are developed in fields other than nursing and subsequently arc used for nursing purposes. the perspective mismatch heralds a validity issue. This paper presents a case for clinical construct validity as one method of evaluating whether the substantive meaning of a test captures the nursing meaning. [ABSTRACT FROM AUTHOR]

This paper presents a proposed model for continuing nursing education based on Imogene King's conceptual framework. The rationale for using King's conceptual framework as the foundation underlying this proposed model is three-fold: the concepts--social systems, health, perception, and interpersonal relationships--are relevant in every nursing situation; the interacting levels of operation--individuals, groups, and society-depict a reciprocal relationship between human behaviour and the environment; and the triad of elements-continuing nursing education, nursing practice, and nursing research-are interrelated in the nursing profession. The authors contend that this approach to continuing nursing education is beneficial to participating nurses, the health care consumer, and to the advancement of the nursing profession. Based on its simplicity and flexibility, the proposed intra-systems model described in this article is useful as a systematic guide for continuing nursing education. The authors believe that this proposed model provides an approach for stimulating continued learning, for establishing innovative foundations for nursing practice, and for generating inquiry through research. Utilizing this approach in maintaining the educational standards for professional practice will promote change for the advancement of the nursing profession. [ABSTRACT FROM AUTHOR]

The Research Unit was established in 1968 and one of its primary functions since then has been an attempt to evaluate experimental schemes of nurse training. Two of the explicit objectives of the research were to establish whether students could be attracted to such schemes of training and, if so, whether they could be successfully prepared by them to pass State finals examinations. The author is concerned that courses are 'evaluated' too readily in terms of single criterion measures such as pass rates, which may in fact be misleading. The paper argues that evaluation of a training course should involve the question 'Is it worth it?' and this implies a need for the use of multiple criteria. [ABSTRACT FROM AUTHOR]

This article presents information related to nursing. At a reception given by Her Majesty Queen Elizabeth the Queen Mother at St James's Palace, London to mark the thirtieth birthday of The British Commonwealth Nurses War Memorial Fund, future plans were announced. The Council of the Royal College of Nursing of Great Britain has decided to create fellows from amongst its members of at least five years' standing who have made exceptional contributions to the advancement of the science and art of nursing. Fellows will be expected to have completed a course in post-basic nursing education where appropriate, and to present a paper or thesis and/or demonstrate innovation or exceptional competence in advancing nursing.

This paper summarizes some of the principles and experience in nurse education based on the recommendation of the Nurse Tutor Working Party 1970. St Crispin is one of four British nurse training schools where a pilot modular system was introduced in February 1972. This account shows how the historical gap between the classroom and the ward teaching was narrowed if not bridged. The system, according to this experience, is flexible enough to adapt to any local needs and with suitable preparation the scheme could be successfully implemented without incurring additional expense. Points to avoid are shown, but these are few and on balance the scheme has proved to be successful and offers scope and potential for future developments. [ABSTRACT FROM AUTHOR]