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Abstract Background Nursing education necessitates vigilance for clinical safety, a daunting challenge given the complex interchanges between students, patients and educators. As active learners, students offer a subjective understanding concerning safety in the practice milieu that merits further study. This study describes the viewpoints of senior undergraduate nursing students about compromised safety in the clinical learning environment. Methods Q methodology was used to systematically elicit multiple viewpoints about unsafe clinical learning from the perspective of senior students enrolled in a baccalaureate nursing program offered at multiple sites in Ontario, Canada. Across two program sites, 59 fourth year students sorted 43 theoretical statement cards, descriptive of unsafe clinical practice. Q-analysis identified similarities and differences among participant viewpoints yielding discrete and consensus perspectives. Results A total of six discrete viewpoints and two consensus perspectives were identified. The discrete viewpoints at one site were Endorsement of Uncritical Knowledge Transfer, Non-student Centered Program and Overt Patterns of Unsatisfactory Clinical Performance. In addition, a consensus perspective, labelled Contravening Practices was identified as responsible for compromised clinical safety at this site. At the other site, the discrete viewpoints were Premature and Inappropriate Clinical Progression, Non-patient Centered Practice and Negating Purposeful Interactions for Experiential Learning. There was consensus that Eroding Conventions compromised clinical safety from the perspective of students at this second site. Conclusions Senior nursing students perceive that deficits in knowledge, patient-centered practice, professional morality and authenticity threaten safety in the clinical learning environment. In an effort to eradicate compromised safety associated with learning in the clinical milieu, students and educators must embody the ontological, epistemological and praxis fundamentals of nursing.

Copyright of Diversity of Research in Health Journal / Revue de la Diversité de la Recherche en Santé is the property of Diversity of Research in Health Journal 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.)

Copyright of Diversity of Research in Health Journal / Revue de la Diversité de la Recherche en Santé is the property of Diversity of Research in Health Journal 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.)

Copyright of Diversity of Research in Health Journal / Revue de la Diversité de la Recherche en Santé is the property of Diversity of Research in Health Journal 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. The implementation of evidence-based policies and standards is necessary to guide patient safety within the complexity and specificity of intensive care units (ICU). Clinicians within these settings develop experiential insights that have the potential to further advance patient safety. Aim. The purpose of this study was to explore patient safety priorities, as perceived by clinical experts working in an ICU in northern Ontario, Canada. Methods. A modified Delphi technique was used to reach consensus regarding patient safety priorities. Two rounds of questionnaires were used to elicit the expert opinions of clinicians regarding patient safety priorities. Thirty participants completed the first round of data collection, and 19 clinical experts representing both registered nurses and intensivists participated in the final round of data collection. Descriptive statistical analysis was completed at each round of the Delphi process. Findings. Three points of consensus were reached in round two. These included improving pain and agitation management, incorporating a checklist into the bullet-round reporting tool, and implementing the use of visual cues for high-risk lines. Conclusion. The findings of this study emphasize the value of engaging clinicians in identification of site-specific safety priorities to improve patient safety in an ICU setting. [ABSTRACT FROM AUTHOR]

The purpose of this work was to develop an understanding of the meaning of disability for individuals living with chronic obstructive pulmonary disease (COPD) in a Canadian midwestern community from an emic perspective. A focused ethnographic design was used. Fifteen individuals participated in interviews. Narrative analysis was used to examine the interview data. Data analysis revealed 65 dilemma stories consisting of two structural components: the impairment, and the justification/explanation of the impairment. Participants’ impairment might or might not have been known to others. In both situations, individuals were faced with choices of whether to explain/justify or attempt to conceal the impairment. Participants told these dilemma stories to convey the meaning of COPD as a disability invisible to others, and at times, to themselves. The information gained from this research will serve as an essential complement to the existing knowledge about this important yet often invisible chronic illness. [ABSTRACT FROM PUBLISHER]

The article presents a story of a mother suffering from mental illness. It features a mother named Claire, how she copes with her mental illness and at the same time tries to puts up with the demands of caring for her child in the presence of poverty. Aside from the task of caring for herself and her child, additional adversities also faced Claire such as insecure housing, exploitation, and the threat of losing custody of her child due to her mental illness.

The purpose of this work was to develop an understanding of the meaning of disability for individuals living with chronic obstructive pulmonary disease (COPD) in a Canadian midwestern community from an emic perspective. A focused ethnographic design was used. Fifteen individuals participated in interviews. Narrative analysis was used to examine the interview data. Data analysis revealed 65 dilemma stories consisting of two structural components: the impairment, and the justification/explanation of the impairment. Participants' impairment might or might not have been known to others. In both situations, individuals were faced with choices of whether to explain/justify or attempt to conceal the impairment. Participants told these dilemma stories to convey the meaning of COPD as a disability invisible to others, and at times, to themselves. The information gained from this research will serve as an essential complement to the existing knowledge about this important yet often invisible chronic illness.