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Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses articles within the issue on topics including issues relating to everyday nursing, changes in nursing education and practice in Australia, and differences in nursing thought inherent in internationalization.

From the 1920s to the 1950s, the American tobacco industry targeted female nurses to promote cigarette smoking as modern, healthy, fashionable, and safe. While such ads conflicted with the profession's responsibility to protect the public's health, they also offered nurses a long-sought recognition of professional respectability. As a result, nurses increasingly embraced their commercial representation instead of combating tobacco promotion as a public health crisis. Analyzing the gradual rise and abrupt end to the cultural icon of the smoking nurse, this article focuses on the gendered and professional tensions represented through a three-decade conflict between the international nursing leader Lavinia Dock and major American nursing institutions. Complicating broader historical assumptions about women and smoking, this article shows how the tobacco industry gradually co-opted and dismantled the shared gendered vision of emancipation and professionalization among women in nursing, public health, and the women's movement from the early twentieth century. [ABSTRACT FROM AUTHOR]

Aim: To reveal correlates of the decrease of Spanish nurse migration (1999–2007). Background: Nursing outmigration is a concern for countries. Nurse migration from Spain began in the 1990s. Introduction: From 1999 to 2007, the yearly number of migrations dropped significantly. We ask what social, economic and policy factors could be related to this drop. Methods: We used publicly available statistics to confirm hypothesis (1) The drop in nursing migration coincided with a drop in nursing unemployment. Then we hypothesized that this coincided with (1a) a decrease in the number of graduates, (1b) an increase in the number of hospitals and/or beds functioning, and/or (1c) an increase in the ratio of part‐time contracts. Results: Our analysis confirms hypotheses (1) and (1c) and disconfirms (1a) and (1b). Conclusion: The greater availability of part‐time contracts seems to have encouraged nurses to remain in Spain. Implications for Nursing Management: The strategy to reduce nursing unemployment with more part‐time contracts, while temporarily successful in Spain, brings with it major challenges for patient care and the working life of nurses. We suggest that nurse leaders and health policymakers consider proactive policies to adjust the balance between supply and demand without decreasing the quality of available positions. [ABSTRACT FROM AUTHOR]

Background After the financial crisis of 2008, increasing numbers of nurses from Spain are going abroad to work. Objectives To examine the health and workforce policy trends in Spain between 2009 and 2014 and to analyze their correlation with the migration of nurses. Design Single embedded case study. Data sources We examined data published by: Health Statistics, Organization for Economic Cooperation and Development (1996 to 2013); Ministry of Education, Culture and Sports (2006 to 2013); Ministry of Employment and Social Security (2009 to 2014); Ministry of Health, Social Services and Equality (1997 to 2014); and National Institute of Statistics (1976 to 2014). In addition to reviewing the scholarly literature on the topic in Spanish and English, we also examined Spanish mobility laws and European directives. Population We used the Organization for Economic Cooperation and Development definition of “professionally active nurses” which defines practising nurses and other nurses as those for whom their education is a prerequisite for employment as a nurse. Moreover, we used the term “nursing graduate” as defined by Spanish Ministry of Education to describe those who have obtained a recognized qualification in nursing in a given year, the term “registered nurses” is defined by Spanish law as nurses registered in the Nurses Associations and “unemployed nurses” are those without work and registered as seeking employment. Results A transformation of the Spanish health system has reduced the number of employed nurses per capita since 2010. Moreover, reductions in public spending, labour market reforms and widespread unemployment have affected nurses in two ways: first by increasing the number of applicants per vacancy between 2009 and 2013, and second, by an increase in casual positions. However, despite the poor job market and decreasing job security, the number of registered nurses and nursing graduates in Spain per year has continued to grow, increasing the pressure on the labour market. Conclusions Spain is transforming from a stable nursing labour market, to one that is increasingly producing nurses for foreign markets, principally in Europe. With its low birth rate, increased life expectancy and increasing rates of chronic disease, it is critical for Spain to have sufficient nurses now and into the future. It is important that there be continued study of this phenomenon by Spanish policy makers, health service providers and educators in order for Spain to develop health human resources policies that address the health care needs of the Spanish population. [ABSTRACT FROM AUTHOR]

Objective: to analyse the differences between medication prescriptions by nurses in Brazil and Ontario, Canada. Methods: a comparative study between two different scenarios; this comparison was not performed between the two countries because Canada does not standardize this practice, which is legally established and is considered as an advanced professional knowledge area in Brazil. Results: prescription is a professional position to be occupied by nurses. However, there is tension surrounding this practice because it is perceived as a threat to privileges or traditions of other health professionals. Prescibing medication by nurses in Brazil and Ontario follows current legislation and training proccess in each context. Conclusions: there are some challenges to be overcome in ensuring the visibility and consolidation of the practice by nurses in these realities: guarantee of professional competence, credibility, acceptability, and the respectability of clientele in your professional scope by other health professionals. [ABSTRACT FROM AUTHOR]

Despite the fact that there is unmet demand for nurses in health services around the world, some nurses migrate to destination countries to work as domestic workers. According to the literature, these nurses experience contradictions in class mobility and are at increased risk of exploitation and abuse. This article presents a critical discussion of the migration of nurses as domestic workers using the concept of 'global care chain'. Although several scholars have used the concept of global care chains to illustrate south to north migration of domestic workers and nurses, there is a paucity of literature on the migration of nurses to destination countries as domestic workers. The migration of nurses to destination countries as domestic workers involves the extraction of reproductive and skilled care labor without adequate compensatory mechanisms to such skilled nurses. Using the case of the Canadian Live-in Caregiver Program, the study illustrates how the global movement of internationally educated nurses as migrant domestic workers reinforces inequities that are structured along the power gradient of gender, class, race, nationality, and ethnicity, especially within an era of global nursing shortage. [ABSTRACT FROM AUTHOR]

This paper historicizes the taken-for-granted acceptance of reflection as a fundamental professional practice in nursing. It draws attention to the broad application of reflective practice, from pedagogy to practice to regulation, and explores the epistemological basis upon which the authority of reflective discourse rests. Previous work has provided a series of critiques of the logic and suitability of reflective practice across all domains of nursing. The goal of this paper is to commence a history of nursing's reflective identity. The paper begins with a discussion of Dewey and Schön then focuses on Habermas's Theory of Communicative Action as the epistemological basis of reflective practice's standing as a authoritative discourse in nursing. [ABSTRACT FROM AUTHOR]

Nursing history has been a much debated subject with a wide range of work from many countries discussing the profession’s identity and questioning the nature of nursing and professional practice. Building upon a review of the recent developments in nursing history worldwide and on primary research that examined the structure of mandated nursing history courses in 14 nursing schools in the state of Santa Catarina, Brazil, this paper analyzes both the content and the pedagogical style applied. We postulate that the study of history offers an important opportunity for the development of student learning, and propose that more creative and dynamic teaching strategies be applied. We argue the need for professors to be active historical researchers, so they may meaningfully contribute to the development of local histories and enrich the professional identities of both nursing students and the profession. We conclude that historical education in nursing is limited by a traditional and universalist approach to nursing history, by the lack of relevant local sources or examples, and by the failure of historical education to be used as a vehicle to provide students with the intellectual tools for the development of professional understanding and self-identity. [ABSTRACT FROM AUTHOR]

The article informs that most nurses agree that the profession needs a contemporary image to attract new recruits and reinforce the idea that nursing is a profession grounded in science, technology, and knowledge. Today's nurses are under increasing pressure to concretely connect nursing practice and patient outcomes. It is thus difficult to understand why nursing and nurses appear to have such a limited vocabulary when discussing and promoting their own work. Even more difficult to understand is why, when there is a great deal of data documenting the critical importance of nursing in patient care, nursing groups and their political supporters make so little use of it. INSET: A New Image for Nursing?.

NELSON S and PURKIS ME.Nursing Inquiry2004;11: 247 –257Mandatory reflection: the Canadian reconstitution of the competent nurseOver the past two decades, the competency movement has been gathering momentum internationally within the ranks of professional nursing. It can be argued that this momentum is in response to government initiatives aimed at improving consistency in workforce training and accreditation, and fostering national and international portability of qualifications. At the same time, the competency movement has provided the opportunity for regulators, service providers and government to develop mechanisms to reconstitute competent nurses as accountable, self-regulating subjects and to monitor this transformation in particular ways. The ways in which competencies have been taken up to do this transforming work in Canada are unique and deserving of some detailed description and analysis.We argue that Canadian nursing regulatory authorities have chosen to view competence as the rehearsal of ethical attributes consonant with the professional role,as opposed to the enactment of skilled conduct. As a result, reflective practices rather than skill and knowledge have become the cornerstone of nursing competency formulation and review. We argue that this distinctly Canadian approach to competency serves three ends. First, it privileges the‘attribute’ element of the nursing competency model and side steps the ever-problematic‘nursing knowledge’ issue; second, self-surveillance by nurses shifts the onus for professional development from industry to the individual; and third, it concedes responsibility for skill assessment by the regulatory authorities to industry control, leaving employers free to determine skill base and skill mix requirements for practice. Finally, we argue that the reflective component of the regulatory framework for Canadian nurses radically fails as a tool for auditing quality and assessing competency. Rather, it functions as a governmental practice that furthers the deregulatory and economic rationalist aims of the Canadian health reform agenda. [ABSTRACT FROM AUTHOR]

This paper examines the increasing trend by nursing scholars such as Patricia Benner to conceptualize ethics as a contextual and embodied ‘way of knowing’, embedded in nursing expertise. The intellectual origins of this development and its debt to neo-Aristotelian thinkers such as philosopher Charles Taylor are discussed. It will be argued that rather than revealing a truth about ethical expertise, the emergence of the ‘expert’ nurse as a moral and ethical category is the result of the elaboration of neo-Thomist discourses in the educational and professional shaping of nurses. These discourses act on and are enacted by the individual nurse through his or her participation in specific ethical exercises that result in the constitution of the desired subjectivity – or ‘expertise’. Central to this shaping are particular notions of ‘the good’ and its relationship to knowledge, skill and practice. Critiques of these neo-Aristotelian perspectives are discussed and applied to the notion of moral expertise in nursing, and the claims made by its proponents concerning the ‘ethical’ distinction between experienced and expert nurses. Finally, a call is made for a more pluralistic approach to ethics. [ABSTRACT FROM AUTHOR]

Examines the emergence of civics discourse in nursing. Examination on the discursive displacement of religious vocational fervor through civic and patriotic imperatives; Focus on the professional history of nursing; Role of civic and patriotic discourse in the framing of a subjective secular nursing.

Technology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited. To examine the impact of technology and digitalization on regulation, we conducted an exploratory case study of the regulatory bodies for nursing, law, and social work in Ontario, Canada. Data were collected over two phases. First, we collected documents from the regulators' websites and regulatory consortiums. Second, we conducted key informant interviews with two representatives from each regulator. Data were thematically analyzed to explore the impact of technological change on regulatory activities and policies and to compare how regulatory structure and field shape this impact. Five themes were identified in our analysis: balancing efficiency potential with risks of certain technological advances; the potential for improving regulation through data analytics; considering how to regulate a technologically competent workforce; recalibrating pandemic emergency measures involving technology; and contemplating the future of technology on regulatory policy and practice. Regulators face ongoing challenges with providing equity-based approaches to regulating virtual practice, ensuring practitioners are technologically competent, and leveraging regulatory data to inform decision-making. Policymakers and regulators across Canada and internationally should prioritize risk-balanced policies, guidelines, and practice standards to support professional practice in the digital era. [ABSTRACT FROM AUTHOR]

The authors reflect on the failure of nurses to perform their core constituency due to their lack of interest in the care of the sick. The authors argue that caring for the sick has prevented nurses from being seen as educated and knowledgeable. The authors suggest that nurses should stimulate their critical rethinking of nursing to ensure a strong practice-based profession.

The authors reflect on the importance of health professional obligations and duty in situations of SARS occurrence. They provide information on the exposures of individuals to the risk of infection in communicable disease outbreaks. Reports about the SARS pandemic and outbreaks in Toronto, Ontario, which induced a vital research program and health guide policies into the issues raised in the care of individuals with communicable diseases, are discussed.

The article presents the author's views on the interprofessional collaboration of doctors and nurses in the medical care system of Canada. According to the author, collaboration between the professions works to break down boundaries, facilitate communication and create the conditions for better medical care. He predicts that with time the collaboration may flow from successes at the local level, negotiated individually in a range of different wards, practices and teams.

Editorial. Discusses issues concerning the nursing discipline. Nurses' leadership; Relationship between the academy and practice; Professionalization of nursing.

Background: Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry-to-practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care. Methods: This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions. Discussion: Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation. Systematic review registration: This protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/BD2ZX). [ABSTRACT FROM AUTHOR]

The article reflects the author's view on the methodological and conceptual dilemma of how to write a history of nursing prior to the nineteenth century. He stresses that examining nursing practice prior to the development of the modern hospital and scientific medicine caters significant challenges to historians. Possible problems hounding the nursing practice in pre-19th century are presented.

The article focuses on the evolution of "Nursing Inquiry" from an Australian journal to an international institution in 2006. Professor Judith Parker has resigned as editor-in-chief. She is succeeded by Sioban Nelson, the dean of the Faculty of Nursing at the University of Toronto. However, Professor Michael Nelson will assume the role of European editor.

Comments on the staffing and workforce issues in nursing in Australia. Concerns over political differences within the nursing profession; Adjustment to the total nursing budget; Implications of nursing for the quality of patient care and patient outcomes.

Nursing historians well understand the importance of' history in furthering the understanding of' nursing practice, the profession, and the healthcare and social systems in which nursing takes place. These are all important issues for readers of nursing inquiry. One of the most important functions a historical perspective performs is to shatter the historical illusion that the problems and challenges faced by contemporary nurses, patients and healthcare providers are solely by-products of' the here and now. The struggle for control of nursing practice and negotiations over the elastic boundaries of' nursing knowledge, skill and work have formed the basis of heated battles since at least the rise of the "clinic" in eighteenth-century France.

MIRÓ M, GASTALDO D, NELSON S and GALLEGO G. Nursing Inquiry 2012; 19: 270-280 Spanish nursing under Franco: reinvention, modernization and repression (1956-1976) This article examines Spanish nursing during a critical 20-year period (1956-76) when, under the dictatorial government of General Franco, nursing became the target of a modernization strategy. In the national standardized system of state-run schools, the previously distinct nursing and midwifery programmes were merged into a new training programme which created the single professional denomination of ATS- Ayudante Técnico Sanitario (Technical Sanitary Assistant). Under the leadership of medicine, and with the blessing of the Catholic Church and the Sección Femenina (Women's Section of the Falangist Party), nursing was positioned as feminized and subordinate to medicine, a predominantly male profession in mid-twentieth century Spain. This article discusses this crucial phase of Spanish nursing history by focusing on one influential historical document (published in 1956), Professional Moral Orientation for the Sanitary Technical Assistants, a nursing textbook on professional morals for first-year nursing students written by Rosamaria Miranda, a Catholic nun and a trained nurse. Our analysis reveals that gender-related and technical discourses concerning disciplinary and pastoral power relations presented in this textbook legitimate the core beliefs of Franquism put forward by the politically powerful women's branch of the ruling Falangist Party in mid-twentieth century Spain. [ABSTRACT FROM AUTHOR]

MIRÓ M, GASTALDO D, NELSON S and GALLEGO G. Nursing Inquiry 2012; 19: 270-280 Spanish nursing under Franco: reinvention, modernization and repression (1956-1976) This article examines Spanish nursing during a critical 20-year period (1956-76) when, under the dictatorial government of General Franco, nursing became the target of a modernization strategy. In the national standardized system of state-run schools, the previously distinct nursing and midwifery programmes were merged into a new training programme which created the single professional denomination of ATS- Ayudante Técnico Sanitario (Technical Sanitary Assistant). Under the leadership of medicine, and with the blessing of the Catholic Church and the Sección Femenina (Women's Section of the Falangist Party), nursing was positioned as feminized and subordinate to medicine, a predominantly male profession in mid-twentieth century Spain. This article discusses this crucial phase of Spanish nursing history by focusing on one influential historical document (published in 1956), Professional Moral Orientation for the Sanitary Technical Assistants, a nursing textbook on professional morals for first-year nursing students written by Rosamaria Miranda, a Catholic nun and a trained nurse. Our analysis reveals that gender-related and technical discourses concerning disciplinary and pastoral power relations presented in this textbook legitimate the core beliefs of Franquism put forward by the politically powerful women's branch of the ruling Falangist Party in mid-twentieth century Spain. [ABSTRACT FROM AUTHOR]

Maternal mortality has traditionally been the key element in the monitoring of maternal health and adequacy of obstetric services in Australia and around the world. In developed countries, the ability of maternal mortality to serve this purpose is reduced because of the rarity of maternal mortality, reflected in very low maternal mortality ratios. Internationally, there has been increasing interest in severe maternal morbidity as an indicator to monitor maternal health and maternity services. The aim of this paper is to critically examine the capacity to measure and monitor maternal morbidity in Australia. There is a paucity of reliable maternal morbidity data in Australia; Australia is lagging behind peer countries that are endeavouring to monitor severe maternal morbidity. Dedicated efforts and adequate resources are needed in order to monitor severe maternal morbidity in Australia. [ABSTRACT FROM AUTHOR]

Introduction and Background: The full participation of women as healthcare providers is recognized globally as critical to favorable outcomes at all levels, including the healthcare system, to achieving universal health coverage and sustainable development goals (SDGs) by 2030. However, systemic challenges, gender biases, and inequities exist for women in the global healthcare workforce. Fragile and conflict-affected states/countries (FCASs) experience additional pressures that require specific attention to overcome challenges and disparities for sustainable development. FCASs account for 42% of global deaths due to communicable, maternal, perinatal, and nutritional conditions, requiring an appropriate health workforce. Consequently, there is a need to understand the impact of gender on workforce participation, particularly women in FCASs.Methods: This scoping review examined the extent and nature of existing literature, as well as identified factors affecting women's participation in the health workforce in FCASs. Following Arksey and O'Malley's scoping review methodology framework, a systematic search was conducted of published literature in five health sciences databases and grey literature. Two reviewers independently screened the title and abstract, followed by a full-text review for shortlisted sources against set criteria.Results: Of 4284, 34 sources were reviewed for full text, including 18 primary studies, five review papers, and 11 grey literature sources. In most FCASs, women predominate in the health workforce, concentrated in nursing and midwifery professions; medicine, and the decision-making and leadership positions, however, are occupied by men. The review identified several constraints for women, related to professional hierarchies, gendered socio-cultural norms, and security conditions. Several sources highlight the post-conflict period as a window of opportunity to break down gender biases and stereotypes, while others highlight drawbacks, including influences by consultants, donors, and non-governmental organizations. Consultants and donors focus narrowly on programs and interventions solely serving women's reproductive health rather than taking a comprehensive approach to gender mainstreaming in planning human resources during the healthcare system's restructuring.Conclusion: The review identified multiple challenges and constraints facing efforts to create gender equity in the health workforce of FCASs. However, without equal participation of women in the health workforce, it will be difficult for FCASs to make progress towards achieving the SDG on gender equality. [ABSTRACT FROM AUTHOR]

Aim: To analyse the relationship between Spanish nurses' intention to migrate and job security. Background: Nursing emigration from Spain increased dramatically between 2010 and 2013. By 2015, emigration had returned to 2010 levels. Methods: Single embedded case study. We examined publicly available statistics to test for a relationship between job security and applications by Spanish nurses to have credentials recognized for emigration purposes. Results: Between 2010 and 2015, job security worsened, with poor access to the profession for new graduates, increased rate of professional dropout, increased nursing jobseekers and falling numbers of permanent contracts. Conclusions: The number of accreditation applications in Spain in 2010 and 2015 was very similar, but job security worsened on a number of fronts. The distribution of work through part‐time contracts aided retention. Implications for nursing management: Policymakers and health care administrators can benefit from understanding the relationship between mobility, workforce planning and the availability of full‐time, part‐time and short‐term contract work in order to design nursing retention programmes and ensure the sustainability of the health care system. [ABSTRACT FROM AUTHOR]

A response by Wendy Pollock and her colleagues to a letter to the editor about their article on monitoring maternal morbidity in Australia is presented.