Minimum nurse-to-patient ratios in acute care hospitals in California.
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Many registered nurses believe that nurse staffing in acute care hospitals is inadequate. In 1999 California became the first state to mandate minimum nurse-to-patient ratios in hospitals. State officials announced draft ratios in January 2002 and expect to implement the legislation by July 2003. We estimate that the direct costs of compliance will be small. However, mandatory ratios could generate opportunity costs that are not easily measured and that may outweigh their benefits. Policymakers elsewhere should consider other strategies to address nurses' concerns, because other approaches may be less costly and produce greater benefits to nurses and patients. (+info)
Understanding the role of nurse practitioners in Canada.
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The practice of medicine and nursing continues to evolve as a result of changes in knowledge, technology and health care needs. New areas of specialization have developed and, in particular, the roles and duties of registered nurses have been expanded. This expansion has enabled nurses with advanced education and skills to function as independent and interdependent clinicians who practise in partnership with physicians and other health care professionals. (+info)
Assistants to primary physicians in California.
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The mid-level practitioner movement is no longer experimental; nurse practitioners and physician's assistants in California have proved to fill a necessary and viable professional role in the delivery of primary health care. The physician's assistant law (AB2109) and the Experimental Manpower Act (AB1503) have facilitated the training and functioning of these new health care professionals; more comprehensive laws are still needed to permit optimal utilization. National agencies for approval of teaching programs and testing of individual graduates will play an increasing role in the accreditation and certification procedures. Professional role difficulties, issues of sex and questions of delegation of responsibility are being resolved and it is hoped that a more equitable and patient-oriented system is evolving. (+info)
Educating nursing students about quality care and safe practices in the AIDS epidemic.
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Nursing students, as future health care providers, need comprehensive instruction about AIDS--the many manifestations of both the disease itself and the pandemic. As health educators and practitioners, nurses play a major role in safeguarding the health care setting and the community by their efforts in preventing transmission of the AIDS virus. Nurses are and will continue to be responsible for administering the major portion of the direct health care that AIDS patients require and for teaching basic nursing skills to other care givers. According to a 1987 survey of 461 nursing programs conducted by the American Association of Colleges of Nursing, AIDS content is being incorporated into the curriculums of the majority of programs that responded. Students require an in-depth knowledge of AIDS to enable them to address effectively the needs of AIDS patients and their families. Because of the complex psychosocial, ethical, and legal issues, careful attention must be given to the development of students' skills in making clinical decisions that will promote effective nursing intervention when addressing problems in nursing care. Curriculums should also include assessment of the special needs of members of minority groups that are disproportionately affected by AIDS. Schools of nursing in colleges and universities can serve as key resources for developing curriculums, policies, and practice patterns that will assist the nursing community and the public in responding to the AIDS epidemic. (+info)
The nurse under physician authority.
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A medical centre is an institution established for a specific purpose: to facilitate the health and health-related welfare of the medical centre's patients. Within this institution, there are a variety of professionals who act and interact to serve this purpose. Of particular interest is the interaction between physician and nurse. Generally, the nurse is thought to be under a certain obligation to implement a physician's orders unless there is good reason not to do so. This qualifier places a conflicting obligation upon the nurse not to implement some physician orders. How should a judgement about which orders there is 'good reason' not to implement be made? I propose to approach this question through an analysis of the obligation the nurse has to implement the order of a physician, and the conditions under which the order does not pose such obligations. This analysis will consist of an examination of the obligation in terms of the purposive authority of the physician. For example, in the context of the medical centre, the physician's medical training qualifies her as best able to make determinations of what treatment would promote the patient's health. However, this purpose not only serves as the basis of the physician's authority, but also serves as a limitation upon the physician's authority (for example, an order which would harm the patient would not reflect the purpose for which the physician has been given authority). Thus, a philosophical investigation into the nature of the obligation to implement a physician's orders can help to clarify those occasions when a nurse should not implement an order. (+info)
Royal College of Nursing (Rcn) code of professional conduct: a discussion document.
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We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (+info)