新形势下专科护生临床实习存在的问题及对策

由于护理模式及市场环境的转变,护生实习期间存在管理制度不够健全、实践技能操作机会不多、沟通能力有待加强、生活保障不到位、对自己的个人发展设计欠缺等问题。为此,可以采取以下对策应对存在的问题：通过树立服务意识,强化沟通能力的培养;加强对临床带教的管理,共建实训基地;规划职业生涯,丰富择业途径等。     

More than ‘information provider’ and ‘counselor’: Constructing and negotiating roles and identities of nurses in genetic counseling sessions

This paper contributes to research on genetic counseling by exploring the complexity of this activity from the angle of identity construction. We argue that an analysis of the processes through which healthcare providers construct and negotiate their roles and identities in these encounters may contribute to a better understanding of the complexities of genetic counseling. Drawing on more than 150 video‐recorded genetic counseling encounters between nurses and clients in Hong Kong, we illustrate that the discursive processes involved in the construction of the nurses' identities are complex, overlapping and at times contradictory as the nurses respond to the (sometimes) competing norms and expectations of their institution, their clients and their own. They manage to solve these tensions by drawing on the roles traditionally assigned to nurses in these encounters such as information provider and counselor, as well as creating the new roles of co‐decision maker and cultural broker/mediator.     

优质病区护士压力源及应对方式调查与分析

目的：探究优质病区护士压力的来源和应对方式.方法：对南京市3所三甲医院优质护理示范病区238名护士进行了问卷调查.结果：不同科室、学历和职称的优质病区护士压力差异有统计学意义,优质病区护士积极应对压力得分均大于消极应对得分,消极应对与压力存在正相关性.结论：建议采取增加人员的配备,合理排班,提高护士的工作热情,减少压力源.     

论医护合作

当前医疗实践中存在三种主要医护关系类型。医护关系类型的不同,影响到医疗、护理服务效率和医护人员的工作满意度。随着护士专业自主性扩大,医护之间的权力也从医生向护士转移,医患合作的方式和内容也在变化。调查显示：48．5％的护士（n=3665）称本科室医生与护士合作状况良好。导致医护合作不顺畅的因素主要有四种,即医护双方在知识、技能及人文素质等方面的差异所导致的主观态度和实际行为上的差异;医护之间的沟通能力不强,导致相互问不信任、相互不尊重;临床科室医护合作的特点不同,影响医护合作因素也不同;“医尊护卑”的传统观念作祟。作者认为促进医护合作的策略有明确医护人员各自韵职责,加强医护沟通互信,营造体现平等互助的医院文化。     

护生临床实习期间的心理问题与对策分析

护士的心理品质关系到为病人服务过程中综合能力的发挥,医院实习护生心理品质的培养对其护理生涯有重要意义。分析实习护生的主要心理问题,结合心理学等理论知识及临床带教的经验,进而提出提高护士心理品质的对策,有助于实习护生尽快地成长并适应现代护理工作的人性化需求。     

Policy Targets and Ethical Tensions: UK Nurse Recruitment

In July 2000 Britain's New Labour government set a target of 20,000 extra nurses for the NHS by 2004. In February 2002, two years ahead of schedule, the target was achieved. The government is to be congratulated on meeting its target but ethical questions over recruitment practices remain. Nurse registrations to the UK from the (then) fifteen EU countries remain flat despite government guidance making this the first priority for international recruitment. Registrations from developing countries with nursing shortages continue despite repeated guidance discouraging this. The government appears to have been caught in a policy bind. On the one hand it needed to be seen to be acting to prevent “poaching” while waiting for fresh intakes of trainees to come through; on the other, if it had succeeded it would have struggled to meet a key policy pledge and certainly not ahead of schedule. New Labour's stated commitment to an ethical foreign policy seems more apparent than real. The paper reports a clear dissonance between the thrust of national policy on nurse recruitment and current employment practices within the UK.     

Health Insurance for All Long-Term Care Workers: Estimated Costs and Coverage Impacts in Minnesota and Recommendations for States

A major barrier to building a strong workforce to meet the growing need for long-care is lack of affordable health benefits. This study projects impacts of funding health coverage for all long-term care workers in Minnesota. Under the most cost effective model plan design, enrollment in employer-sponsored coverage would increase 73% to 100% for individual coverage and 26% to 42% for family coverage. Total monthly costs would be $698/worker in the commercial market or $634/worker through a new dedicated risk pool. Based on our findings and past research, the authors present recommendations for structuring and implementing a long-term care worker health insurance initiative.     

Consistent Assignment of Nurse Aides: Association With Turnover and Absenteeism

Consistent assignment refers to the same caregivers consistently caring for the same residents almost every time caregivers are on duty. This article examines the association of consistent assignment of nurse aides with turnover and absenteeism. Data came from a survey of nursing home administrators, the Online Survey Certification and Reporting data, and the Area Resource File. The measures were from 2007 and came from 3,941 nursing homes. Multivariate logistic regression models were used to examine turnover and absenteeism. An average of 68% of nursing homes reported using consistent assignment, with 28% of nursing homes using nurse aides consistent assignment at the often recommended level of 85% (or more). Nursing homes using recommended levels of consistent assignment had significantly lower rates of turnover and of absenteeism. In the multivariate analyses, consistent assignment was significantly associated with both lower turnover and lower absenteeism (p < .01). Consistent assignment is a practice recommended by many policy makers, government agencies, and industry advocates. The findings presented here provide some evidence that the use of this staffing practice can be beneficial.     

Human Resource Management Best Practices and Globalization: The Universality of Common Sense

Popular strategies for reform have come directly from the private sector in what is perhaps the most profound redefinition of public administration since the field first emerged as an identifiable specialty. The purpose of this paper is to examine the context out of which these reforms have grown, the challenges that have arisen as a result, and cases where private sector reform strategies have been successfully (and sometimes unsuccessfully) applied in human resource management (HRM). We discuss the benefits and hazards of many of the reforms and conclude that restoring a measure of confidence in the legitimate role of the civil service is essential for nations dealing with the challenges of globalization.