Power And Conflict Between Doctors And Nurses

Through observations in three intensive care units, this book draws on the reality of practice to explore how nurses and doctors work in intensive care settings. It examines: · the power held by the competing knowledge bases · the roles of the different professions · the decision-making process · the sources of conflict · the need for change. Drawing together sociological theories and clinical practice, Power and Conflict Between Doctors and Nurses explores the role of nurses in delivering contemporary health care. It makes a strong case for interdisciplinary working and is particularly timely when health care policy is challenging work boundaries in health care.

Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.

"Doctors heal, or try to, but as nurses we step into the breach, figure out what needs to be done for any given patient today, on this shift, and then, with love and exasperation, do it as best as we can."—from Critical Care "At my job, people die," writes Theresa Brown, capturing both the burden and the singular importance of her profession. Brown, a former English professor at Tufts University, chronicles here her first year as an R.N. in medical oncology. As she does so, Brown illuminates the unique role of nurses in health care, giving us a deeply moving portrait of the day-to-day work nurses do: caring for the person who is ill, not just the illness itself. Critical Care takes us with Brown as she struggles to tend to her patients' needs, both physical (the rigors of chemotherapy) and emotional (their late-night fears). Along the way, we see the work nurses do to fight for their patients' dignity, in spite of punishing treatments and an often uncaring hospital bureaucracy. We also see how a twelve-hour day of caring for the seriously ill gives Brown herself a deeper appreciation of what it means to be alive. Ultimately, this is a book about embracing life, whether in times of sickness or health. As she takes us into the place where patients and nurses meet, Brown shows us the power of human connection in the face of mortality. She does so with a keen sense of humor and remarkable powers of observation, making Critical Care a powerful contribution to the literature of medicine.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Nurses make up the largest segment of the health care profession, with 3 million registered nurses in the United States. Nurses work in a wide variety of settings, including hospitals, public health centers, schools, and homes, and provide a continuum of services, including direct patient care, health promotion, patient education, and coordination of care. They serve in leadership roles, are researchers, and work to improve health care policy. As the health care system undergoes transformation due in part to the Affordable Care Act (ACA), the nursing profession is making a wide-reaching impact by providing and affecting quality, patient-centered, accessible, and affordable care. In 2010, the Institute of Medicine (IOM) released the report The Future of Nursing: Leading Change, Advancing Health, which made a series of recommendations pertaining to roles for nurses in the new health care landscape. This current report assesses progress made by the Robert Wood Johnson Foundation/AARP Future of Nursing: Campaign for Action and others in implementing the recommendations from the 2010 report and identifies areas that should be emphasized over the next 5 years to make further progress toward these goals.

This is the first book on the market or within academia dedicated solely to moral distress among health professionals. It aims to bring conceptual clarity about moral distress and distinguish it from related concepts. Explicit attention is given to the voices and experiences of health care professionals from multiple disciplines and many parts of the world. Contributors explain the evolution of the concept of moral distress, sources of moral distress including those that arise at the unit/team and organization/system level, and possible solutions to address moral distress at every level. A liberal use of case studies will make the phenomenon palpable to readers. This volume provides information not only for academia and educational initiatives, but also for practitioners and the research community, and will serve as a professional resource for courses in health professional schools, bioethics, and business, as well as in the hospital wards, intensive care units, long-term care facilities, hospice, and ambulatory practice sites in which moral distress originates.

Nurses who conduct research have a longstanding interest in questions of nursing knowledge. Nursing Knowledge is a clear and well-informed exposition of the philosophical background to nursing theory and research. Nursing Knowledge answers such fundamental questions as: How is nursing theory related to nursing practice? What are the core elements of nursing knowledge? What makes nursing research distinctive as nursing research? It examines the history of the philosophical debates within nursing, critiques the arguments, explains the implications and sets out to rethink the philosophical foundation of nursing science. Nursing Knowledge begins with philosophical problems that arise within nursing science. It then considers various solutions with the help of philosophical ideas arguingargues that nurses ought to adopt certain philosophical positions because they are the best solutions to the problems that nurses encounter. The book argues claims that the nursing standpoint has the potential to disclose a more complete understanding of human health than the common disease-and-dysfunction views. Because of the relationship to practice, nursing science may freely draw theory from other disciplines and nursing practice unifies nursing research. By redefining theory and philosophy,With a new philosophical perspective on nursing science, the so-called relevance gap between nursing theory and practice can be closed. The final chapter of the book ‘redraws the map’, to create a new picture of nursing science based on the following principles: Problems of practice should guide nursing research Practice and theory are dynamically related Theory research must provide the knowledge base necessary for nurse interventions, training, patient education, etc. Nursing research should develop midrange theories and its results are nursing theory is strengthened when it uses theories confirmed by is integrated with other disciplines Key features Clear and accessibly written Accurate and philosophically well-informed, Discusses philosophical problems in contexts familiar to nurses Systematically examines the philosophical issues involved in nursing research Examines epistemology (how we know what we know), theory development, and the philosophical foundations of scientific methodology. Develops a new model of nursing knowledge Dr. Mark Risjord is Associate Professor in Philosophy at Emory University, and has a faculty appointment in the Nell Hodgson Woodruff School of Nursing. His main research areas have been in the philosophy of social science and the philosophy of medicine. He was invited to has been teaching philosophy of science and theory development in the new PhD program in the Nell Hodgson School of Nursing at Emory University insince 1999. He has been awarded two competitive teaching prizes: Emory Williams Distinguished Teaching Award (2004) and the Excellence in Teaching Award (1997). He is presently serving as the Masse-Martin/NEH Distinguished Teaching Chair (2006-2010).

Focusing on the nurse researcher's dual role as practitioner and researcher, as well as research ethics and the relationship between practitioner and academic agendas, The Reality of Nursing Research helps to: locate the practical dilemmas of nursing research in historical and policy context prepare those about to embark on research for some of the issues they will face reassure researchers that they are not the only ones to encounter the complexity of real life research support the research teacher or supervisor in preparing and mentoring their students share experiences of others who have encountered similar issues and provide some practical advice on their solution. With illustrative case studies and practical advice, this book looks at the real life dilemmas faced by nurse researchers at key stages of the research process from developing a research question through to disseminating the findings. It is an essential text for nurse researchers, teachers of research, research supervisors and nurses undertaking research at diploma through to doctoral level.