Reflective practice: decoding ethical knowledge.

Background: Critical reflection is an essential curricular component for learning from experience that determines placement quality in postsecondary experiential learning placements. However, there are poor empirical connections between the use of critically reflective processes and learning outcomes. Purpose: This research explored reflective processes professionals use in their practice and how these processes compare with the reflective activities postsecondary instructors in professional faculties use during experiential learning. Methodology/Approach: This collective case study used focus group interviews, field notes, and professional grey literature to examine the research questions. Findings/Conclusions: Professional training programs must align their reflective practices with more integrated and holistic models of reflective practice to better mirror the professional skills demanded in professional practice contexts. Professionals in context-laden professional environments should integrate reflective activities into their practice based on emergent, iterative, and cocreative models that are more like their lived realities at work. Reflective practices which better fit and mirror these lived realities may lead to better connections between reflective activities and work outcomes. Implications: Professional environments are complex, dynamic, and affected by contextual factors. New integrated and holistic models of reflective experience should replace the separated, stepwise, or automatic models that have guided reflective practices in the past.

Through the 1990s most hospitals were involved in restructuring. As a result, maintaining professional nursing practice is challenging in these cost-constrained hospital environments. In new models of care, professional nursing practice expectations are often reconceptualized into multidisciplinary care team structures in which the team is empowered and becomes the focus rather than the individual nurse caring for her or his patient. Given that nurses provide the greatest part of patient care in hospitals, professional nursing practice has the potential to differentiate one hospital from another. Consequently, it is in the strategic interest of organizational policy makers to implement initiatives that support professional nursing practice.

Community mental health nurses speak out: The critical relationship between emotional wellbeing and satisfying professional practice

Reframing evidence-based practice curricula to facilitate engagement in nursing students

La práctica reflexiva docente es esencial para transformar eficazmente los conocimientos teóricos y prácticos de los docentes, mejorando así su labor pedagógica. Este estudio tuvo como objetivo analizar el saber pedagógico en la práctica reflexiva docente durante los últimos cinco años. Se utilizó la metodología de revisión sistemática para analizar los artículos primarios de las bases de datos Scopus, ERIC y ProQuest. Tras aplicar criterios de inclusión, se seleccionaron 12 artículos para su análisis e interpretación. Se concluyó que el saber pedagógico incide de manera significativa en la práctica reflexiva docente, lo que mejora el desempeño del maestro y, por ende, contribuye de manera sustancial en los aprendizajes de los educandos.

One Nurse, One Life, Many Legacies: A Tribute: Nancy Kostel-Donlon, July 10, 1958-September 17, 2010

Professional practice models (PPMs) guide nursing practice, professional behaviors, and clinical leadership. Health care continues to evolve (e.g., through health system mergers), and nurses may need to adopt and understand new PPMs to confidently align their interventions and professional nursing practice accordingly. The purpose of this project was to create an educational module about a new PPM based on the model of relationship-based care (RBC), which was adopted following a health system merger. The module was presented to a sample of nursing staff and leaders, who subsequently evaluated how it changed their confidence in and understanding and application of RBC in their professional nursing practice. Quantitative data showed that the module was an effective method to increase nurses' understanding of, and confidence in providing care utilizing, the RBC model. Qualitative data analysis generated themes (team building, need for self-care, being present, lack of time and resources, and resistance to or fear of change) about how implementation of RBC as the organization's PPM would change professional nursing practice, and barriers related to its implementation.

Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman.

This expository article describes an overview of salient changes made to a baccalaureate curriculum to meet the ever changing demands of health care, professional nursing practice, and post-secondary education. The innovations were embedded in the tenets of complexity science, mandates of our professional practice, the contextual relevance of the curriculum and the scholarship of integrative learning. The curriculum is present and future oriented, evidence-based and relevant. The curricular structure shifts content and pedagogy from the traditional stance. The planned and integrative semester course design is greater than the sum of its parts; course content is carefully chosen to illustrate the integrative nature of health and illness, and taken together, these strategies prevent notions of simple to complex learning. The shift from a traditional curricular approach necessitated the examination of how we optimized the use of scarce fiscal and physical educational resources and how we collaborated with all of our stakeholders.

A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

This article explores risk in professional nursing practice. Professional risk refers to the threat of professional discipline if it is found that a registered nurse has violated professional nursing practice standards. We argue professional risk is socially constructed and understood differently by nurse regulatory bodies, unions, professional associations and frontline nurses. Regulatory bodies emphasize professional accountability of nurses; professional associations focus on system problems in health-care; unions undertake protecting nurses' right to health and safety; and frontline nurses experience fear and uncertainty in their attempt to interpret practice standards to avoid professional discipline. Perspectives of professional risk are investigated by analyzing three professional nursing bodies' views of professional codes governing the right of nurses to refuse unsafe work assignments. The workplace dynamics surrounding work refusal experienced by frontline nurses are illustrated primarily through the lens of the 2003 SARS influenza outbreak in Ontario, Canada. We conclude that frontline nurses in Ontario are required to manage risk by following professional protocols prioritizing patient care and professional accountability which disregard the systemic, unpredictable and hazardous circumstances in their everyday practice. Moreover, we argue professional protocols cannot anticipate every eventuality in clinical practice creating the fear of professional discipline for nurses.

Knowledge and Practices in the Field of Nursing is a work devoted to reflecting on and deepening the knowledge that underpins professional practice in Nursing. In a context characterized by continuous scientific, technological, and organizational changes within healthcare, strengthening the connection between theoretical knowledge and clinical practice is essential. The publication brings together contributions that […]

Nursing, when establishing certain practices in Primary Health Care, finds itself in a challenging context, in which it needs to improve a series of elements related to its profes-sionalization process for greater autonomy. It´s estimated that this care model has been pro-ducing a privileged space for changes, especially in nurses' practice, representing great po-tential for the development of a differentiated cognitive base, a regulatory framework con-sistent with the changes that have occurred, and may thus interfere with their professional recognition. The purpose of this qualitative research was to analyze the professional practice of nurses in the context of Primary Heath Care in Brazil, considering the context of changes and extensions of their care practices, in the light of the Sociology of Professions theory, with a view to understanding what elements may provoke changes in the archetype of the profession. A documentary analysis was carried out on the legislation and technical and sci-entific guidelines that guide the professional\2019s practices, associated to a field research on the daily work of nurses in the city of Rio de Janeiro, and on the position of COFEN Presidents and to ABEN. The results showed that nursing has developed elements related to the profes-sionalization process in order to achieve full self-regulation and establishing their standard of practice to achieve a professional exercise compatible with Primary Care. It has also been identified that the Ministry of Health is the main regulator of the practice of nurses, as well as there is a low incorporation of the specific cognitive base of nursing in its guidelines. However, the research listed a set of practices with potentialities for changes in nurses' pro-fessional practice, which could be correlated with some extensions of practices observed in other countries. Field research showed that professional education strengthens and integrates nursing practices; the user embracement is a space of tension and potentiality for the changes and the scientific evidences, the goals and the needs of the territory guide the nurses. The conclusion is that Primary Health Care is a potent space for changes in the professional practice of nursing. However, cohesion is necessary for its political, academic and social forces to define the best model for training and professional qualification, such as establishing a teaching staff capable of serving them, which practices should be expanded and regulated and the necessary adaptations to professional legislation.

Ethics deal with standards of conduct and moral judgment. Every day nurses require to make ethical decisions during patient care. They should have good knowledge and adequate practice of ethics to make ethical decisions. The aim of this study was to identify the knowledge and practice of patient care ethics among nurses. A descriptive cross sectional research design was used to conduct the study. Simple random sampling method was adopted to select 108 nurses among 133 nurses working in a regional hospital, Pokhara. Self-administered structured questionnaire schedule was used for data collection and analyzed using IBM SPSS Version 20. Descriptive and inferential statistics such as frequency, percentage, mean, standard deviation, Chi-square test was used to analyze the data. The findings revealed that 65.1 percent of nurses had satisfactory level knowledge and 76.4 percent had adequate practice level of patient care ethics. There was significant association between nurses knowledge level and professional qualification (p<.001). The level of practice does not have significant association with socio-demographic and job related variables. Similarly, no significant association between knowledge and practice level of patient care ethics was found. It concludes that the nurses with satisfactory level of knowledge and adequate level of practice are more than the nurses with unsatisfactory knowledge level and inadequate practice level of patient care ethics. Their practice of ethical principle is better than their knowledge in all principles except in the principle of justice. Nurses’ knowledge and practice of patient care ethics should be upgraded through educational and awareness programme. Janapriya Journal of Interdisciplinary Studies, Vol. 6 (December 2017), page: 17-28

To explore the strengths and weaknesses of clinical reflection and its impact on clinical practice among nursing students. Nursing students experience emotional burdens when transitioning from a student to a practicing clinician, with many struggling to apply theoretical knowledge to clinical competency. Reflective practices serve to bridge the gap between theoretical and practical knowledge, while encouraging professional development through self-discovery and self-awareness among nursing students. A scoping review was conducted in August 2024 across four databases, including PubMed, Scopus, CINAHL and Web of Science. Eligible studies between 2014 and 2024 were included and focused on nursing students undertaking Baccalaureate studies in higher education, who engaged in reflective practice in their program, which included clinical settings such as hospitals, community centres, or simulated learning environments. Data were extracted, grouped into themes and presented through narrative synthesis. The review followed the PRISMA-ScR checklist. Among the 13 identified articles, reflective practice was found to be beneficial for supporting clinical competency through professional development. Furthermore, self-discovery and self-awareness were enhanced in nursing students when reflective practice was incorporated into clinical situations. Reflection had a positive impact on the emotional well-being of nursing students when confronted with the environmental effects of healthcare and supported their clinical reasoning and decision making in clinical situations. Reflective practice has a positive impact on clinical practice and provides emotional support during the transition from student to practicing nurse. Integrating reflective practice in nursing curricula may be beneficial to support and inform nursing students how to reflect and its associated benefits to practice.