The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress (...) are determined for the nurses involved in nursing situations, a phenomenological–hermeneutic analysis of a nurse's report of an experience lived by her as a moral distress situation has been conducted. Nursing emerges as a relational doctrine that requires the nurse to have different degrees of personal involvement, the integration between logical–formal thinking and narrative thinking, the perception of the salience of the given situation also through the interpretation and management of one's own emotions, and the capacity to undergo a process of co‐construction of shared meanings that the others might consider adequate for the resolution of her problem. Moral action requires the nurse to think constantly about the important things that are happening in a nursing situation. Commitment towards practical situations is directed to training in order to promote the nurse's reflective ability towards finding salience in nursing situations, but it is also directed to the management of nursing assistance and human resources for the initial impact that this reflexive ability has on patients' and their families' lives and on their need to be heard and assisted. The only case analysed does not allow generalizations. Further research is needed to investigate how feelings generated by emotional acceptance influence ethical decision making and moral distress in nursing situations. (shrink)

It is frequently claimed that nursing is vital to the safe, humane provision of health care and health service to our populations. It is also recognized however, that nursing is a costly health care resource that must be used effectively and efficiently. There is a growing recognition, from within the nursing profession, health care policy makers and society, of the need to analyse the contribution of nursing to health care and its costs. This becomes increasingly pertinent and urgent in a (...) situation, such as that existing in Ireland, where the current financial crisis has lead to public sector employment moratoria, staff cuts and staffing deficits, combined with increased patient expectation, escalating health care costs, and a health care system restructuring and reform agenda. Such factors, increasingly common internationally, make the identification and effective use of the nursing contribution to health care an issue of international importance. This paper seeks to explore the nature of nursing and the function of the nurse within a 21st century health care system, with a focus on the Irish context. However, this analysis fits into and is relevant to the international context and discussion regarding the nursing workforce. This paper uses recent empirical studies exploring the domains of activity and focus of nursing, together with nurses perceptions of their role and work environment, in order to connect those findings with core conceptual questions about the nature and function of nursing. (shrink)

Immer mehr Menschen verbringen ihren Lebensabend in Einrichtungen der Altenpflege. Zusätzlich zur Sorge um physische, psychische und soziale Belange gilt es, deren spirituelle Bedürfnisse zu berücksichtigen. Ziel dieser Arbeit war es, die spirituellen Bedürfnisse von alten Menschen in Langzeitpflegeeinrichtungen zu erfassen. Gleichzeitig wurde untersucht, welche spirituellen Bedürfnisse Pflegende bei den ihnen anvertrauten Bewohner/-innen wahrnehmen. Dabei wurden Übereinstimmungen bzw. Unterschiede identifiziert. Daten aus 28 Einzelinterviews mit Bewohnerinnen und Bewohnern und 9 Fokusgruppeninterviews mit Mitarbeitenden wurden mittels Qualitativer Inhaltsanalyse ausgewertet und unter die (...) Kernkategorien „Sinn“, „Verbundenheit“, „Transzendenz“ kategorisiert. Die Kategorien beider Befragtengruppen wurden einem Vergleich unterzogen. Trotz zahlreicher Übereinstimmungen in den Aussagen beider Gruppen bleiben Defizite in der Wahrnehmung von Pflegenden. Aus den Ergebnissen der Arbeit werden Schlussfolgerungen für die Einbeziehung der spirituellen Dimension der alten Menschen in die pflegerische Arbeit im Seniorenheim gezogen und Empfehlungen ausgesprochen. (shrink)