i-manager's Journal on Nursing (JNUR)


Volume 11 Issue 3 August - October 2021

Article

A Step by Step Protocol for Breaking Bad News

Karishma Karim*
Addenbrookes Cambridge university hospital, United Kingdom.
Karim, K. (2021). A Step by Step Protocol for Breaking Bad News. i-manager's Journal on Nursing, 11(3), 1-3. https://doi.org/10.26634/jnur.11.3.17739

Abstract

Health is the most important and basic part of a human being. Any discrepancy or alteration in health, the state of thus, creates a period of tension in the person's life. Bad news is defined as any fact that creates an undesirable change in the perspectives on their present and future state. Breaking bad news is the most essential yet distressing part for the health care professionals. Mostly, the bad news has to be given by the physicians but advance nurse practitioners can also take their role in it. To make it more comfortable for the patient and healthcare provider, a step by step protocol, i.e. 'SPIKES' should be followed.

Article

A Comparison and Integration of Two Nursing Theories into Clinical Practice: Betty Neuman and Hildegard Peplau

Farah Wasaya* , Sumera Zulfiqar **, Anila Farhan ***
*-*** Aga Khan University School of Nursing and Midwifery Karachi, Pakistan.
Wasaya, F., Zulfiqar, S., and Farhan, A. (2021). A Comparison and Integration of Two Nursing Theories into Clinical Practice: Betty Neuman and Hildegard Peplau. i-manager's Journal on Nursing, 11(3), 4-9. https://doi.org/10.26634/jnur.11.3.17881

Abstract

Nursing is a unique profession, which requires a commitment to provide services, that benefits individuals and the community. The aim of this paper is to illuminate the core concepts of nursing practices based on two extinguishing nursing theories namely Betty Neuman's System Model (1970) and Hildegard E. Peplau's Theory of Interpersonal Relations (Peplau, 1997). Moreover, this paper will execute a fundamental comparison and contrast between the two theories, extensively through its application in clinical practice. The four nursing meta-paradigms including person, health, environment, and nursing will be the guiding force to evaluate the applicability of both the nursing theories in the clinical scenario. In conclusion, both Neuman's and Peplau's work are pertinent to the Pakistani context, though the mixed approach of both the theories may contribute nurses to provide better comprehensive care.

Research Paper

Examining Perceptions of Clinical Competence of Undergraduate Nursing Students During the Era of Social Distancing

Victoria Foster * , Elicia S. Collins **, Dianne E. Nelson***, Rebecca Morgan****, Comfort N. Obi*****, Sue Gronka******, Jennie Bergen*******, Shereda Taylor-Shaw********, Angela Hollis*********, Martricia Turner**********, Samina Damani***********, Annette Crew-Gooden************, Crystal Marchant*************
*-************* Clayton State University Georgia.
Foster, V., Collins, E. S., Nelson, D. E., Morgan, R., Obi, C. N., Gronka, S., Bergen, J., Taylor-Shaw, S., Hollis, A., Turner, M., Damani, S., Crew-Gooden, A., and Marchant, C. (2021). Examining Perceptions of Clinical Competence of Undergraduate Nursing Students During the Era of Social Distancing. i-manager's Journal on Nursing, 11(3), 10-20. https://doi.org/10.26634/jnur.11.3.17837

Abstract

In the year 2020, COVID-19 caused dramatic changes in nursing education. Traditional educational methods were rapidly replaced with distance learning and virtual simulation. This study examined the impact of these changes on undergraduate education and students' perceptions of clinical competence, along with use of virtual simulation in light of social distancing. The study design was cross-sectional and comparative. Data were obtained from undergraduate nursing students at a public university in the Southeast who have completed the Clinical Competence Questionnaire (CCQ) and the Simulation Effectiveness Tool-Modified (SET). Data were analyzed with SPSS® Version 26. The SET was completed by 57 students with a mean of 2.31 (SD 0.47) and CCQ mean of 4.4 (SD 0.35). Scores were higher for senior-level students and for those who experienced some traditional learning. Scores on the SET and CCQ were positively correlated. Findings revealed that the students perceived a sense of clinical competence through virtual simulation.

Research Paper

Association between level of Emotional Intelligence GPA and other Demographic variables among BS Nursing Students

Hawa Gul* , Shams Ul Huda**, Mehbooba Jan***
* NCS University Islamabad Campus, Pakistan.
** Ayub Teaching Hospital, Abbottabad, Pakistan.
*** University of Ovoidio, Span.
Gul, H., Huda, S. U., and Jan, M. (2021). Association between Level of Emotional Intelligence GPA and other Demographic Variables among BS Nursing Students. i-manager's Journal on Nursing, 11(3), 21-31. https://doi.org/10.26634/jnur.11.3.17770

Abstract

Emotional Intelligence has been considered as a critical factor which influences students' academic achievement, ability to work and potential for success. Although, several studies have been conducted in the nursing discipline to determine the emotional intelligence of nursing students belonging to different populations, but no study has been done on BSN students. That is why this study is unique on the basis of its population. The purpose of this study is to determine the association between the level of emotional intelligence and its relationship with different demographic variables as well as GPA among BSN students in a private college of nursing in Pakistan. A quantitative cross-sectional analytical design was used to answer the research questions. The data was collected from a sample of 140 participants, selected from all eight semesters of BSN program at Shifa College of Nursing. Firstly, the collected data was analyzed on SPSS version 21, then for statistical analysis Stata was used to measure univariate association among Emotional Intelligence and demographic variables. Overall and across four-year BSN domain specific level of Emotional Intelligence, 73.6% of the participants were at moderate level, whereas 26.4% at low level. In wellbeing 77.9% were at moderate level as compared to only 12.1% at highest level. Contrary, in Self Control, only 2.1% were at high level, however 40% at low level. Similarly, in sociability 58.6% were at moderate level and in emotionality 57.9% were at moderate level. Moderate level of Emotional Intelligence was found among BSN students. The components of EI wellbeing, emotionality, sociability and self-control were shown different from Year IV to Year I among participants. In the last two years, sociability and self-control were moderate as compared to BSN Year-I. Students develop emotional intelligence through different mechanisms, e.g. with experience, exposure, academic and clinical environment.

Research Paper

Time Management for Nurses in Healthcare Setting

Salima Bibi Adina Baig*
Aga Khan University School of Nursing and Midwifery, Pakistan.
Baig, S. B. A. (2021). Time Management for Nurses in Healthcare Setting. i-manager's Journal on Nursing, 11(3), 32-40. https://doi.org/10.26634/jnur.11.3.17912

Abstract

Time management is an important skill for nurses. Through effective time management, nurses can reduce stress which is related to workload. In addition, they are able to provide quality and timely care to patients. This article presents a project related to nurses who work in a surgical room area, through observations and needs assessment. Initially, one of the many problems was identified as the issue of lack of time management, which could be improved with a little effort. This project aimed to improve the time management experience among nursing staff. The project was initiated through the needs assessment, and the needs assessment was done by creating an assessment tool questionnaire for registered nurses to fill out. The assessment tool consisted of 16 questions. The sample size was 17 participants who were selected randomly. The inclusion criteria were Registered Nurses with more than one year of experience. Exclusion criteria were Trainee Nursing Interns (TNIs), Critical Care Technicians (CCTs), and Health Care Assistants (HCAs). The result of the project was beneficial for both nurses and patients. As the project was implemented successfully, the positive outcome of the project was anticipated. The staff was able to manage their time better than before. Delays in medication administration were decreased; thus leading to increased patient satisfaction. Staffs were prioritizing their tasks and were able to delegate the tasks effectively. Increasing time management skills among nurses, enhancing patient satisfaction levels and improving quality care are the elongated impact of the project. Time management is important for nurses and this project further emphasized its needs. Therefore, nurses must be taught time management skills from the beginning of their careers. Time management skills must be a part of continuous nursing education in every health care setting.

Case Study

Breaking Bad News to Cancer Patients; Role of an Advanced Practice Registered Nurse

Kausar Karim*
Aga Khan University, Karachi, Pakistan.
Karim, K. (2021). Breaking Bad News to Cancer Patients; Role of an Advanced Practice Registered Nurse. i-manager's Journal on Nursing, 11(3), 41-43. https://doi.org/10.26634/jnur.11.3.17673

Abstract

Disclosing a bad news to a patient is one of the hardest challenge that a healthcare provider faces in their practice. An inappropriate way of delivering bad news to a patient could have a huge influence on their perception about the continuation of their medical treatment. An Advanced Practice Registered Nurse (APRN) is a key member of an interdisciplinary team who is involved in breaking bad news to patients. Therefore, it is an important duty of an APRN to follow a proper protocol for disclosing such news to patients. Several models such as the ABCDE model is for the purpose of delivering bad news and the SPIKES model, serves as a framework for establishing a therapeutic relationship between patient and health professional.

Case Study

Allocating Precious Resources Fairly When Patients Are Tardy: Hemodialysis Ethical Dilemma

Sumera Zulfiqar* , Anila Farhan**, Sumaira Warwani***, Farah Wasaya****
*-****Aga Khan University School of Nursing and Midwifery Karachi, Pakistan.
Zulfiqar, S., Farhan, A., Warwani, S., and Wasaya, F. (2021). Allocating Precious Resources Fairly When Patients are Tardy: Hemodialysis Ethical Dilemma. i-manager's Journal on Nursing, 11(3), 44-48. https://doi.org/10.26634/jnur.11.3.17828

Abstract

Chronic Kidney Disease (CKD), such as End-Stage Renal Disease (ESRD) has the most devastating impact on the life expectancy of the renal patients. CKD and its complication have an impact on the quality of life of the patient and their families. CKD patients stay miserable at the hospital and it leads to psychological stress. Heath Care Professionals (HCP) face ethical dilemmas recurrently, while dialyzing the hemodialysis patients. The cost of the hemodialysis procedure also impacts on the patient’s social life and also the financial and other contributing stressors lead to delayed behavior and noncompliance. There is a role of the nurse for continuous reinforcement of education with the support group to help the patient to deal with these situations. This paper will discuss the scenario and an ethical dilemma that we face routinely in the light of theory of liberal individualism. The principles of ethics should be considered, which are beneficence and nonmaleficence to anyone without compromising care. Ongoing reinforcement has a vital role for the non-complaint patients and tardy behaviors might consequently end up in mortality and morbidity. Innovative strategies should be incorporated to provide proper and relevant treatment, to save resources and provide compassionate care with critical thinking. A multi-disciplinary team should be involved to ensure sound decision-making in such situations. Moreover, nurse vigilance and interventions beyond the horizon could make a great difference.

Case Study

Analyzing Patient’s Outcome by Applying Nightingale’s Environmental Theory into Clinical Practice

Farah Wasaya* , Sumera Zulfiqar**, Anila Rafiq***
*-***Aga Khan University Hospital, Karahi, Pakistan.
Wasaya, F., Zulfiqar, S., and Rafiq, A. (2021). Analyzing Patient’s Outcome by Applying Nightingale’s Environmental Theory into Clinical Practice. i-manager's Journal on Nursing, 11(3), 49-52. https://doi.org/10.26634/jnur.11.3.17882

Abstract

Nursing is a distinctive profession that requires comprehensive understanding based on theoretical knowledge of the discipline. The "Notes on Nursing" is the extensive work, proposed by Florence Nightingale which offers the concept of sanitary nursing by suggesting that the safe, clean, and curative environment could enable nature to influence a curative process. The objective of this paper is to correlate the assumptions, concepts, and sub-concepts of Nightingale's theory with the patient's clinical scenario. Moreover, the paper will further analyze the scenario through the propositions of the theory which tends to prevent unpleasant outcomes while caring for a patient. To conclude, grounding strongly to the theoretical concepts of nursing tends to transform the nurse's approach of planning patient's care, efficiently. Lastly, multiple recommendations would be implemented to build the skills as practitioners, advocates, and influential leaders in the health care setting.