A nursing portfolio: documenting your professional journey

Professional profiling may enhance one's career development. The opportunities to use a current profile abound, and include applying for a new position, a leadership role in a professional society, a scholarship or an award, or career advancement. The true professional updates the profile on an annual basis, emphasizing significant personal and professional accomplishments. Documentation and validation of one's credentials may require substantial effort-but such effort is worth it. Profiling is a step toward recognition and success.

Teaching bandaging and Doppler usage for venous ulcer treatment

This article describes how an assessor's guide and a student learning contract about compression and Doppler therapy was presented to community nurses and practice nurses in an NHS acute and community trust. The objectives were to provide potential assessors with standardized practice in the application of compression bandaging and the use of Doppler-assisted diagnosis in the treatment of venous leg ulceration. This was achieved by a teaching session using two checklists, one for the assessor and the other for the 'student'. Role play was used to allow experience of assessing or being assessed in a classroom setting. References to key pertinent articles were provided to support the learning contract, and the development of a resource file was proposed. In recognizing their own limited knowledge and experience, a small number of practitioners felt unable to assess 'officially' other members of their staff.

Identifying performance criteria for staff development competencies

Performance criteria for specific staff development competencies need to be developed. The primary investigator (PI) surveyed the literature and developed specific performance criteria for objective staff development competencies. A survey was sent to a random stratified sample of 300 nurses certified in nursing continuing education and staff development asking them to rank the performance criteria for the objective statements and provide suggestions for an additional five subjective competencies. The PI reviewed the data and developed criteria for the subjective competencies. A survey with performance criteria for all 10 competencies was sent to National Nursing Staff Development Organization (NNSDO) affiliate groups for validation. Performance criteria were identified for all 10 competency statements. The mean scores for the national and regional samples were very similar in most areas. The data will provide a mechanism to promote and advance evidence-based practice in staff development. Instructors, individual staff development specialists, or organizations can use these performance criteria to determine if staff development personnel are meeting specified competencies.

Deconstructing the myth of the advanced practice blended role: support for role divergence

Since the early 1980s, there has been discussion about combining the clinical nurse specialist (CNS) and nurse practitioner (NP) roles. Examination of recent nursing literature reveals renewed interest in differentiating, rather than combining, these 2 advanced practice roles. Research has shown that although the 2 roles share similarities, these advanced practice pursuits are more different than alike, both philosophically and practically. Despite curricular attempts at "blending" CNS and NP philosophies of nursing care and their distinctive domains of practice in master's level degree programs, the uniqueness of these roles in actual practice demands a continuation of educational differentiation in preparation. Both roles are important and address varied systems requirements. Each role has been shaped by population needs, education, market, and legal forces that transform with time. The differing ideologies of CNS and NP practice lead to diverse patient and system outcomes and reveal different researchable questions.

Continuing Education in Research Ethics for the Clinical Nurse

BACKGROUND

In their role as care provider, clinical nurses are involved in research protocols. Although clinical nurses seldom serve as principal investigators, nursing care often is delivered to patients involved in study protocols. This article explores the need for continuing education in research ethics for clinical nurses and offers recommendations for core research ethics education.

METHOD

Professional nursing statements, federal policy, and federal recommendations for improving protection of human participants in research were reviewed to identify areas pertinent to the role of nurses.

FINDINGS

Continuing education in research ethics is an important component in ensuring protection of human participants in research. Essential research ethics education topics for clinical nurses, including three case studies, are presented.

CONCLUSION

Continuing education that enhances clinical nurses' awareness of the ethical issues involved in research assures nurses have the knowledge and ethical sensitivity needed to act as patient advocates and improves the protection of human rights.

A Delphi study to determine informatics competencies for nurses at four levels of practice

BACKGROUND

Despite its obvious need, a current, research-based list of informatics competencies for nurses is not available.

OBJECTIVE

To produce a research-based master list of informatics competencies for nurses and differentiate these competencies by level of nursing practice.

METHODS

After a comprehensive literature review and item consolidation, an expert panel defined initial competencies. Subsequently, a three round Delphi study was conducted to validate the items. Participants were expert informatics nurse specialists in the United States of America.

RESULTS

Of the initial 305 competencies proposed, 281 competencies achieved an 80% or greater agreement for both importance as a competency and appropriateness for the correct practice level. Five competencies were rejected. Six competencies were considered valid competencies but the appropriate level of practice could not be agreed upon. Thirteen competencies did not reach any consensus after the three Delphi rounds.

DISCUSSION

The Delphi study had a high rate of participation, demonstrating the great level of interest and need for a list of informatics competencies for nurses. Out of the initial 305 competencies, only 24 items were not validated. Respondents commented during each round about whether computer skills should be considered informatics competencies. The authors propose that computer skills, while not high level, are one set of tools within the larger category of informatics competencies. This sample of experts did not deem programming skills as necessary for informatics nurses. This research study is an initial effort to fill the void of valid and reliable informatics competencies. It is the first study to span four levels of nurses, create competencies for both entry-level and experienced informatics nurse specialists, and examine the categories of computer skills, informatics knowledge and informatics skills.

Developing palliative care practice in nursing and residential care homes: the role of the clinical nurse specialist

The development of practice is but one aspect of Clinical Nurse Specialists' (CNSs) work, and a number of factors act to shape the extent to which CNSs are able to work with and develop practice with nursing and residential care homes. A postal survey of 730 community CNSs in palliative care working in the UK was undertaken to explore the involvement of these nurses with nursing and residential care homes. Much of the focus of the involvement was reactive work meeting the direct clinical needs of residents, primarily with cancer. Although the CNSs perceived that there were some educational and care deficits in these care settings, the amount of proactive work undertaken to improve practice was limited. The development work undertaken was focused on educational initiatives and establishing link nurse systems. There is potential to develop palliative care practice in nursing and residential care homes through practice development initiatives.

International collaboration in genetic nursing

Collaboration across national borders presents unique challenges and opportunities. A desire to expand your understanding of healthcare issues, and a willingness to share time and intellectual resources generously, contribute to successful collaboration. This is especially useful in small but rapidly developing healthcare specialities, such as genetic nursing. By outlining the benefits of work between two nurses in the UK and the US, this article argues that specialist nurses can benefit from international collaboration where the partners share problem solving and mentoring on common professional issues.

A survey of tissue viability nurses' role and background in one region

The shift in NHS service provision towards primary care has made investigation of clinical nurse specialists' role in this setting an important issue. This article reports the findings of a preliminary survey of tissue viability nurses in one region

Confusion prevails in defining 'advanced' nursing practice

The Australian nursing profession has accepted the challenge to support and encourage advanced nursing practice role development. A critical review of national and international literature highlights that there is no singular definition or understanding of 'advanced' nursing practice. Instead difficulty with nomenclature and clarification of levels of nursing are perpetuated by unclear distinction between 'advanced', 'specialist' and 'expert' nursing practice. This paper presents the findings of a review of the literature and posits that ambiguity and lack of consistency in defining 'advanced' nursing practice is hampering the progression of the profession towards the development of consistent advanced practice roles in Australia. It is proposed that a universally accepted definition would provide a vehicle for future Australian role development so that all advanced practice roles have a common genesis and national consistency results.

Challenges of advanced practice nursing in pediatric acute and critical care: education to practice

The APN role of the future is dependent on our ability to document through research that NPs, CNSs, and the consolidated role of the NP/CNS plays a critical role in the delivery of high quality cost-effective care. Further information is needed regarding how the APN contributes to and enhances the care delivered by the healthcare team. Cost effectiveness and quality outcome studies are needed including those that describe morbidity and mortality rates, patient satisfaction, and cost effectiveness of models of care that includes APNs. Brooten and Naylor suggest the inclusion of sensitive nursing outcomes, including functional status, mental status, stress level, satisfaction with care, caregiver burden, cost of care. Defining and clarifying the APN functions and qualities of scope of practice is imperative. Perhaps there are populations best served by APNs. Contributions such as continuity, consistency of care, attention to issues such as immobility, skin integrity, and health promotion may have a value added effect. Time motion studies and process logs may add to the information about APNs in pediatric acute and critical care. Professional certification validating competence is essential for the practice of APNs caring for sick children and their families. A disparity exists between the primary care examination now available and the practice of NPs in pediatric acute and critical care. A certification examination is needed with content consistent with the practice of pediatric acute care NP. APNs must possess sufficient knowledge and skill to meet the needs of patients and families in the changing healthcare environment. According to Strodtbeck and colleagues, flexibility, ability to be a self directed learner, critical thinking, relationship skills, and leadership skills including interpersonal insight, interpersonal competence, and ability to stimulate group discussion will serve APNs well as they move into the century. Transitioning brings exciting opportunities along with challenges. Using a blend of abilities, the pediatric acute care APN can provide optimal care to sick children and families.