Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing

"I Call It Health Science, Not Nursing": Male International Students Balancing Nursing Career Aspirations With Cultural Expectations

INTRODUCTION

Male South Asian international nursing students in Australia navigate a complex interplay of cultural expectations, personal aspirations, and gender stereotypes. These students often encounter stigma and familial pressure due to their pursuit of a non-traditional career in nursing.

METHOD

A qualitative descriptive design involving 11 participants was employed. Data were analyzed using a thematic analysis framework informed by principles of transnationalism, intersectionality, and identity work.

RESULTS

Participants strategically employed linguistic camouflage, referring to their studies as "health science" rather than "nursing." Motivations for pursuing nursing included migration opportunities, economic considerations, and aspirations for personal freedom and self-acceptance. The term "nurse" carried significant cultural baggage.

DISCUSSION

This study reveals the strategic and pragmatic nature of these students' career choices. Despite facing unique challenges, including navigating a hostile educational environment, participants demonstrated remarkable resilience. Findings underscore the need for culturally sensitive support programs, curriculum reforms that challenge gender stereotypes, and faculty training in cultural competence to promote inclusivity and empower these students.

Uncertainty experienced by the critical patient upon discharge to the general ward: Care proposals from the perspective of Mishel's theory

BACKGROUND

The process of discharging the critical patient to the ward (discharge from critical care to the general ward-DCCW) is often described as an experience involving uncertainty which may affect the patient's quality of life and ability to cope. Coping with uncertainty is an individual response not related to the course of the illness that is dependent on external and internal resources and the ability to utilize them. Mishel's theory of uncertainty identifies aspects of care that can shape the experience of uncertainty associated with the illness.

AIM

To understand the experiences of uncertainty of critical patients associated with discharge from the intensive care unit (ICU) to glean person-centred care strategies under such circumstances.

STUDY DESIGN

Qualitative study with a phenomenological approach. Between March 2017 and May 2018, 20 in-depth interviews were conducted on patients recently discharged from an ICU.

RESULTS

The patients have been organized according to the following pre-established categories of Mishel's theory: stimulus framework, structure providers and uncertainty assessment. Based on these results, suggestions for the care of the critical patient upon discharge from the ICU are made in each of these categories.

CONCLUSIONS

Applying Mishel's theoretical perspective to care for the critical patient during the process of discharge to the ward can help identify areas for intervention and improvement. To succeed, there is a need to promote a cultural change in ICUs, empower nurses and provide the necessary resources.

RELEVANCE TO CLINICAL PRACTICE

These findings are relevant and timely given the impact of the experience of critical patients discharge to the ward. Uncertainty management has been identified as an important element in the discharge experience of critically ill patients to the ward because, according to the informants' stories, it can make this transition a healthier process with less emotional impact.

Complexities in Studying and Practicing Nursing-A Theoretical Elaboration Based on Reflections by Nurses and Nursing Students

The aim of this study was to explore nursing students' and clinically active nurses' experiential ideas about nursing to provide a foundation for a critical reflection on the complexities involved in studying and practicing nursing. Using a participatory approach, 9 experiential ideas about nursing as a subject, nursing practice, and being a nurse were identified and reflected upon with a total of 238 participants. This was followed by a theoretical analysis in relation to the clinical gaze in nursing and epistemology, which ends in an argument for a rediscovery of the broader Aristotelian view of knowledge in nursing education and practice.

Reflections: The Responsibility of Doctoral Nurses to Lead a Change in Practice

This paper aims to consider the responsibilities of doctoral nurses to lead changes in practice through a very personal reflection of over 52 years in nursing. The reflective learning moves from an early training experience where I learned to ‘do’ to becoming a nursing professor with a doctoral qualification and an ‘evidence-based doer.’ The change witnessed has been considerable. As the highest educated professional, I have learned that doctoral nurses are responsible for leading and directly influencing clinical practice, either as a practitioner, an educator, or a researcher. They are capable of encouraging the development of critical thinking skills and helping practitioners to be curious, take risks with ideas, identify gaps in the evidence base, and be creative in their problem-solving. If the strategic vision for nurses globally is to provide the best quality of patient care, then evidence-based practice is key to leading from the head, hand, and heart. Doctoral nurses understand the patient benefits of a high staff-to-patient ratio and having a critical mass of university qualified nurses and must strive to influence policy to this effect. As each country, particularly in Latin America, develops a critical mass of doctorally qualified nurses, then they can harness their innovation, create new ways of working, attract them back into practice, and strengthen their political voice to lead strategic change. Doctoral nurses must develop their leadership skills and their confidence to lead. They have a responsibility to realise their potential and identify the opportunities to really make a difference.