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Unsafe nurse staffing conditions in hospitals have been shown to increase the risk of adverse patient events, including mortality. Consequently, United States and international professional nursing organizations often advocate for safer staffing conditions. There are a variety of factors to consider when staffing nurses for patient safety, such as the number of patients per nurse, nurse preparation, patient acuity, and nurse autonomy. The complex issue of staffing nurses often is compounded by cost issues and can become politicized. When nurse organizations' recommendations for safe staffing measures are disregarded by hospital administrations, nurse lobbyists and interest groups often pursue legislative action to protect patients and nurses from unsafe staffing conditions. This article presents a narrative review of safe nurse staffing factors and an analysis of nurse staffing legislation. Using a patient‐centric lens, three state‐level nurse staffing policies (mandated nurse‐to‐patient ratios, public reporting of staffing plans, and nurse staffing committees) were evaluated by empirical evidence, cost to hospitals and state governments, political feasibility, and potential to affect patient populations. Although nurse staffing policy analysis can be conducted in several ways, it is crucial that nurses consider empirical evidence related to staffing policies as well as evaluations of implemented policies and political influences. [ABSTRACT FROM AUTHOR]

Problem: Adolescent mental health is a significant health care issue. Friends play an important role in the lives of adolescents with mental health concerns and help to improve outcomes related to depression and suicide. However, little is known about the experiences of adolescents who help their friends with these concerns. Methods: A phenomenological research design involving unstructured interviews was used to answer the question: what is the lived experience of adolescents who provide support to friends with anxiety, depression, or who express suicidal ideation?" Participants for this study were aged 16–17 and included both males (n = 2) and females (n = 3). Findings: Participants described their experience as "Kids Helping Kids" which is defined by the following themes: Being Fearful, Maintaining Vigilance, Seeking Knowledge, Keeping Secrets, Involving Others, Setting Boundaries, and Feeling Honored. Conclusion: Helping a friend with mental health concerns can be challenging yet rewarding. Nurses should be aware of this role that some adolescents undertake and include the friends of adolescents with mental health concerns as part of plans of care. [ABSTRACT FROM AUTHOR]

PURPOSE: This study explored the childhood experiences of perpetrators of child sexual abuse. DESIGN AND METHODS: A blend of narrative inquiry and phenomenology was employed. Interviews were conducted with 23 community-dwelling perpetrators (21 males, 2 females). The education of participants ranged from GED to PhD. FINDINGS: There were four types of narratives: There Was No Love; Love Left; Love Was Conflated With Sex; and a Pretty Good Childhood. Chronic sorrow for a painful childhood was evident in most participants. PRACTICE IMPLICATIONS: Cognitive-behavioral treatment may not be optimal for all perpetrators because it is not designed to facilitate recovery from early trauma and loss. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the quality of peer review in three scholarly nursing journals from the perspectives of authors and editors. Specifically, the study examined the extent to which manuscript reviews provided constructive guidance for authors to further develop their work for publication, and for editors to make informed and sound decisions on the disposition of manuscripts. Methods: Corresponding authors who had submitted manuscripts to the study journals in 2005–2007 were invited via email to complete an online survey about the quality of the peer review process; 320 authors responded. In addition, one third of the reviews of manuscripts submitted in 2005–2007 (a total of 528) were selected for rating by journal editors on level of detail, bias, and constructive tone; usefulness to authors in revising/developing the manuscript; and usefulness to the editor in making a decision. Results: A majority (73.8%) of authors agreed that peer reviews provided constructive guidance, and 75.6% agreed that reviews provided adequate rationale for editors’ decisions. New authors generally reported less satisfaction with reviews than more experienced authors. Ratings of reviews by the editors revealed some problem areas, including inconsistency, insufficient feedback to the author, reviewer bias, and disrespectful tone. Conclusions: Given the inexperience of many nurse authors, it is incumbent upon editors and reviewers to provide guidance and support. Manuscript reviews could be improved by increasing the consistency of numeric ratings, narrative comments, and recommendations regarding disposition of the manuscripts. Nevertheless, the results of this study reaffirm the worth of the peer review approach. Clinical Relevance: Publication of research and other forms of scholarly work is critical to the development of nursing knowledge that can be used in clinical practice. Authors with a variety of backgrounds, knowledge, and skills have important work to share that can serve healthcare providers and their clients. Thus, ensuring the quality of the peer review process is essential. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was ‘what is therapeutic about the therapeutic relationship?’ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counsellors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants' own words: ‘relate to me’, ‘know me as a person’, and ‘get to the solution’. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such as the use of touch, self-disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in-depth personal knowledge, which is acquired only with time, understanding, and skill. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experience of registered nurses (RNs) caring for patients in contemporary hospitals. Design: The descriptive phenomenological study was based in the philosophical perspectives of Husserl and Merleau-Ponty. Methods: A purposive sample of 46 RNs employed in acute care hospitals in the southeastern United States (US) were recruited by network sampling. Data from unstructured interviews were analyzed in an interpretive group and themes were identified. Findings: Four themes were identified: (a) extraordinary caregiving events, (b) incomprehensibility, (c) questioning whether anything else could have been done, and (d) “alone or together,” indicating the isolation nurses often experience while giving care as well as profound moments of connection, especially with patients. Conclusions: Caregiving experiences resulted in an accumulating residue of moral distress which in turn became ground for future experiences in the everyday work life of RNs. Sometimes years later, participants were still trying to justify and understand the outcomes and perhaps to absolve themselves from blame. Participants were confronted with the limits of science and skill and plunged into the realm of existential questions for which they had no ready answers. [ABSTRACT FROM AUTHOR]

Phenomenology has proved to be a popular methodology for nursing research. I argue, however, that phenomenological nursing research could be strengthened by greater attention to its philosophical underpinnings. Many research reports devote more page space to procedure than to the philosophy that purportedly guided it. The philosophy of Maurice Merleau-Ponty is an excellent fit for nursing, although his work has received less attention than that of Husserl and Heidegger. In this paper, I examine the life and thought of Merleau-Ponty, with emphasis on concepts, such as perception, intentionality and embodiment, which have particular relevance to the discipline of nursing. [ABSTRACT FROM AUTHOR]

PROBLEM. Youth violence research often focuses on risk factors arising from early familial interactions rather than school-related factors. METHODS. Via an Internet questionnaire, 282 girls and boys (ages 7-19, mean 15.3) from 47 states and Washington, DC, reported on school connectedness, interpersonal relationships, and anger behaviors. FINDINGS. Substantial percentages of violent youth did not perceive themselves to be liked by classmates and reported loneliness. If not liked by classmates, 80% hated school hikers and haters of school differed on seven variables (all p≤.01). CONCLUSIONS. Insufficient attention is paid to the alienation experienced by disliked and lonely students. Mental health nurses could play a pivotal role in fostering change in the social climate of schools and helping youth to achieve better anger management and social skills. [ABSTRACT FROM AUTHOR]

This study used the Interaction Model of Client Health Behavior (IMCHB) as a conceptual guide to explain the correlates of children's diet and physical activity and explore the relationships of sex with their diet and physical activity of the school-aged child. A descriptive correlational study was conducted on 371 fifth-grade students and their parents. Information on the family's demographics, health experience, social influence, and environmental resources was collected, as well as data on the children's intrinsic motivation, cognitive appraisal, and affective response to food/physical activity. Children's self-reports on diet and physical activity were collected, as were parents' self-reports on health habits. Food preferences and diet self-efficacy explained the most variance in diet behavior for girls and boys. Girls scored healthier on food preferences and diet self-efficacy than did boys, but no difference was detected in their diet behavior. Girls participated in more low-intensity physical activity, but boys participated in more high-intensity physical activity than did girls. Findings provide strong support for the use of the IMCHB to explain children's diet but weak support for the explanation of children's physical activity. Further study of additional factors predictive of physical activity is indicated. [ABSTRACT FROM AUTHOR]

Describes a psychoeducational intervention called anger management and offers guidelines for assessing potential participants and teaching healthy behaviors. Distinctions between anger and related concepts; Indications and contraindications for anger management; Role of advanced practice psychiatric nurses in the intervention.

Comments on the increasing incidents of violence and rage in the United States. Way in which psychiatric nurses can make a difference; Men's reaction to women's anger; Typical representation of women's anger; Rate of arrests for juvenile females between 1973 and 1992.