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This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change., (© 2022 John Wiley & Sons Ltd.)

In recent years, healthcare organisations in North America have undergone major structural changes. In particular, the province of Quebec in Canada adopted a reform in 2015 which led to the merging of healthcare organisations into centralised regional administrations (the 'CISSS'). As research indicates negative impacts of mergers on patient outcomes and difficulties for the nursing work group in particular, the present paper aims to answer calls for more research about the long-term effects of major organisational changes on nurses' professional practice and well-being. We used an exploratory qualitative research design and report on data collected from 42 nursing professionals, ranging from clinical nurses, nurse practitioners, to head nurses and nursing advisors. Drawing on the job demands-resources model and the person-environment fit theory, our findings yield three main conclusions regarding the state of nursing practice 5 years after the 2015 reform: (1) emergence of a new demand for work harmonisation; (2) growing gaps in the nursing practice environment across departments; (3) evidence of a structural disempowerment of the nursing practice in healthcare organisations. There is hope that a vast project for practice harmonisation initiated and led by local senior nursing advisors will bring about positive outcomes for the nursing practice, and nurses' overall working conditions in the province., (© 2023 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

A legislatively regulated and self-regulating profession, such as nursing, holds its members (registered nurses) accountable to the public it serves for the continuous development of the competencies they profess to hold. A requirement for competency is lifelong learning and can be evidenced through certification. In this paper, the interrelationship of lifelong learning, certification, and registered nursing practice is examined. Strategies used to support certification through a lifelong learning approach are described.

In Germany and Canada, the integration of immigrants into the labour market is closely related to the various approaches towards the recognition and validation of informal learning. This paper aims to analyse the informal learning measures undertaken by immigrants as well as those offered by employers in the health and information and communication technology sectors during the labour market integration process. The study focused on nurses as well as IT project managers and programmers. The comparison focuses on the occurrence and quality of the four dimensions of the dynamic model of informal learning from an individual and an organisation perspective. The results show similarities between these two perspectives regarding the relevance of the four dimensions in the integration of immigrants into the labour market. In addition, clear differences between the two investigated sectors as well as country-specific differences appear.

Aim: This study aims at better understanding the relationships between nurses' enacted scope of practice, work environment and work satisfaction, missed care, and organizational indicators of performance., Background: The enacted scope of practice model describes the determinants and consequences of the actual enactment of the nursing scope of practice., Method: A correlational design was used to investigate nurses' enacted scope of practice in five Canadian healthcare centres., Results: Suboptimal enacted scope of practice were found in the current sample. Significant positive correlations were found between the total enacted scope of practice score, use of qualification, control over tasks, decisional latitude and psychological demand as well as role ambiguity. Moreover, a higher enacted scope of practice was correlated with lower organizational indicators of short-term absenteeism., Conclusion: Results suggest an insufficient deployment of nurses' enacted scope of practice, likely caused by some job characteristics, leading to lower work satisfaction and negative patients and organizational outcomes., Implications for Nursing Management: Optimizing nurses' enacted scope of practice would be a significant integrated strategy for improving organizational performance, patient care and nurses' satisfaction and well-being. Nurses and frontline managers must be involved in the decision-making process necessary to improve nurses' enacted scope of practice., (© 2021 John Wiley & Sons Ltd.)

Background: The COVID-19 pandemic has overwhelmed health care systems globally. To understand how health care systems can best support frontline health care providers caring for patients in similar situations, it is necessary to gain insights into their experience., Purpose: This quality improvement study explored the lived experience of Canadian frontline medicine nurses caring for COVID-19 patients during the first wave of the pandemic., Method: A qualitative interpretive phenomenological approach was conducted. Forty-three eligible nurses participated in semistructured interviews and online surveys. Full transcription and thematic content analysis were performed., Results: Three overarching themes were deduced: (1) a traumatic experience, (2) living through the experience, and (3) achieving transcendence., Conclusion: Several recommendations were identified. These recommendations aim to aid health care systems in emergency preparation planning and future pandemic responses while supporting frontline health care providers' resilience and well-being., Competing Interests: The authors declare no other conflicts of interests., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

This study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in-depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse-patient and nurse-patient's family member conflicts in direct care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de-escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health-care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers., (© 2021 John Wiley & Sons Ltd.)

Aim A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Background Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Design Discussion paper. Data sources A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. Discussion The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. Implications for nursing A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Conclusion Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. [ABSTRACT FROM AUTHOR]

This rapid systematic review examined the reported effects of large-scale online education on the behaviour and, ultimately, practice of health and social care professionals. Electronic databases of health and education literature were searched, 193 unique records were screened against inclusion and exclusion criteria, 31 papers were accessed for full text reading and six were included. Identified studies reported primarily qualitative results, which were synthesised according to outcomes. Factors that contributed to the results were also identified. All papers reported that participation in e-learning programmes resulted in changes in behaviour and practice, including: increased awareness, changes in attitudes, improved communication, increased confidence and the actual changes applied in a workplace. Observed benefits of these programmes ranged from gaining new insights into own practice, through feeling empowered to apply changes, to eventually being able to provide more person-centred services and willing to adopt and spread a more humane evidence-based practice. While the current study is an early indication of the potential of large-scale online education to effect practice change, further research is recommended as is further in-depth investigation into how these changes are achieved and what factors contribute to success.

In a milieu where traditional views of scholarship are embedded in the culture of educational institutions, and nursing programs in particular, this paper reports on a research project designed to support nurse educators' capacity to engage in scholarly activities. Rogers' (2003, 2004) "Diffusion of Innovation" model provided a theoretical vantage point from which to consider the ways scholarly inquiry in and across the nursing programs could be promoted. The project was evaluated between 2004 and 2007 using both quantitative and qualitative methods. In this paper we highlight some of the meanings emerging from the qualitative information collected because this data best illustrates Rogers' (2003) model. Although significant progress was made towards building scholarship capacity with nursing faculty there remains ongoing work to be undertaken. Continuing to support a broader view of scholarship and intentional scholarship capacity building, particularly the scholarship of teaching and learning is becoming increasingly difficult given existing cultural and structural contradictions such as traditional ideologies associated with research; the competitiveness associated with the valuing of individual research; lack of infrastructure supports; and time for research in contexts where there are decreasing numbers of faculty. The authors think it is important to pay attention to this feedback as advances in scholarship of teaching and learning may be at risk. (Contains 1 table and 2 footnotes.)

Nurses' experiences in, and the overall effectiveness of, widely used alternative-to-discipline programs to manage nurses' substance-use problems have not been adequately scrutinized. We uncovered the conflicted official and experiential ways of knowing one such alternative-to-discipline program in a Canadian province. We explicated this conflict through an institutional ethnography analysis. Ethnographic data from interviews with 12 nurses who were enrolled in an alternative-to-discipline treatment program and three program administrators, as well as institutional texts, were analyzed to explore how institutional practices and power relations co-ordinated and managed nurses' experiences. Analysis revealed the acritical acceptance of a standardized program not based on current norms of practice. Potential and actual conflicts of interest, power imbalances, and prevailing corporate interests were rife. Nurses were not afforded the same rights to quality ethical health care as other citizens. 'Expert' physicians' knowledge was privileged while nurses' knowledge was subordinated. Conclusions were that regulatory bodies cannot rely on the taken-for-granted standardized treatment model in widespread use. Individualized treatment alternatives reflecting current, scientific evidence must be offered to nurses, and nurses' knowledge, expertise, and experiences need to be included in decision-making processes in these programs., (© 2019 John Wiley & Sons Ltd.)

This article proposes a critical analysis of the effectiveness of the nurses' labour market by addressing the classic dimensions of a labour market: supply, demand, and the impact of wages. Specifically, this work aims to (1) clarify the various concepts of labour shortage and present the evidence and (2) provide a critical analysis of the literature in terms of the efficiency of the nurses' labour market, while presenting descriptive statistics relevant on the supply and demand of nurses' labour. Such work elucidating the concepts and bringing a critical retrospective and prospective analysis on the subject at the pan-Canadian level constitutes an important contribution to the literature on the trends in the nursing labour market. The results suggest that this shortage in Canada was around 2.6% in 2012; it would continue until 2022 but would be reduced to 1.3% on average (corresponding to more than 46 000 nurses). Quebec would be the province with the highest vacancy rate. Besides, the analysis suggests that the postrecession period of 2008 was managed more effectively than that in the early 1990s. Measures particularly related to the provision of health services and adequate management of the workload by the institutions are to be prioritized in order to solve the shortage problem., (© 2019 John Wiley & Sons, Ltd.)

Explores the role of nurse practitioners (NP) in the emergency department (ED) in Canada. Definition of NP; Special groups commonly referred to as NPs; International perspectives on ED nurse practitioners; Educational requirements for ED service; Benefits and pitfalls of ED nurse practitioners; Real imperative for introducing nurse practitioners in the ED; Barriers to the introduction of NPs into the ED.

Nurses in Canada face diverse challenges to their ongoing educational pursuits. As a result, they have been early adopters of courses and programs based on distance education principles and, in particular, online learning models. In the study described in this paper, nurses studying at two northern universities, in programs involving online learning, were interviewed about their learning experiences and the impact of these experiences on their practice. The study led to insights into the factors affecting teaching and learning in distance settings; the complex work-life-study roles experienced by some nurses; life and work realities in northern settings; and the sustained importance of access enabled by online learning approaches.

This paper reviews the foundational literature of contemporary e-learning, with a focus on scaffolding, instructional design, and engagement. These concepts are then considered in two limited case studies, each involving e-learning and adult learners--in particular, nurse-learners. The first case study describes the use of a scaffolding model called Introduction, Connect, Apply, Reflect, and Extend (ICARE) in e-learning for nursing education. The second is a reflection on the use of engagement strategies for the purposes of discourse and learning in a different online nursing context. Because nursing educators were among the early adopters of e-learning, they are important mentors to others who are adopting e-learning strategies at this time. Additionally, the paper is a crossroads publication: it reminds the reader of the imperative to review theory and emerging evidence related to e-learning and to bring key findings to the actual practice of e-learning in order to benefit the adult student. This commitment to theory and practice will enable the evolution of e-learning for all learners, including returning adult learners and working professionals.

The study of workplace learning and informal learning are not new to adult education and pedagogy. However, the use of mobile devices as learning tools for informal learning in the workplace is an understudied area. Using theories on informal learning and constructivism as a framework, this paper explores informal learning of registered nurses using mobile devices to meet their learning needs for continuing professional education, professional development, and continuing competence within the challenging healthcare workplace. In this mixed methods study, participants used their devices for self-directed informal learning with non-collaborative strategies/processes for evidence-based support, new procedures/treatments, professional development, patient/client teaching, and maintaining competency. Positive perceptions were articulated. Minimal differences were associated to the nurses' age. However, workplace-related influences were relevant to the informal learning experiences with the mobile devices.

Since 2005, in Ontario, RPN's have had the option to return to school to obtain their BScN degree in three years of full time study instead of four years. Many of these students are mature and come with prior family and financial responsibilities that add extra challenges to their learning experience. Questioning their choice of investment in returning to post secondary education becomes more evident as they progress through the program and try to meet the large financial demands of university education. This paper reviews literature on personal investment in higher education in an effort to understand how one would begin to make a decision in personally investing in higher education. Recommendations for leaders in higher education are also discussed to encourage support for mature students who return to school.

There is no formal mandate for or tradition of inter-sectoral collaboration between community colleges and universities in Ontario. Following a regulatory change introduced by the College of Nurses of Ontario in 1998, all Registered Nurse educational preparation was restructured to the baccalaureate degree level through province-wide adoption of a college-university collaborative nursing program model. Despite complex sectoral differences in organizational culture, mandates, and governance structures, this program model was promoted by nursing educators and policy-makers as an innovative approach to utilizing the post-secondary system's existing nursing education infrastructure and resources. This paper provides an overview of the introduction of Ontario's collaborative baccalaureate nursing programs and discusses some of challenges associated with implementing and maintaining such programs. (Contains 1 table.)

Introduction: Throughout the COVID-19 pandemic, primary care nurses were often redeployed to areas outside of primary care to mitigate staffing shortages. Despite this, there is a scarcity of literature describing their perceptions of and experiences with redeployment during the pandemic. Objectives: This paper aims to: 1) describe the perspectives of primary care nurses with respect to redeployment, 2) discuss the opportunities/challenges associated with redeployment of primary care nurses, and 3) examine the nature (e.g., settings, activities) of redeployment by primary care nurses during the COVID-19 pandemic. Methods: In this qualitative study, semi-structured interviews were conducted with primary care nurses (i.e., Nurse Practitioners, Registered Nurses, and Licensed/Registered Practical Nurses), from four regions in Canada. These include the Interior, Island, and Vancouver Coastal Health regions in British Columbia; Ontario Health West region in Ontario; the province of Nova Scotia; and the province of Newfoundland and Labrador. Data related to redeployment were analyzed thematically. Results: Three overarching themes related to redeployment during the COVID-19 pandemic were identified: (1) Call to redeployment, (2) Redeployment as an opportunity/challenge, and (3) Scope of practice during redeployment. Primary care nurses across all regulatory designations reported variation in the process of redeployment within their jurisdiction (e.g., communication, policies/legislation), different opportunities and challenges that resulted from redeployment (e.g., scheduling flexibility, workload implications), and scope of practice implications (e.g., perceived threat to nursing license). The majority of nurses discussed experiences with redeployment being voluntary in nature, rather than mandated. Conclusions: Redeployment is a useful workforce strategy during public health emergencies; however, it requires a structured process and a decision-making approach that explicitly involves healthcare providers affected by redeployment. Primary care nurses ought only to be redeployed after other options are considered and arrangements made for the care of patients in their original practice area. [ABSTRACT FROM AUTHOR]

Describes "Taking Control of Your Career and Your Future, for Nurses by Nurses," a professional development initiative that consists of a workshop and follow-up career counseling. (JOW)

The ubiquity, flexibility, and accessibility of mobile devices can transform how registered nurses in Canada learn beyond the confines of traditional education/training boundaries in their work settings. Many Canadian registered nurses have actively embraced mobile technologies for their work-based learning to meet their competency requirements for professional nursing practice. As self-directed learners, they are using these learning tools at point-of-need to access rich online healthcare resources, collaborate, and share information within their communities of practices. Yet, paradoxically, there are Canadian healthcare organizations that have not embraced work-based mobile learning and their contextual factors constrain and/or impede registered nurses' learning. Therefore, the goal of this reflective paper is to stimulate discussion on distributive leadership strategies for embedding this pedagogical mode of learning into Canadian healthcare workplaces for registered nurses' ongoing skills and continuing professional development.

Introduction: In 2016, 5,712 American Indian/Alaskan Native (AI/AN) women and girls were reported missing in the United States. In Canada, 4% of the population is Indigenous, yet Indigenous females represent 50% of all sex trafficking victims. This systematic mixed-studies review examined the effects of Missing and Murdered Indigenous Women and Girls (MMIWG) to define a role for nurses., Methods: We used five databases with keywords, inclusion criteria, and the Mixed Methods Appraisal Tool., Results: Findings of 22 papers discuss: (a) demographic data; (b) factors that increase vulnerability of AI/AN women; and (c) how nurses can decrease the prevalence of MMIW., Discussion: Nurses are the first provider patients see when accessing care. Increasing knowledge about the impact of violence against AI/AN women and girls is the first step in identifying measures needed to address this public health concern., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support nurses' actions through unpredictable health service demands. The purpose of this paper was to examine frontline managers' experiences and organizational leadership responses that activated organizational resilience during the COVID-19 pandemic, and to learn for ongoing and future responses to healthcare crises. Fourteen managers participated in semi-structured interviews. We found that: (1) leadership challenges (physical resources and emotional burden), (2) the influence of senior leader decision-making on managers (constant change, shortage of human resources, adapting care delivery, and cooperation and collaboration), and (3) lessons learned (managerial caring behaviours and role modelling, adaptive leadership, education and training, culture of care for self, and others) were evidence of managers' responses to the crisis. Overall, the study provides evidence of managers experiences during the early waves of the pandemic in supporting nurses and fostering organizational resilience. Knowing manager's experiences can facilitate planning, preparing, and strengthening their leadership strategies to improve work conditions is a high priority to manage and sustain nurses' mental health and wellbeing. [ABSTRACT FROM AUTHOR]

hack t.f.,crooks d., plohman j. & kepron e. (2010) Research citation analysis of nursing academics in Canada: identifying success indicators. Journal of Advanced Nursing 66(11), 2542-2549. Aim. This article is a report of a citation analysis of research publications by Canadian nursing academics. Background. Citation analysis can yield objective criteria for assessing the value of published research and is becoming increasingly popular as an academic evaluation tool in universities around the world. Citation analysis is useful for examining the research performance of academic researchers and identifying leaders among them. Methods. The journal publication records of 737 nursing academics at 33 Canadian universities and schools of nursing were subject to citation analysis using the Scopus database. Three primary types of analysis were performed for each individual: number of citations for each journal publication, summative citation count of all published papers and the Scopus h-index. Preliminary citation analysis was conducted from June to July 2009, with the final analysis performed on 2 October 2009 following e-mail verification of publication lists. Results. The top 20 nursing academics for each of five citation categories are presented: the number of career citations for all publications, number of career citations for first-authored publications, most highly cited first-authored publications, the Scopus h-index for all publications and the Scopus h-index for first-authored publications. Conclusion. Citation analysis metrics are useful for evaluating the research performance of academic researchers in nursing. Institutions are encouraged to protect the research time of successful and promising nursing academics, and to dedicate funds to enhance the research programmes of underperforming academic nursing groups. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

For many patients throughout the world, access to healthcare depends on the patients" and healthcare providers' ability to communicate efficiently in each other's language. One way to reduce linguistic barriers to healthcare access is to increase the number of linguistically and culturally competent healthcare professionals. Conspicuously absent in the literature on second language (L2) training of healthcare professionals, however, is the use of technology that combines meaningful interaction, feedback, simulation, and asynchronous access. The goal of this paper is to fill this gap by describing and evaluating the "Virtual Language Patient," a computer-based L2 training module for healthcare professionals. The module employs automatic speech recognition technology, pronunciation assessment, and video clips of a simulated medical history interview with a minority language patient. Five nurses-in-training at a French-language nursing college in Quebec reported that the module was easy to operate and that it addressed their anticipated language learning needs. More importantly, analysis of the data file automatically generated by the module revealed improvements in acceptability of the nurses' pronunciation of the medical interview questions. These findings suggest that the module can be effective in language training for healthcare professionals. Implications for the improvement of virtual dialogue systems are discussed. (Contains 5 figures.)

Context: Examination of factors related to the retention or voluntary turnover of Registered Nurses (RNs) has mainly focused on urban, acute care settings. Purpose: This paper explored predictors of intent to leave (ITL) a nursing position in all rural and remote practice settings in Canada. Based on the conceptual framework developed for this project, potential predictors of ITL were related to the individual RN worker, the workplace, the community context, and satisfaction related to both the workplace and the community(s) within which the RN lived and worked. Methods: A national cross-sectional mail survey of RNs in rural and remote Canada provided the data (n = 3,051) for the logistic regression analysis of predictors of ITL. Findings: We found that RNs were more likely to plan to leave their nursing position within the next 12 months if they: were male, reported higher perceived stress, did not have dependent children or relatives, had higher education, were employed by their primary agency for a shorter time, had lower community satisfaction, had greater dissatisfaction with job scheduling, had lower satisfaction with their autonomy in the workplace, were required to be on call, performed advanced decisions or practice, and worked in a remote setting. Conclusions: The statistical evidence for predictors of ITL supported our framework with determinants related to the individual, the workplace, the community, and satisfaction levels. The importance of community makes this framework uniquely relevant to the rural health context. Our findings should guide policy makers and employers in developing retention strategies. (Contains 1 figure and 3 tables.)

How nurses understand and integrate their understanding of place is important to nursing practice. In this paper, we explore the concept of place in relation to our varied backgrounds, with the understanding that this concept differs from one person to another depending on their experiences. By coming together to talk about place, and the intersections between our common circumstances, interests, and beliefs, we share and discuss the realm of place as home, as relationship(s), as memory. Each of our unique and distinct identities-Mi'kmaw, M'etis, Jewish, and newcomer to Canada-brought varied perspectives on how place is integrated into our lives and our work as nurses. When we pay close attention, we can begin to understand that nursing research, practice, and education are intertwined with place. Along with spirit and healing, these factors have implications in our health and wellbeing. [ABSTRACT FROM AUTHOR]

This paper is an examination of the methodological and theoretical perspectives of a study with an inquiry focus on the experiences and perspectives of staff who worked at an injectable opiate assisted (iOAT) clinic. Twenty-two staff members, including nurses, social workers, and peer support workers, were interviewed. The goal of the study was to uncover how the clinic staff provided care to the clients who attend the clinic, their perspectives on how the clinic program impacted both them and their clients, and their experiences with the program itself. This interpretive descriptive study was underpinned by critical social theory. Thematic analysis was undertaken to identify recurring, converging, and contradictory patterns of interaction, key concepts and emerging themes. In this paper we examine and discuss how the relationship between critical social theory and interpretive description enhanced the study. Examples from the study are presented to provide insight into the relationship. [ABSTRACT FROM AUTHOR]

The Working Together (WT) project involved the design and delivery of an online learning resource for healthcare teams in long-term care (LTC) so that knowledge regarding interprofessional collaborative patient-centred practice (ICPCP) could be readily accessed and then transferred to the workplace. The purpose of this paper is to better understand the process of knowledge translation in continuing education for healthcare professionals by documenting our experiences using Lavis et al.'s (2003) organizing framework for knowledge transfer, and highlighting the impact this approach had on the design, development, delivery, and evaluation of the WT program. Fifty-nine pharmacists, physicians, nurses, and nurse practitioners from 17 LTC homes across Ontario, Canada participated in this project. The effectiveness of the knowledge translation of ICPCP through the WT project was evaluated using the Demand-Driven Learning Model (DDLM) evaluation tool (MacDonald, Breithaupt, Stodel, Farres, & Gabriel, 2002) to assess learners' reactions to the learning resource. Data from quantitative pre-post surveys and qualitative interviews revealed that learners found using the WT online resource to be a satisfactory learning experience, obtained new knowledge and skills regarding ICPCP, transferred knowledge to the workplace, and reported that learning had a positive effect on the residents they cared for. (Contains 2 figures, 4 tables, and 1 note.)

Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra‐professional and Inter‐professional and Inter‐sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter‐related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra‐ and inter‐professional and inter‐organisational contexts. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As uses of plasma-derived medical products increase globally, so does the demand to collect plasma from donors. There is evidence that positive interactions with center staff motivate plasma donors to return. This paper reports on a focused ethnography investigating experiences of nurses and phlebotomists in one of Canadian Blood Services' first source plasma collection center during the COVID-19 pandemic. Participants found the transition from whole blood collection to source plasma amid a global pandemic challenging, but they adapted by coming together as a team, and then worked to put the donor experience first. Their experience resonates with scholarship on emotional labor. As blood services worldwide attempt to increase source plasma collection, there is a need to understand care work that nurses and phlebotomists perform on the front-line. This study offers insight into how blood services can support staff in plasma operations by recognizing emotional labor. [ABSTRACT FROM AUTHOR]

The labour market for care professionals has experienced significant changes, resulting in critical shortages globally. Nurses represent the largest share of health workers worldwide; nonetheless, an estimated 13 million more nurses will be needed over the next 10 years. Prior to the pandemic, the domestic supply of nurses in Canada had not kept pace with the ever-increasing demand for services. Pre-pandemic age- and needs-based forecasting models have estimated shortages in an excess of 100,000 nurses nationwide by 2030. While COVID-19 has accelerated the demand for and complexity of service requirements, it has also resulted in losses of healthcare professionals due to an increased sick leave, unprecedented burnout and retirements. This paper examines key factors that have contributed to nursing supply issues in Canada over time and provides examples of policy responses to the present shortage facing the healthcare system. To provide adequate care, the nursing workforce must be stabilized and—more importantly—recognized as critical to the health of the population. [ABSTRACT FROM AUTHOR]

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The aim of this study was to synthesize previous knowledge about ethics in nurses' interprofessional collaboration in clinical practice. Although healthcare professionals have common goals and shared values, ethical conflicts still arise during patient care. We carried out a meta-synthesis of peer-reviewed papers published in any language from 2013-2019, using both electronic searches, with the CINAHL, PubMed, Scopus, and SocINDEX databases, and manual searches. We identified 4,763 papers and selected six qualitative papers, and three theoretical papers, based on predetermined inclusion and exclusion criteria and quality appraisal. The studies came from the USA, Canada, Sweden, Australia, Botswana, and the Netherlands. We found that in ethics studies on nurses' interprofessional collaboration in clinical practice the focus has been on factors that affect how patients receive care. These factors were patients' wishes, whether they were told the truth about their condition, and how different professionals recognized and treated their pain. The focus in the papers we reviewed was on the roles of different professionals during the care process, including ethical conflicts with regard to their aims, commitment, and the balance of power among them and other professions. More research is needed to raise the visibility of how nurses and other professionals recognize, and evaluate, their professional and interprofessional ethics.

Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. [ABSTRACT FROM AUTHOR]

The purpose of this scoping review was to assess the state of the literature concerning the experiences of new PhD-prepared tenure-track faculty, with a keen interest in nursing faculty. Effective recruitment and retention strategies for new nursing academic faculty need to be found and implemented. A literature review based on Arksey and O'Malley's five-stage framework for scoping reviews was undertaken. Using the PRISMA protocol, a systematic literature search was conducted in seven databases of studies published in English. Based upon inclusion criteria and relevance, 13 studies out of 90 papers were included in this study. Themes identified from the studies were transitioning to academia, developing a research program, balancing work and life, and perceived inequity. The research was predominately American and Canadian based. Several gaps in the literature were identified. Further research is critical to make recommendations to key stakeholders for recruitment and retention strategies. [ABSTRACT FROM AUTHOR]

This paper examines masculinity, migration and the changing occupational status of nursing through the lens of therapeutic mobilities; health related mobilities of people (nurses) and products (credentials). Indian men have become increasingly interested in nursing as a career, and this interest is strongly associated with the profession's international motility-its mobility potential. The research reported in this paper traces the migration trajectory across time (2008-2016) and over space (India to Canada) and reveals an overrepresentation of male nurses in international migration contexts (Canada), compared to the Indian context. Male nurses also disproportionally benefit from these mobilities in terms of their occupational success post-migration. Mobilities can be therapeutic for the status of nursing in India, which rises in line with the degree of international motility the profession offers, but gendered distinctions in the outcomes of the migration process illustrate the importance of highlighting uneven mobilities. International mobilities are also deeply implicated in ongoing transformations occurring in the 'moorings' of nursing educational, employment and regulatory structures in India. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to provide a concept analysis of 'pandemic influenza'. Background Pandemic influenza can have a devastating impact as individuals have little to no immunity towards the newly encountered virus. It is a persistent societal threat due to the advancement of multiple technological processes. Nurses work in multiple roles in pandemics. As such, a thorough understanding of the concept and its implications from a nursing perspective is required. Design Rodgers' Evolutionary Method was used to conduct the concept analysis of the term 'pandemic influenza'. Data sources Forty-nine papers were examined from the disciplines of public health, medicine, law, bioethics and healthcare policy. Papers were found from the PubMed, CINAHL and Google Scholar databases all dates up to December 2013. Limits were set to include peer-reviewed, English language articles. Methods Identified papers were critically analyzed to explore the concept's antecedents, attributes and consequences. Surrogate and related terms, and an exemplar, were identified. Results Attributes of pandemic include original viral structure, increased human susceptibility, younger vulnerable populations and unpredictable time frames. Antecedents include processes that enable the increased geographical transmission of a newly created influenza. Consequences include higher morbidity and mortality rates and the need for an efficient pandemic response. Conclusions This analysis identified the attributes of pandemic influenza through a synthesis of the current pandemic literature. However, no articles were identified as specifically nursing in nature. Therefore, more research is required to examine the impact of a pandemic declaration on the nursing profession. [ABSTRACT FROM AUTHOR]

Surgical site infections increase health care costs, morbidity, and mortality in 2% to 5% of surgical patients. Standardised post‐surgical surveillance is rare in community settings, causing under‐reporting and under‐serving of the documented 60% of surgical site infections occurring following hospital discharge. This study evaluated feasibility and concordance (inter‐rater reliability) of paired registered nurses using a web‐based surveillance tool (how2trakSSI, based on validated guidelines) to detect surgical site infections for up to 30 days after surgery in a cohort of 101 patients referred to Calea Home Care Clinics in Toronto, Canada, March 2015 to July 2016. After paired registered nurse assessors used the tool‐less than 10 minutes apart to measure concordance 5 to 7 days postoperatively, they provided feedback on its usefulness at two teleconference discussion groups September 6 to 7, 2016. Overall concordance between assessors was 0.822, remaining consistently above 0.65 across assessor education level and experience, patient age and weight, and wound area. Assessors documented 39.6% surgical site infection prevalence 5 to 7 days after surgery, confirming clinical need, relevance, reliability, and feasibility of using this web‐based tool to standardise community surgical site infection surveillance, noting that it was user‐friendly, more efficient to use than traditional paper‐based tools and useful as a registry for tracking progress. [ABSTRACT FROM AUTHOR]

Nurses' use of mHealth remains largely unexplored despite enthusiasm for its use in health systems. We conducted a survey (n=341) to examine nurses' use of mHealth technologies in Canada; this paper presents findings of sub questions within a larger study. Differences in common mHealth functions used by nurses were examined by population setting (large urban centre, medium centre, small centre, and rural area) and type of organization (hospital, community health, nursing home or long-term care, and other). A significant difference by population setting was found in the use of the mHealth functions to support decision making. Significant differences by type of organization were found in the use of the mHealth functions for care plans, outside communication, general/basic documentation, accessing information resources, and 'other' functions. Results from this study are the first to provide details of the current state and nature of nurses' use of mHealth.

Background: Multiple challenges impede the Internationally Educated Nurses (IENs) professional development and success in writing the registration examination. This paper aims to explore these challenges and describes the educational program which adopts a tailored mentoring approach to facilitate their successful completion of the registration exam. Methodology: Participatory Action Research model informed the development and revision of the educational process. For this qualitative study, individual 1:1 audiotaped and telephone interviews were conducted among the initial participants to explore their experiences in the program., Results: Findings from this study provided more insights as to participants' success in passing registration examination and enhanced performance in their clinical practices. From the thematic analysis, we interpreted the IEN's journey in their knowledge transition into four major themes: Acknowledging the barriers, Learning the new culture, Making progress, Transitioning into power., Conclusion: This project demonstrated that the integration of a strong mentor-mentee relationship that gives voice to the participants' learning experience so as to meet their knowledge gaps, engenders a deeper understanding of Canadian professional nursing practice, positions them for success in writing the registration examination and builds a sense of empowerment among them.

Abstract: Aim: To explore the collaborative nature of an international research project with other advanced practice nurse researchers and critically analyse the process. Background: Research within the nursing community is recognized internationally as important to ensure that nurses participate in cutting‐edge health care and promote evidence‐based practices, yet there is little detail found in literature on how a successful collaborative relationship is initiated and conducted in advanced practice research. Design: Discussion paper: The purpose of this paper is to discuss the process of collaboration on a research study among advanced practice nurses from four countries who are members of an international organization. Implications for Nursing: The collaborative process in international nursing research can be challenging and rewarding. It is important to remember that there is a relationship between the complexity of the study and the time required to complete it. Keys to success include following established guidelines. Conclusion: This project was a valuable experience in developing collaborative relationships as well as creating partnerships for future research to build on the knowledge gained. The authors' linkages to universities facilitated their participation in the research and completion of the ethical review processes. The use of social media and university resources was indispensable. [ABSTRACT FROM AUTHOR]