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Recent regulatory changes mean Canadian nurses are writing a US-based entry to practice exam and a US company is assessing credentials of internationally educated nurses (IENs) for Canadian registration. This paper asserts that this policy direction has significant consequences for Canadian content and integrity of education programs, francophone parity in testing, and the future of primary health care and health system reform. Furthermore, writing a US exam means Canada is at risk of losing nursing human resources to the United States while trade agreements endanger Canadian nursing intellectual property.À la suite de changements de réglementation, les diplômés en science infirmière doivent passer un examen d'autorisation à pratiquer mis au point aux EU, et les diplômés internationaux en science infirmière sont évalués par une entreprise, elle aussi des États-Unis. Dans cet article, nous considérons que ces changements ont un impact significatif sur le contenu canadien et l'intégrité des programmes de formation, l'égalité de traitement dans l'évaluation pour les francophones et le futur des soins de santé primaire et la réforme des soins de santé. De plus, en uniformisant l'accréditation avec les EU, le Canada court le risque de laisser partir sa main d'oeuvre infirmière dans ce pays, au moment même où les accords commerciaux mettent en danger la propriété intellectuelle infirmière canadienne.

As the late Robert Kane observed, the term nursing home is often a misnomer. Most U.S. nursing homes lack adequate nursing staff, and they are typically not very homelike in either their physical structure or culture. These problems were magnified during the pandemic. The underlying reasons for these longstanding issues are that most state Medicaid payment systems reimburse nursing homes at a relatively low level and the government does not hold nursing homes accountable for spending dollars on direct resident care. To encourage increased staffing and more homelike models of care, policymakers need to reform how nursing homes are paid and hold facilities accountable for how they spend government dollars. With these reforms, the term nursing home will become more appropriate in the United States.

NURSING HOMES: QUALITY AND CARE ISSUES -- NURSING HOMES: QUALITY AND CARE ISSUES -- CONTENTS -- PREFACE -- Chapter 1 NURSING HOME REFORM: CONTINUED ATTENTION IS NEEDED TO IMPROVE QUALITY OF CARE IN A SMALL BUT SIGNIFICANT SHARE OF HOMES -- Why GAO Did This Study -- What GAO Found -- Background -- Survey Process -- Enforcement -- Oversight -- Quality of Care Remains a Problem for a Small but Significant Proportion of Nursing Homes Nationwide -- CMS Has Strengthened Its Enforcement Capabilities, although Key Initiatives Still Need Refinement

Negotiating nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged men within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men physically, emotionally and spiritually from the battlefield and for the war, despite concerns about their presence on the frontline. The book maps the developments in nurses' work as the Q.A.s created a legitimate space for themselves in war zones and established nurses' position as the expert at the bedside. Using a range of personal testimony the book demonstrates how the exigencies of war demanded nurses alter the methods of nursing practice and the professional boundaries in which they had traditionally worked, in order to care for their soldier-patients in the challenging environments of a war zone. Although they may have transformed practice, their position in war was highly gendered and it was gender in the post-war era that prevented their considerable skills from being transferred to the new welfare state, as the women of Britain were returned to the home and hearth. The aftermath of war may therefore have augured professional disappointment for some nursing sisters, yet their contribution to nursing knowledge and practice was, and remains, significant.

Intro -- Contents -- Cases -- 1. Moral Dilemmas and Ethical Inquiry -- 1. Moral dilemmas in nursing -- 2. Ethical codes: uses and limitations -- 3. The fundamental question of morality -- 4. Ethical inquiry -- 5. Ethical autonomy and institutional-hierarchical constraints -- 2. Unavoidable Topics in Ethical Theory -- 1. Introduction -- 2. Basic ethical principles -- 3. Knowledge in ethics -- 4. Ethics, law, and religion -- 3. Nurses and Clients -- 1. Introduction -- 2. Parentalism -- 3. Deception -- 4. Confidentiality -- 5. Personal risks and professional obligations -- 6. Conflicting claims -- 4. Recurring Ethical Issues in Nurse-Physician Relationships -- 1. Conflicts between nurse and physician -- 2. Nurse autonomy -- 3. Collaboration -- 4. Integrity-preserving compromise -- 5. Conscientious refusal -- 6. Determining responsibility -- 5. Ethical Dilemmas Among Nurses -- 1. Tensions between nurses -- 2. Respect for persons -- 3. Professional obligations -- 4. Administrative dilemmas -- 6. Personal Responsibility for Institutional and Public Policy -- 1. The scope of individual responsibility -- 2. Institutional policies and strikes -- 3. Institutional ethics committees -- 4. Blowing the whistle -- 5. Public policy: advance directives -- 6. Putting it all together -- 7. Cost Containment, Justice, and Rationing -- 1. Introduction -- 2. Cost containment and the claims of justice -- 3. Access to care -- 4. The concept of rationing -- 5. The Oregon proposal -- 6. Toward ethical rationing -- 7. Rationing and the importance of nursing care -- 8. The expanding scope of nursing ethics -- APPENDIX A: International Council of Nurses Code for Nurses -- APPENDIX B: American Nurses' Association Code for Nurses -- APPENDIX C: American Hospital Association: A Patient's Bill of Rights -- APPENDIX D: Cases for Analysis -- Suggestions for Further Reading -- Index.

Nudging is a concept in behavioural science, political theory and economics that proposes indirect suggestions to try to achieve non-forced compliance and to influence the decision-making and behaviour of groups and individuals. Researchers in medical ethics are currently discussing whether nudging is ethically permissible in health care. In this article, we look into current knowledge about how different decisions (rational and pre-rational decisions, major and minor decisions) are made and how this decisionmaking process pertains to patients. We view this knowledge in light of the nursing project and the ongoing debate regarding the ethical legitimacy of nudging in health care. We argue that it is insufficient to discuss nudging in nursing and healthcare in light of free will and patient autonomy alone. Sometimes, nurses must take charge and exhibit leadership in the nurse-patient relationship. From the perspective of nursing as leadership, nudging becomes a useful tool for directing and guiding patients towards the shared goals of health, recovery and independence and away from suffering. The use of nudging in nursing to influence patients' decisions and actions must be in alignment with the nursing project and in accordance with patients' own values and goals. ; This research has been funded by the Oslo and Akershus University College, and the Norwegian Research Council (Grant number: 250503). ; acceptedVersion

A survey of six Nigerian nursing program curricula was conducted to determine the extent to which family nursing theory was used as a reference for conceptualizing nursing care in Nigeria. In addition, 25 nurse clinicians were purposively selected from three levels of primary, secondary, and tertiary health care units in Ile-Ife, Nigeria, and were interviewed to determine the extent to which nurses in practice reported using family assessment tools in their practice. The survey of the postgraduate curricula showed that master's and doctorally prepared nurses specializing in community health nursing have a theoretical base in family nursing theory. The limited focus on family nursing theory in basic, postbasic, and first-degree nursing curricula was deemed inadequate to develop the knowledge and skills necessary for all practicing nurses to embrace family-focused care in Nigeria. In nursing practice, families were seen to be involved in nursing care only to the extent of meeting financial and physical care needs of their family members. Findings from this study point to the need for a reorientation of the nursing curricula in Nigeria to include more family nursing theory. Specialized education of family nurse practitioners who would function at all levels of care also is a desirable goal to provide holistic health care to Nigerian families.