What Got Us Here Won't Get Us There: Critical History in Radical Black Re-imaginations of Canadian Nursing Histories.

As a "foursome" of nursing history students and scholars, upcoming, junior, and seasoned, we presented a panel on new work and possibilities related to histories of Blackness and Black nurses in Canadian nursing history. Our presentation was the 2023 keynote Hannah Panel Presentation for the joint Canadian Society for the History of Medicine (CSHM-SCHM) and the Canadian Association for the History of Nursing (CAHN-ACHN) conference. Reflecting and expanding our perspectives, we share the relevance and significance of engaging with histories of Canadian Blackness and (in)visibility of Blackness in nursing history. This paper considers the overarching question of how does engaging with histories of Canadian Blackness serve as an anti-racist strategy when examining, analyzing and understanding the history of nursing and health care? A core tenant of this work aims at acknowledging how institutional relationships of power are reproduced within scholarship unless there is space for radical re-imaginations. The disruption to power is achieved by exploring the connections between nursing and history from the perspective of Black nurses' history or Black feminist thought. We also disrupt power by our form, in challenging expectations of scientific inquiry as the only format of valid knowledge production within the discipline. Possibilities of arts-based methodology as a site for democratization in nursing knowledge are evoked through the metaphoric language (water, fire, air and earth) interwoven within the text. We highlight how each of us engages with nursing history, further complicating previous narratives of our collective Canadian past. In publishing our thoughts on historical inquiry in a nursing journal, we hope to provoke more curiosity and interest in history within our discipline as a site for liberation!

Reflections on Black Nurses' Invisibility: Exploring the Contribution of Black Nurses to British Columbia (Canada), 1845-1910.

Black nurses are at the margins of the annals of history and there is a dearth of historical accounts of their work. Drawing on our historical research about Black nurses in British Columbia (Canada) between 1845 and 1910, we point to the complexity of Black women's lives and argue that Black nurses disrupted the conceptualization of Blackness and Black womanhood of the time. We demonstrate the vital contributions of Black nurses to the health of communities and add to existing scholarship that redefines the nursing narrative: one in which white nurses are not the start and end point of history.

The Contribution of Documentation Systems to How Nurses Understand Older People's Cognitive Function in Hospital.

Nurses are central to the care of older people in hospital. One issue of particular importance to the experience and outcomes of hospitalized older people is their cognitive function. This article reports findings from a focused ethnographic study demonstrating how documentation systems-documents and the social processes surrounding their use-contribute to how nurses come to understand the cognitive function of hospitalized older people. We found that documents contribute to nurses' understanding by serving as a frame of reference, by directing assessments, and by constraining communication. The findings highlight the potential to improve the documents nurses use in hospitals.

Professional Development Needs of Novice Nursing Clinical Teachers: A Rapid Evidence Assessment.

The current nursing profession is challenged with a decreasing supply of competent clinical teachers due to several factors consequently impacting the quality of nursing education. To meet this demand, academic nursing programs are resorting to hiring expert nurses who may have little or no teaching experience. They need support during their transition from practice to teaching. Using the systematic approach of a Rapid Evidence Assessment (REA), scholarly literature was reviewed to identify existing professional development needs for novice clinical teachers as well as supportive strategies to aid the transition of experienced nurses into teaching practice. The REA included 29 relevant studies. Findings revealed three main professional development needs for novice clinical teachers and key supportive strategies. Based on these findings recommendations for best practices to support and prepare novice clinical teachers are presented.

Community mental health nursing in Alberta, Canada: an oral history.

Community mental health nurses had a central role in the construction of new rehabilitative practices and community mental health services in the 1960s and 1970s. The purpose of this article is, first, to explore how nurses understood and created their new role and identity in the turbulent context of deinstitutionalization. The development of after care services for patients discharged from Alberta Hospital in Ponoka (AH-Ponoka), a large mental institution in Calgary, in the Canadian province of Alberta, will be used as a case study. I specifically focus on the establishment of outpatient services in a new psychiatric department at Foothills General Hospital in Calgary. Second, I examine how deinstitutionalization itself shaped community mental health nurses' work. Oral history interviews with nurses and other mental health professionals, who had a central role in this transformation process, provide a unique lens through which to explore this social change. The article concludes that new rehabilitative, community-based mental health services can better be understood as a transformation of former institutional practices rather than as a definite break with them.

Beyond greener pastures: exploring contexts surrounding Filipino nurse migration in Canada through oral history.

The history of immigrant Filipino nurses in Canada has received little attention, yet Canada is a major receiving country of a growing number of Filipino migrants and incorporates Filipino immigrant nurses into its healthcare workforce at a steady rate. This study aims to look beyond the traditional economic and policy analysis perspectives of global migration and beyond the push and pull factors commonly discussed in the migration literature. Through oral history, this study explores biographical histories of nine Filipino immigrant nurses currently working in British Columbia and Alberta, Canada. Narratives reveal the instrumental role of the deeply embedded culture of migration in the Philippines in influencing Filipino nurses to migrate. Additionally, the stories illustrate the weight of cultural pressures and societal constructs these nurses faced that first colored their decision to pursue a career in nursing and ultimately to pursue emigration. Oral history is a powerful tool for examining migration history and sheds light on nuances of experience that might otherwise be neglected. This study explores the complex connections between various factors motivating Filipino nurse migration, the decision-making process, and other pre-migration experiences.

Outcomes of dental hygiene baccalaureate degree education in Canada.

There is little published literature about the outcomes of dental hygiene baccalaureate degree education, particularly in Canada. Since there are various dental hygiene entry-to-practice educational models in Canada, exploring baccalaureate dental hygiene education is becoming an increasingly important subject. The purpose of this study was to explore the personal outcomes and dental hygiene practice outcomes of dental hygiene degree-completion education in Canada from the perspectives of diploma dental hygienists who have continued their education to the bachelor's degree level. This study employed a qualitative phenomenological design, using a maximum variation purposeful sampling strategy. Data generation occurred with sixteen dental hygienists across Canada through individual semistructured interviews. Interviews were audiorecorded, transcribed verbatim, and coded for data analysis, involving pattern recognition and thematic development. Themes that emerged included changes in self-perception, values, and knowledge base. Changes in self-perception were reflected in a reported increase in self-confidence and perceived credibility. Changes in values included a greater appreciation for lifelong learning. Advancements in knowledge strengthened the development of specific abilities that ultimately influenced participants' dental hygiene practice. These abilities included an increased ability to think critically, to make evidence-based decisions, and to provide more comprehensive care. Participants also commented on having more career opportunities available to them outside of the private clinical practice setting. These results reveal important insights into the impact of earning a dental hygiene baccalaureate degree on oneself and one's dental hygiene practice.

Deinstitutionalization reconsidered: geographic and demographic changes in mental health care in British Columbia and Alberta, 1950-1980.

Using demographics on admission to, and discharge from, mental hospitals in Alberta and British Columbia, this paper analyzes the social process commonly framed as deinstitutionalization between 1950 and 1980. A focus on the two most western Canadian provinces permits an exploration of these changes in these regional contexts. Pressured by new funding arrangements, a shift towards community care, and growing criticism of the alleged oppressive nature of large institutions, the three main mental hospitals scaled down as of the 1950s. This trend did not mean, however, that the overall number of hospitalized patients decreased during this time period. The total number of hospitalizations, particularly short-term admissions, actually expanded, while trans-institutionalization also occurred. This case study mirrors larger trends of postwar mental health care, illustrating the social, political, and cultural challenges experienced in the reconstruction of institutional care.

Strengthening communication education in an undergraduate nursing curriculum.

As effective communication is an essential professional competency that is conceptualized and developed during undergraduate education, the purpose of this study was to investigate and reinforce the role of communication in the nursing undergraduate curriculum. Analysis of faculty and student focus group discussions revealed the benefit of purposefully structuring and explicitly articulating communication education throughout the undergraduate curriculum for increased accessibility and visibility of communication education, expanded ranges of available teaching and learning methods and resources, and strengthened ability to address undermining mixed communication messages. These findings have implications for how to specifically include communication education in a learning-centered undergraduate curriculum.

The development of nurse practitioner preparation beyond the master's level: what is the debate about?

The nursing discipline in the United States (US) has a history of creating various doctorates. One such degree, the Doctor of Nursing Practice (DNP), serves as an alternative to the traditional Doctor of Philosophy (PhD) degree for Nurse Practitioners (NPs) exploring career options. The availability of the DNP has sparked a debate within the profession: close attention to the issues is warranted for any school considering the development of a DNP program. However, some of these issues are not applicable, or apply differently to other contexts including Canada, where the highest level of education for an NP is a PhD. This article will review the history of doctoral education in both countries, compare the practice-focused and research-focused doctorates, discuss the issues of debate, and explore implications for NP practice. To fully inform the decision of the NP, we recommend further research to explore the need for a practice doctorate.

Developing Nursing Scholarship and Research: The Innovative Leadership of Margaret Scott Wright, 1946 - 1985

Life history is a powerful methodology and framework to analyze and interpret events and

changes in nursing's past. The life history and innovative leadership of Margaret Scott Wright,

nurse leader first in the United Kingdom and then in Canada, illustrates how in the 1970s and

1980s nursing scholarship and research grew in importance. Through her personal recollections

and supportive documentary evidence we can learn how nurses in the post-World War Two era

pioneered new roles in clinical nursing, education, and research. In the process they linked the

three into new scholarly endeavors and academic nursing pursuits. The need for more and better

educated nurses in post-war health care forged a stronger link between nursing and the university,

generating new leaders in nursing scholarship and research. Margaret Scott Wright was one of the

Bertha Harmer's 1922 textbook - The Principles and Practice of Nursing: clinical nursing from an historical perspective.

AIMS AND OBJECTIVES: This study analyses the origins of a widely used textbook of nursing, commonly utilised in North American Schools of Nursing since 1922, and eventually worldwide. A biography of its first author, Bertha Harmer, is also included. BACKGROUND: Tracing central ideas of nursing throughout the various editions, the book provides a commentary on the cultural-historical context of nursing and reveals how nursing leaders conceptualised the day-to-day knowledge base nurses would need for their practice. DESIGN AND METHODS: Historical analysis. RESULTS: The core nursing concept of 'human needs' was central to Harmer's work and thinking. CONCLUSIONS: Its continuous development by her and her later co-author, Virginia Henderson, reflected broader changes in nursing that were central to the construction of nursing as hospital-based care during the twentieth century. RELEVANCE TO CLINICAL PRACTICE AND CONCLUSION: Renewal of nursing practice exists by the virtue of nurses' collective ability to question continuously and critically, the foundations of their practice. Historical analysis of core nursing concepts is one approach to further such critique.

Nursing and anaesthesia: historical developments in Canada.

There is little historical knowledge available about nurses' role in anaesthesia in Canada. It appears, from the few sources available, that nurses did administer anaesthesia in the early 20th century in Canada. The limited historiography reveals that nurses who worked in small rural hospitals across Canada were, due to the lack of physician specialty and coverage, involved in the administration of anaesthesia. To learn more about nurses' role in this area the authors explored the oral history collection from the British Columbia's History of Nursing group at the College of Registered Nurses of British Columbia Library. Several stories indicated that between 1917 and 1953 there were opportunities for Canadian nurses to administer anaesthesia. The oral histories identified that there was a need for the administration of anaesthesia, that nurses had the skill to provide it, and that flexibility in their nursing practice enabled them to fulfill this role. There was an increasing need for anaesthesia service that was not being filled by physicians. To further explore nurses' role the authors also examined nursing and medical journals from that time period. There is limited understanding of how this role ceased to exist in Canada while it became well established in the United States. Various legal cases from that time period, and the substantially different results between Canadian and America cases, provide some insight into the reasons why nurse anaesthetists were excluded from anaesthesia practice in Canada. As the Canadian healthcare environment continues to change, and the need for anaesthesia services increases, new questions have begun to arise about the potential for an advanced practice role in anaesthesia for Canadian nurses. The demand for anaesthesia services is increasing in-line with the aging Canadian population and the shortage of available services is most dramatic in small, rural hospitals. This article provides important historical background on the development of the role of nurse anaesthetists in Canada.

Elective caesarean section as a transformative technological process: players, power and context.

AIM: In this paper we present a critical analysis of the debate surrounding elective caesarean section using the Social Construction of Technology perspective as a framework of analysis. BACKGROUND: The rate of caesarean section births is increasing worldwide in industrialized countries. Reasons given for the increase include women's characteristics, care providers' attitudes, prevention of pelvic floor disorders and adverse outcomes. DATA SOURCES: CINAHL, PubMed, Ovid, Academic Search Premier and Cochrane Data bases were searched for the years 2000 to 2007 using search terms elective caesarean section, caesarean section on demand and maternal choice caesarean section. DISCUSSION: The social constructivist approach explains how caesarean section as a mode of delivery has been transformed from an emergency to an elective procedure. Analysing elective caesarean section as a socially constructed technological process exposes positions taken by obstetricians, midwives, perinatal nurses and women, including the power dynamics and contextual influences. CONCLUSION: The Social Construction of Technology perspective creates space for perinatal nurses to examine the implications of the use and meaning of elective caesarean section in a broader social context. Examining elective caesarean section from the Social Construction of Technology perspective exposes an emphasis on safety and risk for the foetus, while avoiding the equally important goal of promoting optimal postnatal health for mothers and infants. The Social Construction of Technology perspective highlights how those who define the problem control the solution.

Patterns of research utilization on patient care units.

BACKGROUND: Organizational context plays a central role in shaping the use of research by healthcare professionals. The largest group of professionals employed in healthcare organizations is nurses, putting them in a position to influence patient and system outcomes significantly. However, investigators have often limited their study on the determinants of research use to individual factors over organizational or contextual factors. METHODS: The purpose of this study was to examine the determinants of research use among nurses working in acute care hospitals, with an emphasis on identifying contextual determinants of research use. A comparative ethnographic case study design was used to examine seven patient care units (two adult and five pediatric units) in four hospitals in two Canadian provinces (Ontario and Alberta). Data were collected over a six-month period by means of quantitative and qualitative approaches using an array of instruments and extensive fieldwork. The patient care unit was the unit of analysis. Drawing on the quantitative data and using correspondence analysis, relationships between various factors were mapped using the coefficient of variation. RESULTS: Units with the highest mean research utilization scores clustered together on factors such as nurse critical thinking dispositions, unit culture (as measured by work creativity, work efficiency, questioning behavior, co-worker support, and the importance nurses place on access to continuing education), environmental complexity (as measured by changing patient acuity and re-sequencing of work), and nurses' attitudes towards research. Units with moderate research utilization clustered on organizational support, belief suspension, and intent to use research. Higher nursing workloads and lack of people support clustered more closely to units with the lowest research utilization scores. CONCLUSION: Modifiable characteristics of organizational context at the patient care unit level influences research utilization by nurses. These findings have implications for patient care unit structures and offer beginning direction for the development of interventions to enhance research use by nurses.

Family visitation in the PACU, 1984-2006.

Family visitation in postanesthesia care remains a controversial issue in North American hospitals. Historically, PACUs have been a closed and restricted area to the general public. Over the past 20 years, a growing body of nursing research has emerged challenging the restrictive practices of excluding family visitation in the immediate postoperative period. Because of the inconsistencies and gaps between current clinical practice and research, a review and analysis of past and present family visitation literature was conducted. Findings indicate that a further study of beliefs and workplace culture can contribute to a better understanding of impeding factors on a much needed change in policy.