[Advanced practice nurse, a growing status]. / Infirmier en pratique avancée, un statut en plein essor.

Present throughout the country, nurses are a considerable asset in a context of medical desertification. It is therefore important to rethink the healthcare system by questioning the central place of doctors in the care pathway and by opening the way for direct access to other professionals, such as advanced practice nurses (APN). The year 2023 saw a change in this direction, with the passage of the Rist bill on improving access to care. This bill opens direct access to APNs working in coordinated practice structures and announces the implementation of an experiment in six departments on direct access to APNs working in territorial professional health communities.

[The report's conclusions as seen by professional nursing organizations]. / Les conclusions du rapport vues par les organisations professionnelles infirmières.

Nurses have largely contributed to the national effort to fight the Covid-19 crisis, but have also been strongly affected by its consequences. This observation, reinforced by the recent recommendations of the World Health Organization's report on the situation of nurses in the world, underlines the need to initiate changes in the nursing field in France without delay.

Vaccine hesitancy and self-vaccination behaviors among nurses in southeastern France.

BACKGROUND: Health care worker vaccine uptake rates are below official targets, and studies demonstrate some are vaccine hesitant. We assessed self-vaccination behavior, vaccine hesitancy (VH), and associated factors in a representative sample of nurses. METHODS: Cross-sectional questionnaire survey in 2017-18 in southeastern France (5 million inhabitants): community nurses were randomly selected from a list provided by the Inter-Regional Nurses' Council (stratified by gender and district of practice) and interviewed by telephone. Because no such list exists for hospital nurses (74% of all nurses in southeastern France), we randomly selected hospitals, taking their size into account and stratifying by district. Hospital nurses practicing in medicine, surgery, obstetrics, and gynecology departments and present at the time of the survey were included and interviewed face-to face. We measured VH according to the WHO definition (refusal, delay, or acceptance with doubts about at least one vaccine). Interviewers administered the questionnaires. We used multivariable logistic regression to analyze potential associations between VH, vaccine risk perceptions and trust in health authorities. RESULTS: Interviews were completed with 1539 nurses (response rate: 85%). Self-reported vaccine coverage ranged from 27% (seasonal influenza vaccine, recommended, 2016/17 season) to 96% (Bacillus Calmette-Guérin vaccine, mandatory). The VH prevalence rate was 44% (95% confidence interval: 38.7-48.4) and most often concerned seasonal influenza or A(H1N1) vaccines (54%) and the hepatitis B vaccine (18%). VH was significantly more frequent among nurses with low trust in health authorities or high vaccine risk perceptions. CONCLUSION: Nurses in southeastern France have low levels of self-vaccination acceptance for most recommended vaccines. In addition, they have a high VH prevalence focused on the same vaccines as among the general population. These are important findings given that nurses are in regular contact with patients vulnerable to vaccine-preventable diseases and their VH could negatively influence patients' vaccination acceptance.

Leadership professionnelProfessional leadership.

The largest health profession in terms of the number of employees, nurses are affected by the decisions taken with regard to their professional group but they also want to be involved in the decision-making processes relating to healthcare issues. In these negotiations, the task of professional nursing organisations is to demonstrate professional leadership.

[Advanced practice, a springboard for nursing leadership]. / La pratique avancée, un tremplin pour un leadership infirmier.

The introduction of advanced nursing practice in France is a necessity but also constitutes a challenge. The French National Order of Nurses has been a key player in this project. This experience has shown that the profession needs to mobilise itself and acquire the codes and skills needed to tackle the difficulties and obstacles. It must develop its ability to negotiate with stakeholders and with its leadership to move the profession forwards.

Seasonal influenza self-vaccination behaviours and attitudes among nurses in Southeastern France.

BACKGROUND: Despite seasonal influenza vaccination (SIV) being recommended to healthcare professionals to protect themselves and their patients, uptake is low, especially among nurses. We sought to study self-vaccination behaviours, attitudes and knowledge about SIV among nurses in Southeastern France. METHODS: A cross-sectional survey with community and hospital-based hospital nurses was conducted with the same standardised questionnaire. Multi-model averaging approaches studied factors associated with the following dependent variables: self-reported SIV uptake; and considering SIV a professional responsibility. RESULTS: 1539 nurses completed the questionnaire (response rate: 85%). SIV was the most frequently cited vaccine (49%) regarding nurses' unfavourable opinions towards specific vaccines. Thirty-four percent of nurses reported being vaccinated at least once during the 2015-2016 or 2016-2017 seasons. A lack of perceived personal vulnerability to influenza, a fear of adverse effects, and a preference for homeopathy constituted the main deterrents of SIV. Nurses held various misconceptions about the SIV, but 69% considered its benefits to be greater than its risks. The multi-model averaging approach showed that considering SIV as a professional responsibility was the main factor associated with SIV uptake among nurses (Nagelkerke's partial R-squared: 15%). This sense of responsibility was strongly associated with trust in various vaccine information sources. CONCLUSION: Nurses had low SIV uptake rates and held various concerns and a lack of knowledge surrounding the vaccine. This is concerning considering the impact that these factors can have on nurses and patients' health, especially considering the increased role that nurses could have surrounding SIV in the near future.

[Promoting the code of ethics for nurses]. / Diffuser le Code de déontologie des infirmiers.

The publication of the code of ethics for nurses requires the French National Order of Nurses' structures to undertake initiatives with the aim of promoting it as well as implementing the public service missions which have now been attributed to the Order. Each regional and departmental body has its role to play in raising awareness of this code and its application in the field.