Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.

AIMS AND OBJECTIVES: To propose the Careful Nursing Philosophy and Professional Practice Model© as a conceptual and practice solution to current fundamental nursing care erosion and deficits. BACKGROUND: There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. DESIGN: This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model© (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. METHOD: A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. CONCLUSIONS: Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. RELEVANCE TO CLINICAL PRACTICE: This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care.

Exploring implementation of the Careful Nursing Philosophy and Professional Practice Model© in hospital-based practice.

AIM: To explore the effectiveness and feasibility of implementing the two clinical dimensions of the Careful Nursing Philosophy and Professional Practice Model© (Careful Nursing) in an acute care hospital. BACKGROUND: Implementation of a professional practice model by nurses in hospitals supports nurses' control over their practice and enhances the quality of their contribution to patient care. Implementing such change is complex and initially best approached on a small scale. METHODS: A mixed methods exploratory design was used. Data were sought from 23 professional nurses practising in a 26-bed acute medical ward for older persons. Quantitative data were collected on nurses' control over and documentation of their practice. Qualitative data were collected on nurses' perceptions of their practice. RESULT: Nurses' control over practice and adherence to practice documentation standards increased. Overall, the nurses perceived Careful Nursing-guided practice positively. Feasibility issues were identified and addressed. CONCLUSION: Exploratory evidence suggests that Careful Nursing could influence nurses' practice and overall perception of practice positively; its implementation is feasible. IMPLICATIONS FOR NURSING MANAGEMENT: Careful Nursing offers a distinctive nursing framework for professional practice. This study can provide a strategy for implementing Careful Nursing-guided changes in hospital-based practice on an exploratory level.

Spirituality and spiritual care from a Careful Nursing perspective.

AIM: To provide a brief historical background of spirituality in nursing and describe spiritual care from the perspective of the Careful Nursing philosophy and professional practice model. BACKGROUND: The previously overshadowed role of spirituality in modern nursing has re-emerged and been widely debated. Less attention has been given to how spiritual care is implemented in practice. EVALUATION: Findings from historical research. Elaboration of a previously derived Careful Nursing concept and dimensions as a model of spiritual nursing practice values. KEY ISSUES: In spite of the diversity of nurses' philosophical beliefs about spirituality, common ground can be found when these are translated into spiritual nursing practice values. Spiritual care in nursing is primarily expressed in the attitudes and actions of nursing practice guided by spiritual nursing values, particularly recognition of human dignity, kindness, compassion, calmness, tenderness, and nurses' caring for themselves and one another. CONCLUSIONS: Spirituality is timelessly interwoven with nursing and health. Careful Nursing suggests a spiritual values model that could be useful in assisting nurses to reach a shared understanding of spirituality and a spiritual approach to nursing practice. IMPLICATIONS FOR NURSING MANAGEMENT: Spiritual nursing values can be shared and developed in practical ways so that they become truly integrated into everyday nursing practice.

Merging time zones: promoting international communication through videoconferencing.

Nursing is viewed increasingly from an international perspective. Communication between nurses from different countries and cultures is becoming an important feature of nurses' education as well as their professional lives. While it is often not possible for nurse educators and students to visit their counterparts in other countries, it is possible for them to engage in personal contact and discussion through videoconferencing technology. An exploratory international videoconferencing case-study project, which was undertaken to enable educators to further their knowledge of videoconferencing as a teaching method, and enable students to meet in a videoconference class and discuss common issues in nursing education and practice with their counterparts in another country is presented. Two groups of registered nurse students, one undergraduate and one graduate, from the Department of Nursing, University of Scranton, Pennsylvania, USA and the School of Nursing and Midwifery, University College Dublin, Ireland were brought together for one class each. This article presents these case studies in the context of videoconferencing in higher education, describes the practical and pedagogical considerations in implementation and makes recommendations for further use of videoconferencing to foster communication and help students in different countries to develop greater international awareness of nursing practice and health care.

Careful nursing: a model for contemporary nursing practice.

BACKGROUND: Careful nursing, a system of nursing developed in Ireland by Catherine McAuley in the early years of the 19th century and used by Irish nurses at the Crimean war, has been described as Ireland's legacy to nursing. Although records of careful nursing have been preserved, it has received little attention in the nursing literature. AIM: The purpose of this study was to conduct a preliminary content analysis of the mainly primary source historical documentation of the careful nursing system and present it within the structure of a contemporary conceptual model of nursing. METHODS: The documents describing the careful nursing system were studied and re-studied to gain understanding of the philosophical assumptions underlying careful nursing and of the thinking, attitudes, actions and practice of the nurses. Content relating to the four central nursing concepts was identified and summarized. RESULTS: Careful nursing definitions of person, environment, health and nursing are presented. Ten key concepts of careful nursing practice are identified as disinterested love, contagious calmness, creation of a restorative environment, 'perfect' skill in fostering safety and comfort, nursing interventions, health education, participatory-authoritative management, trustworthy collaboration, power derived from service and nurses' care for themselves. The spiritual dimension of human life and the spiritual in nursing emerge as important characteristics of the model. CONCLUSIONS: The results of this preliminary analysis require further verification and critical examination. However, the careful nursing model illuminates important aspects of professional nursing and could be further developed to conceptualize and guide nursing practice.