Attributes of a good nurse.

BACKGROUND: The opinions of students regarding the attributes of a good nurse can make a major contribution to the planning and the conducting of professional education. There are few studies which aim at identifying the qualifications of a good nurse from the perspectives of nursing students. OBJECTIVES: To determine the opinions of first- and fourth-year nursing students concerning the 'attributes of a good nurse', and whether and how their views change depending on their year of study. RESEARCH DESIGN: Descriptive research. Participants and research context: This study was conducted in the nursing department of a vocational school of health in the 2010/2011 academic year. The study participants consisted of first-year and intern students. A survey form was used to identify characteristics of participants, and students were asked the following open-ended question about their opinions related to the attributes of a good nurse. Ethical considerations: The permission was taken from the school administration. Informed consent was obtained, and anonymity was ensured for participating students. FINDINGS: A total of 120 students participated in this study. Most frequently expressed attributes were 'professional competence' in first-year and 'responsibility' in fourth-year students. While first-year students placed a greater emphasis on the attributes of 'geniality', 'patience', 'calmness', 'love of nursing', 'loyalty to nursing' and 'not attaching importance to material values', fourth-year students emphasized the attributes of 'empathy', 'honesty', 'responsibility' and 'scientific curiosity' significantly more. DISCUSSION AND CONCLUSION: Fourth-year students placed a greater emphasis on the attributes which the students are expected to acquire through a nursing program and clinical experience. However, they mentioned the attributes related to a good nurse-patient relationship and communication significantly less. Appropriate ethical training methods and good role models can help students acquire attributes that are important for the nursing profession and combine them with the attributes they already have.

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool.

OBJECTIVE: To compare assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool. METHODS: This study was carried out at the psychiatry clinic of Kocaeli University Hospital from June 2007 to February 2008. The decision-making competence of the 83 patients who participated in the study was assessed by physicians, nurses, relatives and MacCAT-T. RESULTS: Of the 83 patients, the relatives of 73.8% of them, including the parents of 47.7%, were interviewed during the study. A moderately good consistency between the competency assessments of the nurses versus those of the physicians, but a poor consistency between the assessments of the physicians and nurses versus those of the patients' relatives, was determined. The differences in the competency assessment obtained with the MacCAT-T versus the evaluations of the physicians, nurses and patients' relatives were statistically significant. CONCLUSIONS: Our findings demonstrate those physicians, nurses and the patients' relatives have difficulty in identifying patients lacking decision-making competence. Therefore, an objective competence assessment tool should be used along with the assessments of physicians and nurses, both of whom can provide clinical data, as well as those of relatives, who can offer insights into the patient's moral values and expectations.

Preliminary Turkish study of psychiatric in-patients' competence to make treatment decisions.

INTRODUCTION: Competence is a prerequisite for informed consent. Patients who are found to be competent are entitled to accept or refuse the proposed treatment. In recent years, there has been an increased interest in studies examining competence for treatment in psychiatric patients. In this study, we aimed to investigate the decision-making competencies of inpatients with a range of psychiatric diseases. METHODS: This study was carried out at the psychiatry clinic of Kocaeli University Hospital in Turkey from June 2007 to February 2008. Decision-making competence was assessed in 83 patients using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T). RESULTS: The study groups consisted of patients with mood (39.8%), psychotic (27.7%) and anxiety disorders (18.1%), and alcohol/substance addiction (14.5%). There was a significant relation between decision-making competence and demographic and clinical characteristics. Appreciation of the given information was more impaired in psychotic disorder patients than in other patients, but understanding and reasoning of the given information was similar in all groups. DISCUSSION: These results reveal the importance of evaluating decision-making competencies of psychiatric patients before any treatment or intervention is carried out to ascertain their ability to give informed consent to treatment. Institutional and national policies need to be determined and put into practice relating to the assessment and management of competence in patients with psychiatric disorders.

Decisions of psychiatric nurses about duty to warn, compulsory hospitalization, and competence of patients.

Nurses who attend patients with psychiatric disorders often encounter ethical dilemmas and experience difficulties in making the right decision. The present study aimed to evaluate the decisions of psychiatric nurses regarding their duty to warn third parties about the dangerousness of the patient, the need for compulsory hospitalization, and the competence of patients. In total, 111 nurses working in the field of psychiatry in Turkey completed a questionnaire form consisting of 33 questions. The nurses generally assessed the decision-making competency of the patient correctly. However, their decisions regarding whether the patient should be compulsorily hospitalized and their understanding of their duty to warn/protect were less consistent. A significant relationship was found between the decisions of the psychiatric nurses and their work experience, them having children, and them having postgraduate education in psychiatric nursing. The nurses stated their desire to be part of the team that decided on ethical problems in psychiatry.

Celalettin Muhtar Ozden (1865-1947): his life, works and contributions to the study of dermatophytes.

BACKGROUND: Most of the distinctive studies concerning dermatophyte infections were carried out at the end of the 19(th) century. One of the contributors of these studies was the Turkish dermatologist Dr. Celalettin Muhtar Ozden. The aim of this study was to introduce his life, works, and contributions to dermatology. METHODS: Dr. Ozden's original works and published memories about him were evaluated. RESULTS: After graduating from the Military Medical School he was sent to Paris to carry out his studies on skin and syphilitic diseases in 1889 by the School. During his practice in Dr. A. Fournier's dermatological clinic at St. Louis Hospital (1889-1892), he diagnosed cases of trichophytosis that affects hands and feet. He published his findings collectively, in which, he presented information regarding the distinctive diagnosis and treatment of the disease, through a series of 25 cases, 18 of which were observed by himself in 1892. After returning to his homeland, Dr. Ozden trained many medical students through the last years of the Ottoman Empire to the first years of the Republic of Turkey. CONCLUSION: His publication dated 1892 is characterized by being the first detailed work on dermatophyte infections affecting hands and feet. Today, he is well known by dermatologists in Turkey and his name has been immortalized through the term, the 'Celal Muhtar's disease.' It is important that this famous Turkish physician should keep his rightful place in the medical history of the world as well.

Attributes of a good physician: what are the opinions of first-year medical students?

BACKGROUND: Undergraduate medical education is beginning to concern itself with educating students about professional attributes as well as about clinical knowledge and skills. Defining these characteristics, and in particular seeking the help of the students themselves to define them, can be a useful starting point when considering how to incorporate aspects of professional behaviour into the medical curricula. METHOD: This study explores the views of first-year medical students at Kocaeli University Faculty of Medicine in the 2007-8 academic year. The students were asked the open-ended question: 'What, in your opinion, are the attributes a good physician should have?' Four topics were defined by researchers based on the undergraduate and graduate education projects. The attributes expressed by the students were evaluated by the researchers according to these topics and compared with the topics covered in the undergraduate and graduate education projects. RESULTS: A total of 127 students responded, and between them suggested 756 attributes. The majority of these attributes (54.6%) were concerned with interpersonal relations and communication, whereas the category representing the fewest attributes (12.3%) was that involving scientific knowledge and medical practice. In general, students' perception corresponded to the concept of the 'competent physician' as described in the professionalism projects, but attributes reflecting their world-view were also expressed. CONCLUSION: Experience suggests that the active participation of students in determining which attributes are necessary for a good physician is a positive way of ensuring they embrace the importance of such qualities and attributes in themselves.

A descriptive study of medical malpractice cases in Turkey.

BACKGROUND: Medical malpractice claims in Turkey have increased. We evaluated the problem by describing medical malpractice cases assessed by the Higher Health Council between 1993 and 1998. Our recommendations should help to improve care and decrease medical malpractice claims. METHODS: We reviewed 997 medical malpractice cases reported to the Higher Health Council between 1993 and 1998 and examined the decisions made by the Higher Health Council. We collected data on demographic characteristics, such as the type of the institution where the defendants worked, type of medical malpractice, and medical outcome. RESULTS: There were 997 medical malpractice cases reported to the Higher Health Council in the six years between 1993 and 1998. The Higher Health Council decided that 47.7% of the physicians were liable. Malpractice cases were mostly seen in state hospitals (42.4%). Fifty-nine percent of the cases resulted in death. Among actions that led to malpractice lawsuits against all health care workers, including physicians, the most common were negligence, inappropriate treatment, and diagnostic failure. CONCLUSION: We think it is necessary to revise the health system and working conditions in hospitals and to develop clinical practice guidelines. We are of the opinion that an emphasis on the use of diagnosis and therapy protocols, standards, post-graduation education, clear and informed patient consent, and improved communication with patients will drastically decrease medical malpractice claims.