Decision-based learning for teaching arterial blood gas analysis.

OBJECTIVES: This case study explored implementation of a Decision-Based Learning (DBL) tool for teaching arterial blood gas (ABG) analysis to nursing students. METHODS: For this mixed-methods study, ABG problems in a DBL model were solved by nursing students. Students answered a survey about their experience with DBL. Quantitative survey results are reported with descriptive statistics. Open-ended questions and instructor and student interview data were qualitatively analyzed. RESULTS: Students had a positive experience with DBL and gained self-efficacy regarding ABG analysis. The tool was engaging, simple to use, and not overly time-consuming. CONCLUSIONS: DBL can be a useful tool for teaching ABG analysis to nursing students. Implications for an international audience nursing students everywhere benefit from understanding ABG analysis. DBL is a promising tool that can be used in any location with digital resources.

The nurse apprentice and fundamental bedside care: An historical perspective.

This historical study aims to explain how the transition from student nurse service to fully qualified "graduate nurse" service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found that the replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement.

Crisis at Guy's Hospital (1880) and the nature of nursing work.

This historical study aims to refine understanding of the nature of nursing work. The study focuses on the 1880 crisis at Guy's Hospital in London to examine the nature and meaning of nursing work, particularly the concept of nursing work as many 'little things.' In this paper, an examination of Margaret Lonsdale's writing offers an original contribution to our understanding of the ways in which nursing work differs from medical practice. In this way, we use the late-nineteenth-century controversy at Guy's Hospital as a prism through which to examine the contested nature of nursing work. Lonsdale's ideas are corroborated by examination of writings by nurse leaders Florence Nightingale and Eva Luckes. Luckes, in particular, elaborated what was meant by nursing as the performance of a thousand little things, which are specific to nursing work. While physicians had been performing much of what was considered to be nursing work, nurses developed some of these and other interventions into a unique body of work characterized by meticulous attention to significant details. Some implications regarding current nursing practice are discussed.