Sharing Nurses' Voices in Challenging Times.

It is easy to get lost in a sea of negativity about everything that is going wrong with healthcare and nursing today. Nurses' Voices (https://nursesvoices.ca/) was launched to amplify the voices of Canadian nurses in challenging times. We listened to amazing stories of nurses making a difference in our healthcare system despite the difficult situations they faced. Our guests talked about their experiences, their aspirations, their challenges, what brings them joy in tough situations and their determination to deliver the best care possible to Canadians despite everything. Talking with these nurses reaffirmed for us that if we want to grow and thrive as a profession in an ever-changing healthcare system, where the new normal is uncertainty, then we need to listen and learn from each other. This is what we heard, and this is what we learned.

What If? Reimagining Structural Change for the Nursing Workforce of the Future.

The past two years have demonstrated that we are not in a "new normal" but in something "new altogether." As a result, incremental change will not be enough to support the nursing workforce now or in years to come. This commentary summarizes a series of cross-generational conversations about the structural change needed to enable nurses to learn, work and lead in the health system of the future. We examine a series of questions (What ifs?) intended to challenge what transformational structural change could look like and call on the Canadian nursing community to collectively lead reform within the profession.

The Unexpected Journey of Caring: The Transformation from Loved One to Caregiver.

When I learned this book was about to be published, I knew I would want to read it for three reasons: First, I worked with Donna Thomson on Bringing Care Home, a report I chaired for the then Ontario Minister of Health and Long-Term Care Eric Hoskins on homecare in Ontario, and knew Donna to be a dedicated, experienced caregiver and a fierce advocate for caregiving and homecare; second, I am passionately committed to ensuring that the role and importance of caregivers in our healthcare system is valued and supported; and third, I saw that Judy Woodruff had written the foreword. I am a big fan of Woodruff, who is the managing editor of PBS Newshour, a program of which I am a very loyal listener. I had no idea that Woodruff was a caregiver herself and that speaks volumes about the "hidden army," as Woodruff calls them, of caregivers who provide the largest share of care (estimated to be in the area of 70% in Canada) to their families, friends and neighbours. The authors have written this book to help caregivers find meaning in their caregiving experience and to provide them with tools to manage the transition and advocate for their loved ones.

Nursing Leadership in Home and Community Care: An Introduction.

There is agreement across all provinces that there is transformation needed in the area of home and community care. Yet, where is the collective voice of nurse leaders in this transformation? The guest editor calls on nurses to respond to this unique opportunity to shape the transformation of our health system, and improve care for patients and their caregivers.

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.

The efforts of critical care nurses to pass along knowledge about patients.

The purpose of this descriptive, interpretive study was to explore and describe the work of critical care nurses in sharing and discussing their knowledge about patients with other members of the health-care team. Three questions were examined: Which aspects of their understanding of patients do nurses pass along? How is knowledge passed along? To what ends is knowledge passed along? Data collection took place in 2 intensive care units in a tertiary care hospital and involved observation of 10 nurses followed by interviews. Nurses "filled out the picture" for others by passing along knowledge about the patient's status, patient responses over time, interventions that had been beneficial, and the patient as a person. This aspect of nurses' work was facilitated by proximity to both patients and other team members and the inclusion of nurses in multidisciplinary rounds. The results have implications for staffing patterns, the layout of hospital units, the structure of rounds, and nursing education.