Too familiar for words: considering unaccounted-for aspects of nurse's work.

When things are too close to us, we have trouble seeing them clearly. Such may be the case with aspects of nursing work that are too familiar for words. The article reports a small case study from a qualitative study asking nurses to discuss work that no one else sees. Nurses use words such as facilitating, making it happen, filling in gaps, and putting the self in the situation to describe this work. With further study, these descriptions may offer insight into how nurses intervene to personalize the patient's experience with the health care system.

Dimensions of the staff nurse role in ambulatory care: Part II--Comparison of role dimensions in four ambulatory settings.

Ambulatory care nursing is one of the fastest growing and least studied areas of nursing practice. Information from a national survey of ambulatory nurses has been used to delineate the core dimensions of the current staff nurse role. Comparison of practice patterns of ambulatory staff nurses employed in university hospitals, community hospitals, physician group practices, and health maintenance organizations can provide insights for nurse managers interested in improving ambulatory nursing care delivery. Part III of this series, which will be published in the July/August 1995 issue, will examine how to use research data to design new models of nursing care delivery.

Dimensions of the staff nurse role in ambulatory care: Part I--Methodology and analysis of data on current staff nurse practice.

Defining the core dimensions of the current staff nurse role is a critical first step in demonstrating the worth of professional nurses in ambulatory settings. Data generated by a 1992 national survey of 606 ambulatory staff nurses provides insight into current practice. Managers may use this information to attract and retain staff nurses, remove barriers to clinical practice, and modify practice patterns to improve the quality of care in ambulatory settings. Part II of this series, which will be published in the May/June 1995 issue, will examine the scope and dimensions of the staff nurse role in different practice settings.

Computerized documentation systems: blessings or curse?

This article considers the possibility that computerized documentation systems will negatively impact knowledge development in nursing. Ideas from three vantage points is presented. First, systems are being developed from theoretical frameworks that are not necessarily grounded in nursing, and these systems, in turn, influence the nurses's ability to process and conceptualize information. Second, computer systems may support the retrieval of empirical data to the elimination of other types of data necessary to the development of nursing knowledge. Third, computers may decrease opportunities for collegial dialogue. These factors together create an atmosphere of "technologic determinism" (Robinson & Robinson, 1990), which can inhibit the development of new ideas in nursing.