http://science.sciencemag.org/content/sci/201/4359/899.2.full.pdf

Phenomenology of perception.

Health professionals for a new century: transforming education to strengthen health systems in an interdependent world

Risky families are characterized by conflict and aggression and by relationships that are cold, unsupportive, and neglectful. These family characteristics create vulnerabilities and/or interact with genetically based vulnerabilities in offspring that produce disruptions in psychosocial functioning (specifically emotion processing and social competence), disruptions in stress-responsive biological regulatory systems, including sympathetic-adrenomedullary and hypothalamic-pituitary-adrenocortical functioning, and poor health behaviors, especially substance abuse. This integrated biobehavioral profile leads to consequent accumulating risk for mental health disorders, major chronic diseases, and early mortality. We conclude that childhood family environments represent vital links for understanding mental and physical health across the life span.

/pdf/risky-families-family-social-environments-and-the-mental-and-2ydtsobufc.pdf

Risky Families: Family Social Environments and the Mental and Physical Health of Offspring

Committee for assessing progress on implementing the recommendations of the institute of medicine report the future of nursing: leading change, advancing health

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62631-8.pdf

Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

The Carnegie Foundation for the Advancement of Teaching joins a chorus of calls for transformation of prelicensure nursing education (Benner, Sutphen, Leonard, & Day, 2009). Citing the shift of significant responsibility to nurses for managing complex medical regimens, as well as the increasing complexity of community-based practices, Benner and colleagues concluded that nurses entering the field are not equipped with the essential knowledge and skills for today's practice nor prepared to continue learning for tomorrow's nursing (p. 31). They found: a) weak curricula in natural sciences, technology, social sciences, and humanities, and in developing cultural competency; b) weak classroom instruction and limited integration between classroom and clinical experiences; c) limited strategies in helping students develop habits of inquiry, raising clinical questions, seeking evidence for practices; d) faculty and student perception that students are ill prepared for their first job and dissatisfaction with the teaching preparation of current nursing faculty; and e) multiple pathways to eligibility for the licensure examination, with tremendous variability in prerequisites, curricular requirements, and the quality of offerings.

TRANSFORMING PRELICENSURE NURSING EDUCATION: Preparing the New Nurse to Meet Emerging Health Care Needs

This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.

Thinking like a nurse: a research-based model of clinical judgment in nursing.

This book examines the nature of clinical knowledge and judgment. The authors present a report of a six-year study of over 1,300 hospital nurses, primarily in critical care. The contributors document and analyze their clinical narratives for stages of clinical skill acquisition and the components of expert practice. Ultimately, this work examines the meaning of expertise in nursing practice through the nurse's use of scientific knowledge, professional experience, and careful attention to each patient's changing condition.

Expertise in Nursing Practice: Caring, Clinical Judgment and Ethics

Clinical judgment: how expert nurses use intuition.

Background Although hermeneutical interpretive phenomenological methodology has been used in many nursing research studies, reports of findings are generally not specific regarding the analysis, or "interpretive process," of this methodology. Approach The purpose of this article is to assist researchers in analyzing interviews and observations, as part of hermeneutical interpretive phenomenology. In this article the interpretive process is explained, illustrated by examples from a recent research study. Results Other facets of the methodology including research question development, sampling issues, and interview and observation methods are briefly reviewed. Discussion Approaching the interpretive process as systematically as possible within a nonlinear methodology streamlines and clarifies interpretations of the interview data.

Christine A Tanner

Papers

TRANSFORMING PRELICENSURE NURSING EDUCATION: Preparing the New Nurse to Meet Emerging Health Care Needs

Thinking like a nurse: a research-based model of clinical judgment in nursing.

Expertise in Nursing Practice: Caring, Clinical Judgment and Ethics

Clinical judgment: how expert nurses use intuition.

Interpretation/analysis methods in hermeneutic interpretive phenomenology.