Professional nurse autonomy, an essential attribute of a discipline striving for full professional status, is often confused with personal autonomy, work autonomy or aggregate professional autonomy. Using Walker & Avant's (1995) model for concept analysis, this paper presents an analysis of professional nurse autonomy. Professional nurse autonomy is defined as belief in the centrality of the client when making responsible discretionary decisions, both independently and interdependently, that reflect advocacy for the client. Critical attributes include caring, affiliative relationships with clients, responsible discretionary decision making, collegial interdependence, and proactive advocacy for clients. Antecedents include educational and personal qualities that promote professional nurse autonomy. Accountability is the primary consequence of professional nurse autonomy. Associated feelings of empowerment link work autonomy and professional autonomy and lead to job satisfaction, commitment to the profession, and the professionalization of nursing. A student-centred, process-orientated curricular design provides an environment for learning professional nurse autonomy. To support the development of professional nurse autonomy, the curriculum must emphasize knowledge development, understanding, and clinical decision making.
Preceptored community experiences present challenges different from those of preceptored experiences in the acute care setting. Instead of focusing on psychomotor skills, faculty must address population-based skills and assess students' abilities to practice these skills. Faculty and preceptors' lack of knowledge to teach these skills further complicate the experiences, an issue indirectly related to faculty and nursing shortages. Although preceptors guide students, faculty are responsible for evaluating students in community preceptored experiences. The Association of Community Health Nursing Educators (ACHNE) Essentials of Baccalaureate Education (Essentials) offers opportunities for guiding and evaluating community health preceptored clinical experiences. Assignments and activities that reflect the ACHNE Essentials provide a firm foundation for the population focus of the course. This focus is validated through faculty visits to students in a variety of community settings. To plan successful community experiences and evaluate students, faculty must be knowledgeable about the population focus of community courses, apply this knowledge to students in a variety of settings, and ask challenging questions to assess student learning.
<h4>ABSTRACT</h4> <P>This study describes the development and testing of an instrument to measure nursing students' perceptions of instructor caring. Originally, 69 statements about instructors' caring behaviors, based on Watson's 10 carative factors, were created with Dr. Jean Watson. The Nursing Students' Perceptions of Instructor Caring (NSPIC) instrument uses a 6-point Likert scale for students' responses to the statements. After pretesting the instrument with a small group of nursing students, the NSPIC was tested with 133 baccalaureate nursing students. Based on item analysis, factor analysis, and student comments, the number of statements were reduced to 31. Psychometric testing revealed that the NSPIC is internally consistent (<img src="http://www.journalofnursingeducation.com/images/content/alpha.gif"> = 0.97) and contains five subscales. Convergent validity was established between the NSPIC and a semantic differential scale of students' perceptions of instructor caring. Predictive validity was assessed with Coates Caring Efficacy Scale. Although the NSPIC is in its early stages of development, its psychometric properties indicate that it is a valid and reliable measure of nursing students' perceptions of instructor caring. </P> <h4>AUTHORS</h4> <p>Received: February 10, 2002</p> <p>Accepted: July 1, 2004</p> <p>Dr. Wade is Associate Professor, University of Delaware, College of Health Sciences, School of Nursing, Newark, and Ms. Kasper is a Pediatric Nurse Practitioner, Alfred I. DuPont Hospital for Children, Wilmington, Delaware.</p> <p>The authors acknowledge funding from the General University Research Program (GUR) of the University of Delaware.</p> <p>Address correspondence to Gail Holland Wade, DNSc, RN, Associate Professor, University of Delaware, College of Health Sciences, School of Nursing, McDowell Hall, Newark, DE 19716; e-mail: <a href= "mailto:ghwade@udel.edu">ghwade@udel.edu</a>.</p>
Preconception healthcare is a way to enhance positive pregnancy outcomes by encouraging women to engage in healthy lifestyles before they become pregnant. Because approximately 50% of pregnancies are unplanned, fetal development may be affected before a woman receives prenatal care. Young women are especially vulnerable to poor outcomes due to risky behaviors. Education about preconception health is not common practice. This article describes a peer education preconception health program for college women that provided a basis for an expanded program with larger, more diverse populations. Nursing students as peer educators presented the program to over 100 young women using the mnemonic REFRAMED PLUS to address eight preconception risk areas and reproductive life planning. Materials to augment the program, developed by peer educators, included a brochure on preconception health, a risk assessment tool, a DVD with stories of young women who experienced unplanned pregnancies, and a Reproductive Life Plan book. Peer educators administered a pretest, showed the DVD, guided discussions, assessed each woman's health risks and administered a posttest. The risk assessment revealed that young women have several preconception health risks. Following the preconception program, posttest scores indicated increased knowledge of preconception health. For preconception healthcare to be successful, preconception risk assessments, education and counseling must be addressed by nurses every time a young woman receives care. When possible, peer educators should be used to disseminate the message to all women of childbearing age.
Quantitative measures did not identify a majority of the variables associated with job enjoyment. Research using a qualitative and quantitative methodology with different practice samples may reveal other variables that influence job enjoyment.
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