Nursing prioritization of the patient need for care: A tacit knowledge embedded in the clinical decision-making literatureEvery day in clinical settings, nurses practise in complex and dynamic situations. Nurses work to achieve emergent order in these situations through nursing prioritization of the patient need for care. As direct research on nursing prioritization had not been reported, a study, using critical realism as method, was designed to discern the profession's embedded understanding from within the clinical decision-making literature. The research synthesizes a tacit knowledge on nursing prioritization of the patient need for care from key international literature (from 1966 to 2003). Nursing prioritization was discerned in both education and practice literatures; interrelationships between these and theoretical approaches were also identified. Nursing prioritization of the patient need for care was revealed both as a non-sequential decision-making process throughout unfolding patient situations and as an advanced skill of nursing practice. Increasing confidence with this skill is the hallmark of developing expertise.

Like the general population, nurses become patients within the health care services available to them. They write anecdotal accounts of their experience and research the experience of their colleagues. This paper reports a small descriptive study of how the positions of senior nurses who experienced a life threatening condition influenced their illness trajectories. Eleven nurses in both New Zealand and Australia told stories of their experiences which focussed on intercessions/intervention by themselves, their family and the health care team. Themes identified were: looking after our own, the gaze of family and friends in advocacy and intercession, stereotypes of nurses as patients, senior nurses as vulnerable patients - existential healing through the small things, and senior nurses as knowledgeable people. Within these themes were narratives of special and meagre care. The authors conclude that all senior nurses should receive care that is regardful of who they are as senior nurses and vulnerable patients.

English Internationally the greater regulation of social work is intended to raise standards and enhance the standing of the profession. Regulatory systems must also be aligned to the demands of an increasingly global workforce. The achievement of limited registration in New Zealand creates challenges and opportunities for the profession. French Une plus grande réglementation du travail social sur la scène internationale vise à hausser les normes et à améliorer la profession. Les systèmes de régulation devraient tenir compte des particularités d’une main-d’oeuvre de plus en plus globalisée. La réalisation d’une inscription limitée en Nouvelle-Zélande crée des défis et des possibilités pour la profession. Spanish Internacionalmente la regularización del trabajo social tiene como objetivo elevar los estándares y mejorar el estatus de la profesión. Los sistemas regulatorios deben tener en cuenta las demandas de un mercado laboral cada vez más globalizado. El registro limitado de Nueva Zelanda crea retos y también oportunidades para la profesión.

BackgroundThis paper describes a rapid assessment of Cambodia’s current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services.A health system approach for strengthening health professions’ regulation is underway and aims to support the Government of Cambodia’s plans for scaling up its health workforce, improving health services’ safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services.MethodsThe assessment used a mixed methods approach including:A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy);Key informant interviews with stakeholders in Cambodia (The term “stakeholders” refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level);Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation;Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; andA rapid literature review to identify:The key functions of health professional regulation;The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and“Smart” health profession regulation practices of possible relevance to Cambodia.ResultsWe found that the current regulatory system only partially meets Cambodia’s needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia’s specific needs in mind. The existing system is also overly complex, with considerable duplication and overlap between governance and regulatory arrangements for the five regulated professions.ConclusionsThere is considerable scope for reform to the current regulatory system to better align the system to Cambodia’s:Current needs and circumstances;Health system strategic priorities; andInternational obligations.Cambodia is also well placed to base its reformed regulatory system on recent developments of “smart regulatory practices” for health professionals.

With the increasing emphasis on the development of nursing, evidence based practice, practice development and new and extended nursing roles, nurses are faced with the challenge of developing effective evaluation practices in an increasingly complex health care environment. This complexity has seen a number of evaluation methodologies and methods used in health care and nurses in clinical settings may find it difficult to know what approach or approaches best apply to their context. Given that evaluation of nursing innovations and interventions can have political, practical and fiscal consequences it is important that nurses have a broad understanding of evaluation, why it is important, the various types of evaluation methods and methodologies as well as some way of working through this complexity in order to develop evaluation plans and practices that best meet their needs. This paper explores a number of common types of evaluation methodologies and aims to assist nurses to better understand the 'why' and the 'how' of evaluation. In addition the paper describes the development of an evaluation tool which aims to assist nurses to develop effective evaluation plans that will best meet their evaluation needs.