It is anticipated that findings from the present study may increase understandings of nurse views of communication within healthcare settings. The study highlights the importance of nurse managers in creating the communication culture that will allow nurses to speak up and be heard. These open communication cultures lead to better patient care, increased safety and better staff satisfaction.

This qualitative study describes the staff nurses' perspective of change in the care delivery model and skill mix in an intermediate care unit. Data were collected in interviews in focus groups with the registered nurses affected by the change. Two major themes emerged: (1) autonomy and control and (2) interdependence. The nurses emphasized an increased satisfaction (self and patient) with this model. This study confirmed that autonomy, control, connection with the patient, and peer and interdisciplinary support and respect are important for the staff nurse. These findings reinforced the value of involving the staff members in change and the importance of giving voice to their perspective through qualitative research.

Information from this study can help to develop creative ways to draw diverse nurses into leadership roles.

This article describes the challenges facing internationally educated nurses working in the United States, combining an extensive literature review with the personal perspectives of a registered nurse from Kenya. An extensive literature search was conducted, and databases were collected and reviewed, while the nurse was participating in an internship at a hospital in a border city in California. Intertwining the personal experiences of the first author with an extensive literature review, the areas of communication, culture shock, nursing roles, and practice and orientation needs are covered. This article reinforces the difficulties faced by internationally educated nurses and makes suggestions for helping them make the adjustment to the US workforce.

The nurses interviewed described situations in their work lives, where they felt that they performed an act of resistance because of unfair treatment, abuse of power, or ethical concerns. It often took courage to do so, but the acts had mainly positive effects on them and their institutions. It is theorized that resistance may actually be positive for both the staff nurse and the organization.

The purpose of the research project was to determine the impact of palliative care education and the writing of a reflective narrative on nurses' self-awareness of their attitudes toward death and care of the dying. Findings support integration of narrative reflection into palliative care education as an effective teaching strategy.Only qualitative findings of a larger study are presented; quantitative results have been published in the Journal of Hospice & Palliative Nursing (Home care and hospice nurses' attitudes toward death and caring for the dying: effects of palliative care education. 2005;7[4], 212-218).

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