Personal control during childbirth was an important factor related to the women's satisfaction with the childbirth experience. Helping women to increase their personal control during labour and birth may increase the women's childbirth satisfaction.
The purpose of this phenomenological study was to understand military nurses' experiences of care for Iraqi patients. Analysis yielded three themes-expanding practice, ethical dilemmas, and the cultural divide. "Expanding practice" is the nurses' descriptions of their personal initiative to seek opportunities for learning additional knowledge and skills so that they would be competent to provide care for all ages of patients from newborns to the elderly with a wide variety of complex diagnoses. "Ethical dilemmas" represented the mental distress the nurses experienced when confronted with moral imperatives related to the safe care of the patient. Nurses were faced with feelings of animosity toward provision of care of host nation patients, lack of trust in interpreters, and distressed because of their inability to ensure continuity of care. The "cultural divide" showed the challenges that the nurses confronted when caring for a population with a different language, value system, customs, and traditions. The themes support existing research and extend information about care of host nation patients adding depth and breadth to specific content areas. These nurses developed situated knowledge needed for particular challenges and experienced personal and professional growth.
Care must be taken in the interpretation of these findings because it was generally not the same nurses who answered both surveys. High staff turnover within this military hospital also affected sustainment of the protocol implementation. Maintenance activities must be constant and visible within the organization. A champion for evidence-based practice greatly enhances uptake and maintenance of nursing practice change.
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