The impact of the re‐engineered world of health‐care in Canada on nursing and patient outcomes

Shannon, Valerie; French, Susan

doi:10.1111/j.1440-1800.2005.00272.x

Cited by 32 publications

(44 citation statements)

References 16 publications

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“…Ritzer (2004) coined this term, using the fast-food company McDonald's to represent the corporate push toward extreme efficiency, calculability, predictability, and control. It involves contracting out of services, the de-professionalizing of care, downsizing through bed closures and withdrawal of funding from community agencies, layoffs, and standardizing practice (also known as ''decreasing variation in the system flow'' (Shannon and French 2005)). Much time and effort goes into measurement and quantified evidence of outcomes.…”

Section: The Inherent Challenge Of Caring Workmentioning

confidence: 99%

Moral Distress and the Contemporary Plight of Health Professionals

Austin

2012

HEC Forum

116

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Once a term used primarily by moral philosophers, "moral distress" is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? "Plight" encompasses not only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of "efficiency," is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals' moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim.

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Section: The Inherent Challenge Of Caring Workmentioning

confidence: 99%

Moral Distress and the Contemporary Plight of Health Professionals

Austin

2012

HEC Forum

116

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“…L'excès de responsabilités, à ce moment-là, était surtout relié à la documentation des soins prodigués (Corey-Lisle, Tarzian, Cohen et Trinkoff, 1999;Rhéaume et al, 2007) et à des tâches sans rapport avec les responsabilités professionnelles de l'infirmière. Par exemple, elles devaient veiller au transport des patients à différentes épreuves diagnostiques, répondre au téléphone et distribuer des cabarets de repas (Aiken et al, 2001;Shannon et French, 2005).…”

Section: Discussionunclassified

“…Quoique aucune étude canadienne n'a exploré le concept de conflit de rôle parmi les infirmières dans un contexte de réorganisation des soins, les écrits suggèrent que les infirmières vivent un conflit de rôle suite à l'ajout de responsabilités et suite aux coupures dans plusieurs services de soutien (Aiken et al, 2001;Baumann et al, 2001;Keddy, Gregor, Foster et Denney, 1999;Rhéaume et al, 2007;Shannon et French, 2005). Plusieurs facteurs ont contribué au conflit de rôle, soit l'augmentation de la charge de travail en général, l'augmentation du nombre de patients assignés aux infirmières ainsi que plusieurs tâches sans rapport avec le travail d'une infirmière, telles que des tâches ménagères et secrétariales (Barter et al, 1997;Blythe et al, 2001;Dunleavy et al, 2003;Ingersoll, 1995;McLaughlin et al, 2000;Rhéaume et al, 2007).…”

Section: Problématiqueunclassified

L’ambiguïté et le conflit de rôle chez les infirmières* dans le contexte des réformes de la santé au Nouveau-Brunswick

Dionne

Rhéaume

2010

rum

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Résumé La province du Nouveau-Brunswick restructure actuellement son système de santé. Un des objectifs de la réorganisation des soins est l’optimisation du rôle des intervenants, et plus précisément, l’élargissement du champ de pratique des infirmières et des infirmières auxiliaires. Le but de la présente étude qualitative est d’explorer l’expérience des infirmières en ce qui concerne les concepts d’ambiguïté et de conflit de rôle dans le contexte des réformes de la santé. Le cadre conceptuel choisi est la théorie des rôles. Les données ont été recueillies auprès de dix infirmières par entrevues semi-structurées. L’analyse du contenu des entrevues montre que les infirmières vivent de l’ambiguïté dans leur rôle, particulièrement en ce qui concerne le transfert des tâches, le modèle de prestation des soins et le manque de connaissance des rôles de chacun. Le conflit de rôle, d’autre part, découle de l’excès de responsabilités engendré par les soins de base, la gestion des soins et le travail d’équipe avec les infirmières auxiliaires.

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“…Since the 1990s, this workplace has undergone continuous restructuring in on-going attempts to meet societal demands related to demographic changes, economics, technologies, and social-cultural issues (Shannon & French, 2005). In this dynamic context, knowledgeable healthcare professionals must continually update their knowledge and skills for maintaining competency and to ensure the provision of quality patient care (Schweitzer & Krassa, 2010).…”

Section: The Canadian Healthcare Workplacementioning

confidence: 99%

Examining Informal Learning using Mobile Devices in the Healthcare Workplace / Examen de l’apprentissage informel par l’utilisation d’appareils mobiles dans le milieu des soins de santé

Fahlman

2013

CJLT / RCAT

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The study of workplace learning and informal learning are not new to adult education and pedagogy. However, the use of mobile devices as learning tools for informal learning in the workplace is an understudied area. Using theories on informal learning and constructivism as a framework, this paper explores informal learning of registered nurses using mobile devices to meet their learning needs for continuing professional education, professional development, and continuing competence within the challenging healthcare workplace. In this mixed methods study, participants used their devices for self-directed informal learning with non-collaborative strategies/processes for evidence-based support, new procedures/treatments, professional development, patient/client teaching, and maintaining competency. Positive perceptions were articulated. Minimal differences were associated to the nurses' age. However, workplace-related influences were relevant to the informal learning experiences with the mobile devices.

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The impact of the re‐engineered world of health‐care in Canada on nursing and patient outcomes

Cited by 32 publications

References 16 publications

Moral Distress and the Contemporary Plight of Health Professionals

Moral Distress and the Contemporary Plight of Health Professionals

L’ambiguïté et le conflit de rôle chez les infirmières* dans le contexte des réformes de la santé au Nouveau-Brunswick

Examining Informal Learning using Mobile Devices in the Healthcare Workplace / Examen de l’apprentissage informel par l’utilisation d’appareils mobiles dans le milieu des soins de santé

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