Shalamar Nursing College

Background: Effective communication between nurses and patients is essential for building trust, understanding patient needs, and promoting active participation in healthcare decisions. However, interpersonal and social factors may create barriers to effective communication and shared decision-making. Objective: To explore the interpersonal and social factors affecting nurse–patient communication and shared decision-making among patients and nurses. Methods: A descriptive, exploratory qualitative design was used. An open-ended, self-structured questionnaire was administered to ten purposively sampled participants (nurses and patients) at Mayo Hospital, Lahore, over a four-month period. Data were analysed thematically, with responses coded and grouped into recurring themes. Results: Communication barriers (30%), patient misunderstandings (25%), and inadequate communication training (20%) were the main concerns. Time constraints and stress/burnout (25% each) also affected communication, while active listening and empathy (25%) were key to patients feeling heard. Conclusion: Interpersonal and social barriers can limit effective communication and shared decision-making. Clear communication, active listening, empathy, and improved nurse training may enhance patient participation in care decisions.

Background:Venous puncture is a routinely performed invasive procedure within the pediatric health context and is likely to cause pain, fear and anxiety. If procedures such as venous puncture are performed without adequately managing pain, this may result in the development of needle phobia, raising stress levels or cause an avoidance of seeking medical health later in life. Ice application or cryotherapy is a simple non-pharmacological technique that has gained recognition as a method of reducing procedural pain in children. Objective:The objective of this study was to assess the effectiveness of pre-procedural ice application in reducing pain during venous puncture in children. Methods:A randomized controlled trial was conducted over a period of four months. This trial was carried out at two hospitals in Punjab, Pakistan. Ninety-four children aged 5 to 7 years were randomly assigned to two groups. 47 children were assigned to the intervention group (ice application group) while other 47 children were assigned to the control group (standard care). The intervention group received ice application at the venous puncture site for three minutes before the procedure. While the control group underwent venous puncture without ice application. Pain intensity was assessed using the Wong-Baker Faces Pain Rating Scale (WBFPS). Pain was assessed both subjectively, by self-reported pain scores from children, and objectively, by observer-based evaluations of video recordings. Data were analyzed using SPSS version 24. Independent t-test and chi-square was applied to the data. A p-value < .05 was interpreted as statistically significant. Results:Pain scores as self-reported by the children showed that the intervention group (ice application) experienced significantly lower score for pain compared to the control group (1.31 ± 1.31 vs. 8.29 ± 1.31; p < 0.01). The pain scores as recorded by the observer also showed a significant reduction in pain intensity in the intervention group (1.57 ± 1.12) when compared to that of the control group (8.59 ± 1.37; p < 0.01). No statistical differences were observed between the two groups in terms of their age, gender, or previous venous puncture experience. Conclusion:In children, venous puncture pain can be reduced by pre-procedural ice application, which is an effective, safe, and low-cost intervention. The findings indicate that cryotherapy can be integrated into routine pediatric clinical practice to enhance procedural comfort and patient experience.

Background: Moral sensitivity is a foundational element of ethical decision-making in nursing practice. Understanding how it varies among students across different institutional contexts can inform targeted educational strategies and ethical training. Objective: To assess impact of Institutional Social Environment on Moral Development and Social Responsibility among Nursing Students. Methods: A cross-sectional comparative study was conducted among nursing students from both public and private institutions. Data were collected using a structured questionnaire measuring moral sensitivity. Demographic variables including age, gender, academic year, and institutional affiliation were analyzed to determine their association with moral sensitivity levels. Results: The majority of participants were female (90.5%), aged between 19 and 23 years (86.4%), and in their final year of study (57.4%). Overall, students exhibited a moderate level of moral sensitivity. Higher moral sensitivity was observed among students from private institutions, those in older age groups, females, and final-year students. Statistically significant associations were found between moral sensitivity and age, gender, academic level, and institutional type. Conclusion: Moral sensitivity among nursing students is influenced by both demographic and institutional factors. Students from private institutions and those with greater academic and life experience demonstrated higher ethical awareness. These findings highlight the need for enhanced, tailored ethical education particularly for younger, male, and early-year students to ensure the development of competent, morally sensitive nursing professionals.

OBJECTIVE:To identify common pitfalls of workplace violence (WPV) prevention programs, as well as platforms for effective WPV prevention and management. This discussion paper elaborates on these pitfalls and platforms, sharing ideas on how to maintain safety and provide support for both colleagues and patients. METHODS:The American Psychiatric Nurses Association (APNA) Council for Safe Environment (CSE) members met monthly to discuss WPV prevention, guided by evidence-based information, clinical expertise, and scholarly work. Concepts around WPV prevention were organized into common pitfalls in WPV prevention programs and optimum WPV prevention platforms. Pitfalls include reliance on attempts to control patients through strict rules, restrictions, and risk identification and monitoring. Alternatively, effective platforms include engagement-focused, relationship-based, trauma-informed and recovery-oriented practices. Education to develop staff skills and expertise beyond crisis prevention training and violence assessment is highlighted, giving voice to nurses' intuitive expertise in preventing, identifying, and diverting aggressive behaviors. Peer and organizational support interventions for nurse victims of violence are also examined. RESULTS:Safe environments are enhanced when staff are actively engaged in efforts to discern and meet individual needs, engage with the patient, build trust, and communicate hope for recovery. Organizational cultures founded on concepts of trauma-informed care can provide the support victims of violence need to recover and develop resilience and post-traumatic strength. CONCLUSION:Risk management strategies alone are ineffective means of preventing WPV in psychiatric settings. Organizations must strike a balance between ensuring safety and providing a therapeutic atmosphere.

Purpose To gain a deeper understanding of Black older adults' (aged ≥65 years) experiences with adverse childhood experiences (ACEs), including racism, and their use of active coping throughout their life course. Method Qualitative interviews were conducted with 21 Black older adults followed by administration of the First 18 Years Survey (measuring ACEs) and the John Henryism Active Coping Scale. Qualitative data were analyzed using thematic narrative analysis. Quantitative data were analyzed using descriptive statistics. Qualitative and quantitative data were integrated using a triangulation process. Results Four major themes emerged from the qualitative data. Participants reported experiencing pervasive racism throughout their lives. Quantitative results indicated participants experienced fewer ACEs and made high use of active coping. Triangulation indicates qualitative findings and explains the quantitative results. Conclusion Although participants faced ACEs including racism, they found strategies to help them actively cope. [ Research in Gerontological Nursing, xx (x), xx–xx.]