Nursing in the 21st century continues to challenge point of care nurses working in high acuity areas. The complexities of patient care are multifaceted, advances in technology, environmental and sociopolitical influences often impede nurse presence at the bedside. Ideally, the intention for these nurses is to broaden their knowledge and ways of knowing beyond the physiological needs of the client, therefore, circumventing biomedical control over their work towards that of a caring science approach. Using Arksey, and O'Malley's five-stage framework, 1) identify the research question, 2) identify relevant studies, 3) study selection, 4) charting the data and 5) collating, summarizing and reporting the results. Eleven papers written in English were selected to examine the research question, "How does the dominance of biomedical approaches to care influence point of care nurses' presence in high acuity areas?" Qualitative software-ATLAS.ti version 7 was used for data collection and analysis; two main themes emerged from the literature: 1) empowered caring, and 2) incommensurable closeness-distance. Future research will need to focus on addressing the challenges acute care nurses face when practicing in high acuity areas heavily influenced by a biomedical approach to care, so that nurses may liberally engage in caring science inclusive of a philosophical worldview and nurse presence regardless of their practice environment.

This meta-synthesis explored the effect of bridging programs on internationally educated nurses (IENs). Eight papers that met the inclusion criteria were selected for this review. There were 437 participants from eight studies who come from different parts of the globe and who settled in either Australia, Canada, New Zealand, or the United Kingdom. Using a grounded theory approach for data analysis, four effects of bridging programs on IENs were identified. These are: (a) the concepts from the regulatory body, the client-centred care; (b) do something better for us, for our future; (c) we have to learn English; and, (d) faculty, program coordinator and preceptors that were willing to work with them. These effects were defined and explored in light of the study samples selected for this study.

Symptom recognition, institutional support, and healthy coping strategies are crucial.