Background: Nursing shortages, increased patient acuity, and early discharges have increased demands on newly graduated nurses. At the same time, financial constraints have curtailed orientation programs. Method: Open-ended interviews were conducted with 11 nurses employed in acute care settings at 3 months following graduation. Results: New nurses defined their work as a set of skills and attended to procedural aspects of care. Most lacked the capacity for helpful communications with patients and families. They relied heavily on routines learned from experienced nurses. Conclusion: At 3 months, new graduates are apprehensive about their work. Approaches to nursing are largely procedural and guided by the routines of senior colleagues.

The purpose of this study was to describe the amount of congruence in the perceptions of 38 matched nurse-patient dyads concerning the nurse's role in patient education. The perceptions of nurses and patients from two hospital settings were measured with two complementary sets of questions, developed for this study; t-tests were used to compare the mean responses of nurses and patients within and between the two settings to each set of complementary questions. The results indicated that incongruencies existed between nurses' and patients' perceptions of the nurse's role in patient education. Patients identified a general teaching function for nurses. When asked who they preferred to have teach them the specific information related to their condition, patients most frequently chose a physician. Nurses most frequently chose a nurse as the current and most desired patient teacher. Nurses incorrectly assumed that the desires of their patients for patient education were similar to their own. The results suggest that nurses need to develop a clear definition of their role in patient education, to validate patients' desires for teaching, and to examine organizational factors influencing their performance of the patient teaching role.

In this paper we discuss the impact of healthcare 'reform' on nurses' personal and professional lives. Using a thematic analysis, we interviewed 38 nurses in Nova Scotia, Canada regarding their experiences of job displacement, inability to find full-time employment and job losses. Their stories reflect how they lived day by day and the effects this had on their children, partners, friends and leisure, as well as their financial burdens. We theorize about the relationship between nurses' work and women's work, and particularly about women working in unstable conditions and the impact on their lives and that of the clients with whom they work.

A descriptive correlational design was used to study quality of life and coping in 39 clients with severe chronic obstructive pulmonary disease (COPD). Quality of life was measured by using the Sickness Impact Profile (SIP) and Cantril's Ladder; coping strategies were measured with Jalowiec's Coping Scale Revised (JCS). SIP and Cantril's Ladder scores revealed that the subjects experienced a high quality of life. Total coping scores were low, however, implying that patients used the JCS coping strategies only minimally and did not find them particularly helpful. A moderately strong relationship was found between the objective and subjective measures of quality of life. Coping strategies and quality of life were found not to be significantly related. Findings suggest that the caregivers of those with severe COPD should consider the client's perception of quality of life and use of coping strategies. Further research is needed to determine the factors that affect quality of life for these persons.