Care left undone, interchangeably referred to as missed care, unfinished nursing care and task incompletion, is pervasive in contemporary healthcare systems. Care left undone can result in adverse outcomes for the patient, nurse and organization. The rhetoric that surrounds care left undone infers it is a contemporary nursing phenomenon; however, a seventeenth‐century Spanish nursing treatise, Instruccion de Enfermeros (Instructions for Nurses), challenges this assumption. Instruccion de Enfermeros was an instructional guide that was written for members of the Congregation of Bernardino (...) de Obregon who worked as nurses at the Madrid General Hospital. The treatise provides a historical commentary on the daily roles, responsibilities and working conditions of the Obregonian nurses. Its content and context suggest the Obregonian nursing resource was consistently time poor due to a confluence of internal and external stressors. Consequently, the Obregonians were under considerable role strain resulting in inferior patient care. This article explores the antecedents of care left undone through a historical lens using exemplars from the 1625 edition of Instruccion de Enfermeros. Factors contributing to care left undone in Obregonian nursing will then be examined to offer insights into the similarities between what a nurse suffered 400 years ago and what exists in contemporary nursing practice. (shrink)

The Fundamentals of Care Framework is an evidence‐based, theory‐informed framework that conceptualises high‐quality fundamental care. The Framework places the nurse–patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse–patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse–patient relationship instruments (...) by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty‐seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring ‘focus’, ‘anticipate’ and ‘evaluate’. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse–patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework. (shrink)

The nurses’ relationship to knowledge has been theorised in a variety of different ways, not the least being in relation to medical dominance. In this study, the authors report on one of the findings of a case study into nurses’ anxiety informed by psychoanalytic theory. They argue that the nurse’s subjection to the knowledge of the other health professional, inclusive of the doctor, can be a transference arising in the context of anxiety for the nurse. Grasped by anxiety, the nurse (...) finds their own knowledge insufficient and in this moment can operate a transference to their non‐nursing colleague, who obligingly, responds. This transference is not present in the change‐of‐shift handover report though, when the other’s knowledge is suspect, even open to derision. Thus, this reference to the knowledge of the other is not consistently present in nursing and can be seen to be just one way that nurses organise themselves in relation to anxiety. Therefore, those wanting to break down the medical dominance of the nursing profession might consider other ways nurses might organise themselves in relation to anxiety, so that the political dominance of the other is not reinforced via transference to that other. (shrink)