The purpose of this study is to demonstrate the driving forces behind mid-career nurses who have been working in children's wards. A semi-structured interview was conducted with seven mid-career nurses who had already been working either in a children's ward of one of two advanced treatment hos-pitals in the suburbs of Tokyo or in a pediatric specialist hospital and had the willingness to work con-tinuously. Modified grounded theory approach was used for analysis.
As a result, through 34 concepts and 11 subcategories, the driving forces behind mid-career nurses who have been working in children's wards were generated as the following three categories; 1) the existence of children who are living toward the future with their illnesses, 2) the rewarding involvement with "children", "family", and "the interactions between children and family", and 3) the actual feeling of working in the self-created place by looking at both the reality and possibilities. Furthermore, we found that these three categories were largely related to; 1) the positive emotions aroused by witnessing the existence of children who are "co-living with illness" and their growth, 2) the rewarding experience gained when tackling and overcoming the core, yet challenging part of pediatric nursing practice, and 3) the feelings of being approved by others that are gained by stepping outside the framework of child care to have a broad perspective and by controlling themselves in the organization. It is consid-ered that these driving forces do not exist independently but complement each other in a continuous and fluid manner, such as a propeller with three rotating wings.
Although the idea of attracting inactive nurses has recently been brought to national attention as an option to reinforce the nursing workforce, little is known about how to support previously inactive nurses after their return to practice. The aim of this study was to conceptualize the process of previ-ously inactive nurses' experiences, and to discuss appropriate support and strategies for retaining them. Data were collected through semi-structured interviews with 11 currently working female registered nurses (RNs) who had become inactive after leaving their previous workplace because of marriage or childbearing. After analyzing the data based on a grounded theory approach, seven categories were gen-erated to reflect the process of returning to practice. Previously inactive nurses faced "Discomposure with working after being inactive" caused by confusion with an overwhelming environment and strug-gles between work and personal life. Then, they tried "Making an effort to compensate for issues (both personal and with others) caused by their period of inactivity" in order to deal with their duties at work and improve unsettled feelings. This effort was encouraged when nurses obtained a "Positive state of mind and stimulating endeavors" and "Support from the workplace." When their effort was encour-aged, they experienced "Feelings of an improved situation." This experience led nurses to "Fit comforta-bly into their new situation," including growing accustomed to their current activities. The process outlined in this study specifically described the desired workplace support and helpful suggestions for currently inactive nurses seeking to return to practice.
This prospective study aimed to clarify the validity of the second and third editions of the Child-Fall Risk Assessment Tool (C-FRAT) for pediatric patients using cribs. The study included 697 pediatric patients (mean age 2.4 years) currently using cribs. The number of assessments was 1,315, and the num-ber of reported falls was 51 (25 while walking, 26 from the crib). Two risk factors were significantly related to falls while walking, including wearing slippers or sandals (p=0.04, OR=4.3), can't watch out when child is running (p=0.02, OR=2.8). Two risk factors were significantly related to falls from cribs, including forgets to raise bed rails when leaving bedside (p<0.01, OR=9.7), improved physical symp-toms (p=0.04, OR=2.0). The most valid cutoff point for the second edition was 13, the area under the curve (AUC) was 0.81, and the sensitivity and specificity were 0.78 and 0.73, respectively. We devel-oped three alternative tools for the third edition of the assessment tool, using different weightings for the various risk factors. Each of our three new tools were analyzed using the second edition's research data, and the AUC for each new tool was found to be 0.83-0.84. We conclude that the second and third editions of the C-FRAT have moderate accuracy.