Model essay on graduation thesis of specialized nursing

Standardized training of nurses after graduation is to improve the nursing education of nurses after graduation, and specialized training of clinical nurses is an important measure to enable nursing graduates to successfully complete the transformation from theoretical knowledge to practical work ability, which is of great significance to improve the professional and technical level and overall quality of nurses. The following is the graduation thesis of college nursing recommended by me for your reference.

Model essay 1: investigation on the present situation of clinical evidence-based nursing

1 objects and methods

1. 1 object

300 clinical nurses from a large general hospital were randomly selected for a questionnaire survey. Age 18~52 years old, average (30.0? 7. 1) year. Education: 84 students in technical secondary school (28.0%), junior college 166 students (55.3%), and 50 students with bachelor degree or above (16.7%). Professional titles: 94 nurses (365,438+0.3%), 65,438+030 nurses (43.3%) and 76 nurses in charge (25.3%). Working years: 1~6 years 94 (3 1.3%), 12 94 (3 1.3%), 18 65 (2 1.7%).

1.2 method

Survey method: Questionnaire survey was used [3]. Self-designed questionnaire, including the basic situation of nurses, the degree of knowledge and understanding of evidence-based nursing, the reference basis for making nursing plans, the methods of clinical nursing research and nursing practice and other 26 related questions. The questionnaire was distributed to 20 clinical nurses for pre-investigation; Invite experts to review and make modifications according to the opinions of experts. The internal consistency reliability of the questionnaire is 0.84, and the content validity is 0.92. Then the author distributed the questionnaire to the respondents and explained the filling requirements to them, and then the respondents filled it out themselves and took it back on the spot. 300 questionnaires were distributed and 300 valid questionnaires were collected, with an effective rate of 100%.

Statistical method: input the data into the computer and use SPSS 10.0 statistical software for statistical analysis, okay? 2 check.

Two results

2. 1 clinical nurses' awareness of evidence-based nursing

63.4% clinical nurses know about evidence-based nursing, but only 15.7%(47/300) clinical nurses are very familiar with evidence-based nursing. Nurses with different academic qualifications, professional titles and working years have significant differences in professional teaching materials, nursing practices, expert opinions and the application of scientific evidence by nurses with different academic qualifications (P

2.2 Clinical nursing staff evidence-based nursing practice status

Statistics show that only 7.7%(23/300) clinical nurses apply the most reliable and scientific evidence, combined with personal clinical experience and patients' needs, to provide nursing programs for patients. Reasons for further inquiry: 54. 1%( 150/277), 20.6%(57/277), 6.8%( 19/277) and 4.0% (lack of internet skills).

3 discussion

3. 1 Popularize evidence-based nursing knowledge and deepen evidence-based nursing education into clinical and continuing nursing education.

This survey shows that 15.7% clinical nurses are familiar with evidence-based nursing, and 84.3% clinical nurses don't know much about evidence-based nursing. The scientific concept of following evidence has not been accepted by most nurses. Therefore, it is necessary to add evidence-based nursing courses in nursing colleges at all levels. Clinical nursing staff must also receive continuing education of evidence-based nursing, such as special lectures and intensive training. Make clinical nurses familiar with more evidence-based nursing knowledge and practice methods, and master learning skills and methods, and become lifelong self-educators, so that they can actively study in their future work and make maximum use of the existing and most reliable scientific evidence to serve patients. So that evidence-based nursing can be applied to daily nursing practice such as rounds, consultations, academic activities and scientific research. Implement evidence-based practice, implement? Patient-centered? Improve the level of nursing service.

3.2 vigorously carry out evidence-based nursing research and provide it in time? The most reliable scientific evidence available?

To evaluate the correctness, usefulness and practicability of evidence, it is often divided into four grades according to the nature of evidence: Grade A, well-designed randomized controlled trial; Grade B, well-designed cohort or case-control study; Grade C, case report or defective clinical trial; Grade d, personal clinical experience [4]. Grade A evidence is the highest, decreasing in turn, and grade D is the lowest.

Following scientific evidence to serve patients is the fundamental difference between evidence-based nursing and traditional experience and intuitive nursing. According to this survey, 50.7%( 152/300) clinical nurses are used to doing things according to nursing routine, and 34.7%( 104/300) clinical nurses are used to doing things according to professional textbooks. This shows that most nurses lack critical thinking. Due to the long publication period of professional teaching materials and the uneven quality of nursing routine in hospitals in different regions, clinical nurses cannot base their nursing services on the existing scientific evidence. As a result, many nursing methods remain in the established habit and experience stage, lacking scientific basis [6]. At the same time, the survey also shows that nurses with different backgrounds have different degrees of application of some clinical references. Nurses with long working years, high academic qualifications and high professional titles are more accustomed to doing things according to professional teaching materials and nursing routines; Only 7.7% of nurses used the most reliable scientific evidence, and most clinical nurses did not use scientific evidence well, which may be related to their aging knowledge, caring for patients by experience and intuition, not knowing how to obtain evidence and lacking the ability of self-education. Nurses in technical secondary schools make good use of scientific evidence, which may be related to their short working years, lack of clinical experience and high frequency of difficulties in nursing patients, prompting them to acquire new nursing knowledge through multiple channels. At present, persuasive nursing research information resources are still limited, and the dissemination and promotion of research results are not sufficient [7], which leads to the narrow application scope of scientific evidence. Nurses seldom refer to journals in clinical work, only 5.0%( 15/300). In essence, the periodical publishing cycle is short, the knowledge is updated quickly, and there are many statistical data, from which a large number of the latest practical scientific evidence can be found. Nurses can still obtain the evidence they need through Medline or Cochrane library and constantly update their professional knowledge. At the same time, the majority of nurses should choose topics according to the conclusions provided by Medline or Cochrane database, vigorously carry out evidence-based nursing research, and provide timely information for clinic? The most reliable scientific evidence available? It is an extremely important work at present and even in the future, and it is also the key to the development of evidence-based nursing.

3.3 Establish evidence-based support groups to improve the evidence-based ability of nursing staff.

The results of this survey show that 54. 1% of clinical nurses are busy with their work, 65.438+00.5% don't know how to get the information they need, 4.0% lack internet skills, and 6.8% have no conditions to access the internet. This shows that clinical nurses are influenced by many factors and evidence-based nursing practice is not carried out enough. Therefore, it is one of the effective methods to select a group of clinical nurses with evidence-based ability to set up evidence-based support groups to participate in or support clinical nurses with different skills and backgrounds to engage in evidence-based nursing practice. Members of evidence-based support group can help busy clinical nurses to obtain scientific evidence from the vast ocean of medical information through the Internet, periodicals, books, etc., and then analyze the applicability of the evidence in combination with nurses' actual situation, needs and personal experience, and formulate high-quality nursing plans and nursing decisions for clinical nurses to use, so as to generally improve the evidence-based ability of clinical nurses, change nursing behavior, engage in more evidence-based nursing practices, and promote the sustainable and healthy development of clinical nursing.

Model essay on graduation thesis of junior college nursing: humanistic connotation of nursing

From a humanistic perspective 1 nursing

1. 1 Nursing is the coupling foundation of natural science and humanities. 1980 American Nursing Association's definition of nursing: nursing is to diagnose and deal with human responses to existing or potential health problems. According to the World Health Organization's definition of health, health is not just the absence of disease or weakness, but a state of complete physical, mental and social well-being (mental and social well-being, not just the neglect of disease). To sum up, defining nursing is an applied science in life science, and natural science and humanities (social) science permeate each other.

1.2 Insufficient humanistic background of nursing: Looking at the formation and development history of nursing, for a long period of time, nursing was good at natural science, but lacked humanistic science, and only fully saw the role of nursing technology, but did not fully see the role of people who mastered and applied nursing technology. They are keen on the operation of nursing technology, focusing on diseases and not seeing people; It only pays attention to nursing research technology and how to make it work, but does not pay attention to how people who use nursing technology correctly and effectively master the technology and play its role, and does not establish the people-oriented concept. As Xi Huanjiu, deputy to the Ninth National People's Congress, dean of Jinzhou Medical College and doctoral supervisor, pointed out, the study of human body structure only carries out pure physiological analysis, such as digestive system, respiratory system, circulatory system and nervous system; Study human etiology, endocrine disorders, decreased immune function or viral infection, etc. All the analysis is based on the anatomical analysis of white mice and white rabbits, and all the conclusions are consistent with the analysis results of white mice and white rabbits. As a result, people's social attributes disappeared. In this way, how can we talk about making our doctors understand, care, love and be considerate? How can we be kind to people and serve others? Lack of humanities may lead to improper use of science and technology, even serious consequences, even catastrophe, such as using B-ultrasound to identify the sex of the fetus and abusing auxiliary examination.

Then, what impact will the lack of humanistic quality have on the country? Founded by Americans in 1967? Zero project? The reason is that the former Soviet Union successfully launched its first satellite in June 1957 1 1, four years earlier than the United States. Zero? It shows the blank of understanding of humanistic education. After decades of relevant research, the Federal Department of Education of the United States has come to the conclusion that American education overemphasizes its economic purpose and function, which leads students to go to school only for future career needs, and the courses are too specialized, especially underestimating the role of humanities education in cultivating people's morality, creativity and interpersonal skills, which is not conducive to cultivating talents with flexible minds and constantly adapting to rapid social changes. The different humanistic qualities of scientific and technological personnel in the two countries led to the backwardness of American space technology [1: 14].

The discipline composition of nursing science and the requirement of knowledge economy for talents will inevitably make nursing science accept humanities examination first in the new century. The great scientist Einstein thought: Science and technology can only tell us? What is this? , but can't solve it? What should it be? . For example, did the Curies discover that artificial radioactivity is a human civilization or a human disaster? ! In other words, technology can only solve right and wrong, but not give it to people? Value? Judge. What can we have? Value? Judgment ability? Einstein told us it was the humanities. The development of nursing and the formation of nursing science in China are deeply influenced by western nursing. Science has no national boundaries and no unique nationality, while humanities have nationality. In nursing science and technology, it is difficult to show the characteristics of China. To truly show the nursing characteristics of China is to infiltrate the traditional culture of China in nursing. At the beginning of Lin's medical practice, a foreign doctor once laughed at her. Do you think you can become a professor by holding a patient's hand and wiping his sweat? Lin asks. Doctors don't know the patient's warmth and coldness, and they don't share the same fate with the patient. How can they cure the disease? Summing up the past, why the implementation of responsible nursing in China is almost abortion; At present, it is so difficult to introduce systematic holistic nursing. All these remind people that we must consider the cultural background of China. We should learn from Europe and America in nursing science and technology, but we should keep China's traditional cultural heritage in humanities. Because the technology of systematic holistic nursing can be introduced, it is impossible to introduce Nightingale with China cultural characteristics. China needs its own Nightingale, Lin Juying and Lin.

2. Construct humanized nursing project

2. 1 create an atmosphere of humanistic spirit in an all-round way "the State Council central Committee's decision on deepening education reform and promoting quality education in an all-round way" points out:? Higher education should attach importance to cultivating students' innovative ability, practical ability and entrepreneurial spirit, and generally improve the humanistic quality and scientific quality of college students. ? Humanistic quality includes humanistic knowledge and humanistic spirit. Humanistic knowledge is the result of subjective reflection on objective; Humanistic spirit is the most fundamental spirit embodied in the whole human culture, the sublimation of humanistic knowledge, the unity of subjective and objective, and the virtue internalized into people's words and deeds. It takes the pursuit of lofty values and ideals such as truth, goodness and beauty as its core and the free and all-round development of human beings as its ultimate goal. However, under the background of technology-centered Taylor system, what should the educated do in the eyes of vocational education? People? No longer exists, just a simple element that can be trained to participate in production; Understand adapting to social needs as specialization, with special emphasis on professional counterparts and fostering unity? Standard parts? In order to manufacture a screw that is tightened in one position and never loosened; Vocational education, is that rice bowl education? . All of these, the educated have to pay the following price: sacrifice the integrity of individual personality, stifle creativity, weaken the ability of sustainable development, and deprive them of the right to choose life and career. Finally, stay away from the humanistic spirit. Einstein, the great scientist, despised it? Reading for a living? He thinks it's motive? Will this directly lead to the damage of ethical values? . He stressed:? Young people should be a harmonious person when they leave school, not just an expert. Otherwise, he and his professional knowledge are like a trained dog. To be a harmonious person, we need to cultivate comprehensive self-discrimination ability, which depends on free and comprehensive education. ? [ 1: 14]

What is education? What is it? Free and comprehensive education? We must reflect deeply. American scholar Laue believes that education is nothing more than what remains in your heart when everything you have learned is forgotten. ? Those things? What is this? It runs through people's beliefs, ideals, values, personality patterns and aesthetic tastes, and is called humanistic spirit. However, the 20th century is an era in which ability-based realism dominates the world. Taylor's theory of division of labor centered on technology as far as possible is the guiding ideology of vocational education: people are regarded as simple elements to participate in production, and vocational technical skills training is provided for the educated from the perspective of pure technology, ignoring their actions? People? The existence of [2]. Nursing education is also doomed: people pay too much attention to knowledge education and professional education and ignore the shaping of thought and soul; The educational process is stagnant at the cognitive level, ignoring the non-cognitive factors such as the feelings and experiences of the educational objects. ? Free and comprehensive education? , is to let the educated have all kinds of vocational skills to adapt to the survival and development, but also have the humanistic spirit. That is, it advocates the combination of scientific spirit and humanistic spirit, which has the consciousness of modern science (natural science and social science) and is full of high humanistic care.

2.2 Reflect the characteristics of humanistic education In the 1990s, people realized more deeply that among the elements that constitute talents, there are things that are more important than knowledge and ability, things that have more influence on talents' acceptance and acquisition of knowledge, improvement and exertion of ability, or things that make people's knowledge and ability play a better role, namely? Quality? . Quality is a relatively stable psychological quality formed by internalizing knowledge on the basis of human innate physiology through acquired education and the influence of social environment. ? Internalization? In other words, the outstanding cultural achievements of human beings will become the personality, temperament and accomplishment of the educational object through the transmission of knowledge and the edification of the environment. Quality education means paying more attention to the cultivation and improvement of talents' humanistic spirit and the continuous improvement of talents' personality, that is to say, paying more attention to letting students learn to learn? Being a man? The educational concept of.

2.3 Establishing humanistic concept of nursing education is an ideal, eternal and spiritual universal category. This word comes from ancient Greek, and its original meaning is image. Western philosophers have used it from different angles. From 65438 to/kloc-0 to March 1997, the concept of nursing education was established for the first time in the four-year teaching plan for secondary nursing specialty formulated by the Ministry of Health. Nursing concept has become the guide and basis of all teaching behaviors and the value orientation and belief of nursing education groups. It includes the philosophical basis, content, object, trained talents, main activity forms of science education and basic concepts closely related to nursing education.

2.4 The outstanding humanistic spirit in the training goal is an inseparable and important part of humanistic spirit, which has been artificially separated for a long time. The important reason is that the society and the public unilaterally emphasize the technical application of science, while ignoring the spiritual value and cultural significance of science. This lack of humanistic spirit training goal leads to? Half-person education? , produced? One-dimensional man? . The goal of humanistic education is to promote the perfection of individual personality and the promotion of moral spirit. It is not only the study and mastery of simple humanistic knowledge, but also the cultivation of humanistic spirit.

Medical talents will serve people in the future, which requires good humanistic quality. Therefore, the training goal of the four-year secondary nursing specialty highlights humanistic requirements: using the basic viewpoints of Marxism, Mao Zedong Thought and Deng Xiaoping and Socialism with Chinese characteristics theory, using the world outlook and methodology of dialectical materialism and historical materialism to understand the subjective world and the objective world, and guiding thoughts and behaviors; Love the motherland, love socialism, support the Communist Party of China (CPC)'s leadership, and have a firm and correct political direction: ideals, morality, education and discipline; Love the nursing profession, have kind and dignified manners, rigorous and diligent style, good professional ethics and dedication to the nursing cause, and serve the people's health wholeheartedly with a high degree of sympathy and responsibility.

2.5 Strengthening the Humanities In the teaching plan for a long period of time, the humanities curriculum is single, with Marxist theory and ideology as the mainstay, supplemented by psychology, ethics and sociology. There are few class hours and there is a lack of organic connection between courses. However, humanities courses in developed countries account for 20%~25% of the total course hours. What are the main characteristics of the teaching plan for four-year secondary nursing specialty? Highlight nursing, pay attention to the whole, strengthen humanities and reflect the community? . According to the overall needs of nursing, the curriculum structure is optimized, so that the traditional biomedical basic courses are further simplified and compressed on the basis of improving the applicability of nursing, and the proportion of humanities courses is greatly improved, and the proportion of humanities teaching hours in the total hours is about 20%.

2.6 The essential knowledge screened by humanistic knowledge module of holistic nursing includes: professional basic knowledge and skills, humanistic (social) scientific knowledge, primary health care knowledge, medical basic knowledge, essential cultural basic knowledge, and knowledge of analyzing and solving problems. Basic concepts closely related to the essential knowledge of holistic nursing: the concept of human wholeness, the concept of primary health care, the concept of dynamic continuity between health and disease, the concept of nursing procedure, the concept of interpersonal cooperation and communication, and the concept of lifelong learning. To construct nursing humanities engineering, we must choose humanities (social) scientific knowledge, necessary basic cultural knowledge, knowledge of analyzing and solving problems, the concept of lifelong learning and other related knowledge and concepts, and establish the curriculum system and curriculum level of humanities.

2.7 Reorganizing the curriculum system of humanities At present, the curriculum structure system of most medical colleges is still composed of three-level courses of general foundation, medical foundation and clinical medicine according to disciplines, and there is no organic connection between the courses. This kind? Three-stage? The curriculum structure tends to ignore humanistic quality education and weaken cultural accomplishment, which leads to the lack of humanistic background of the educated. In order to highlight humanities and make humanities an important part of the curriculum system, the conception of six curriculum structure systems is put forward, namely, basic courses of natural science, basic courses of medicine, basic courses of preventive health care, courses of humanities and social sciences, courses of clinical medicine and courses of new nursing technologies and methods [3:54].

2.8 Establish humanities as a subsystem in the curriculum system of nursing specialty, which is divided into three levels: language, literature, writing and art based on cultural knowledge courses; Nursing ethics, nursing psychology, sociology foundation, aesthetics, interpersonal communication, medical literature retrieval, medical law, etc. , focusing on interdisciplinary courses of humanities and medicine; With what? Two classes? Marxist theory courses (Marxist philosophy, Deng Xiaoping Theory) and moral education courses (ideological and moral cultivation, legal basis) as the core [3:54].

2.9 Innovative and systematic methods of humanistic education Many people think that the humanities and its education are mainly to tell students some humanistic knowledge and let them? Remember? That's all. The way of humanistic education is also teacher-centered, textbook-centered and classroom-centered; Corresponding to this is classroom indoctrination, after-class review and examination. In fact, successful humanities education must be full of imagination and creativity. Because humanistic education is not to explain concepts with concepts, the only real thing to do is to give a place where the meaning can be revealed, so that the educated can have artistic conception and enter the state of mind. Because the essence of humanistic education is spiritual and intelligent. The method of humanistic education must be changed into student-centered, situation-centered, and activity-centered; Corresponding to it are self-study, classroom instruction, computer analysis and simulation/experimental research, thesis/design or experiment, social practice and so on. In this way, the learning process is transformed into a process of learning, applying and developing knowledge. Humanistic education is to cultivate this ability, not only to talk about humanistic knowledge, but also to recite humanistic dogma. In the humanities field, the influence of emotional experience on people is always greater than that of theory.

3 Nursing is no longer far from humanity

At present, there is a certain gap between China's nursing level and that of developed countries. How to combine the traditional culture of China, explore the treasure house of traditional Chinese medicine and establish nursing with China characteristics is a difficult point. The aggravation of humanistic spirit crisis makes the mission of nursing science and nursing education heavier. However, it is gratifying that in the process of constructing nursing education, the humanistic factors of value orientation are highlighted, such as: adapting to the change of medical model, establishing a people-oriented holistic nursing concept, paying full attention to the role of social life and environmental factors in diseases, emphasizing the independence, scientificity and integrity of nursing work, adopting scientific nursing procedures, and implementing the guiding ideology of holistic nursing; It is recognized that the object of nursing service is human, which is a whole composed of physiological, psychological, socio-economic and cultural factors, and its health is closely related to the external natural environment, social environment and human internal environment; The nursing method adopted is to apply nursing knowledge and skills, use nursing procedures, and provide holistic nursing for clients according to people's basic needs and needs at different stages of life development, and so on. ? Patient-centered? Holistic nursing model has been applied in clinic, and its nursing concept has been accepted by nurses. All these indicate that the humanistic project of nursing science and nursing education has been started.