Conectar
To discuss how shared decision-making (SDM) is currently practised in hospitals, to highlight the essential—yet often underacknowledged—contribution of nurses to inclusive SDM in life-prolonging treatment decisions, and to propose a five-step implementation plan to strengthen the role of patients in the SDM process.
A position paper on current SDM practices.
To take a position, we drew on knowledge gained from six empirical studies conducted by our research group and evaluated these findings in light of the most recent literature.
A five-step implementation plan to stimulate SDM: (1) Clarify roles, (2) Organisational alignment, (3) Comprehensive training, (4) Tailored implementation plans, and (5) Sustainable integration.
The plan is ambitious, yet it offers a clear and actionable path forward for healthcare organisations and professionals. It provides a concrete opportunity for collaboration to embed SDM in daily clinical practice. Ultimately, our shared objective is to achieve optimal patient outcomes—an aim that unites all stakeholders.
Integrating nurses into SDM processes will enhance the quality of support for treatment decision-making. However, to realise truly inclusive, high-quality, patient-centred care, coordinated action at multiple organisational levels is essential.
The proposed plan is not only relevant to treatment decisions at the end of life in hospital settings, but also presents broader opportunities to advance SDM across healthcare sectors. It offers nurses a clearly defined and meaningful role in SDM and provides a practical blueprint for implementation at all levels of the organisation—transforming long-standing ambitions into tangible practice.
The 2024 revision of the Declaration of Helsinki (DoH) marks a pivotal shift in biomedical research ethics, with significant implications for nursing research. This paper critically evaluates the Declaration's relevance to nursing practice, with particular attention to challenges in low-resource settings. Key updates emphasising global health equity, environmental sustainability, participant-centred consent and artificial intelligence (AI) governance are examined through nursing's ethical lenses of justice, beneficence and patient advocacy.
Using a multidimensional ethical framework grounded in Virtue Ethics, utilitarianism and phenomenology, the manuscript explores how nurses can ethically engage vulnerable populations, safeguard data privacy and advance inclusive, community-based research.
It highlights gaps in the Declaration, particularly regarding algorithmic bias and digital consent and proposes practical strategies for nurse researchers, such as AI governance tools, dynamic consent models and context-sensitive sustainability practices.
Rather than treating ethics as an abstract principle, the paper grounds theory in real-world practice, offering case examples that reflect the lived constraints of nursing researchers in underfunded and culturally diverse environments. By aligning ethical ideals with operational realities, this work reinforces nursing's critical role in shaping equitable and ethically resilient research practices under the revised Declaration.
To critically and constructively explore the future of mental health nursing in Flanders (Belgium) by examining the historical evolution, current challenges, and potential strategies for clinical excellence and advancement.
This study used a historically informed and contextualised grounded analyses to envision future perspectives that support strategically targeted perspectives in compact regions such as Flanders (Belgium).
A synthesis of published literature, policy documents, academic sources, and Flemish nursing research was conducted to identify key directions.
By addressing local challenges, particularly related to education and labor market scarcity, this paper proposes three key directions for progress: ‘Back to good basics’, ‘Reclaiming the driver's seat of clinical advancement’ and ‘Revitalizing clinical excellence from within clinical nursing practice’.
These interlinked perspectives provide a framework for revitalising mental health nursing in Flanders, supporting clinical excellence and development while responding to the most pressing contemporary challenges. Although rooted in a compact regional context, the insights and proposed directions may inspire similar reflections and initiatives in international mental health nursing contexts.
To explore the potential of multimodal large language models in alleviating the documentation burden on nurses while enhancing the quality and efficiency of patient care.
This position paper is informed by expert discussions and a literature review.
We extensively reviewed nursing documentation practices and advanced technologies, such as multimodal large language models. We analysed key challenges, solutions and impacts to propose a futuristic multimodal large language model-driven model for nursing documentation.
Multimodal large language models offer transformative capabilities by integrating multimodal audio, video and text data during patient encounters to dynamically update patient records in real time. This reduces manual data entry, enabling nurses to focus more on direct patient care. These systems also enhance care personalisation through predictive analytics and interoperability, which support seamless workflows and better patient outcomes. While predictive analytics could improve patient care by identifying trends and risk factors from nursing documentation, further research is required to validate its accuracy and clinical utility in real-world settings. Ethical, legal and practical challenges, including privacy concerns and biases in artificial intelligence models, require careful consideration for successful implementation.
Transitioning to multimodal large language model-driven documentation systems can significantly reduce administrative burdens, improve nurse satisfaction and enhance patient care. However, successful integration demands interdisciplinary collaboration, robust ethical frameworks and technological advancements.
Implementing multimodal large language models could alleviate professional burnout, improve nurse–patient interactions, and provide dynamic, up-to-date patient records that facilitate informed decision making. These advancements align with the goals of patient-centred care by enabling more meaningful engagement between nurses and patients.
The problem being addressed is the administrative burden of nursing documentation. We suggest that multimodal large language models minimise manual documentation, enhance patient care quality and significantly impact nurses and patients in diverse healthcare settings globally.
To critically examine how male privilege operates within nursing leadership by applying sociological theories that highlight the paradox of men's advancement in a female-majority profession.
This position paper adopts a critical sociological lens to explore how gendered power structures continue to shape leadership in nursing.
Three interrelated sociological frameworks (tokenism, the glass escalator, and hegemonic masculinity) are applied to analyse how men, despite being numerically underrepresented, often reach leadership roles and hold institutional authority disproportionately. Literature from gender studies, nursing sociology, and workforce research is synthesised to trace patterns of privilege and exclusion.
The analysis demonstrates that male nurses often benefit from symbolic visibility, access to informal mentorship, and alignment with leadership norms that prioritise traits such as assertiveness and autonomy. Although some men encounter initial marginalisation, their minority status can enhance perceived legitimacy and accelerate advancement. However, these dynamics are not uniformly experienced. Intersections of race, sexuality, and citizenship significantly shape how male privilege is accessed and constrained.
Male privilege in nursing leadership is sustained by deeply rooted power structures. Addressing these disparities requires more than increasing male representation; it demands a redefinition of leadership values, and a critical review of the assumptions embedded in professional advancement.
Identifying the structural and cultural mechanisms that support male advancement can inform more equitable leadership development, guide inclusive policy design, and challenge taken-for-granted assumptions about competence and authority in nursing.
This study did not include patient or public involvement in its design, conduct, or reporting.
Healthcare systems face a growing challenge: as technology advances, patients increasingly feel like data points in systems that prioritise efficiency over empathy. This paper addresses the global healthcare crisis of disconnection, arguing that fundamental change requires putting human experience at the centre through Caring Science principles in nursing.
COVID-19 clearly revealed this disconnect. While showcasing scientific advances, it exposed gaps in compassionate care and fair access globally. Nurses struggled to maintain human connection while dealing with resource shortages and isolation protocols, proving that advanced medical treatments alone cannot address the physical, emotional, spiritual, and social factors that influence health.
This work draws on peer-reviewed studies, contemporary research, and theories of human caring to demonstrate the global responsibility and urgent need for integrating caring practices into healthcare systems. Collectively, this evidence underscores both the necessity of intervention and the effectiveness of Caring Science as a strategy for transforming organisational practices while highlighting a pressing truth: healthcare systems worldwide must move beyond efficiency alone and intentionally weave caring practices into their structures.
This analysis examines Caring Science through three key areas: Relational, Organisational, and Global. Using Watson's Theory of Human Caring and current research, the paper shows how caring relationships can improve through thoughtful use of innovation. Recent healthcare improvements demonstrate promising results when technology integration enhances both nurse empowerment and patient outcomes within frameworks that prioritise human connection.
Future directions position Caring Science as a mature, evidence-informed framework for addressing healthcare's complex challenges. The paper calls for ‘sacred activism’—a commitment to protecting caring's essential dimensions while embracing beneficial innovation, positioning nursing to lead healthcare transformation through both the art and science of nursing that honours human dignity.
To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.
Position paper.
This paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.
This position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID-19 and incoming reforms. It calls for nurse-led research and innovation to deliver tools to address these challenges.
The paper proposes an appropriate holistic, evidence-based nursing framework to optimise the quality and safety of residential aged care in Australia.
This study did not include patient or public involvement in its design, conduct, or reporting.
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