Health care reform has been an international trend. Within this trend, much emphasis is put upon cost containment and reorientation of health services to meet clients' health needs. In this climate, nurses are increasingly aware of the need to demonstrate their contribution to client outcomes. It is also important for nurses to be effective managers so that both an efficient use of health resources and high quality health care delivery are upheld. In addition, to maintain a healthful nursing workforce and to decrease turnover rates, job satisfaction is of paramount importance. In this issue, we are very pleased to present three articles in the Research Forum and one article in the Clinical Forum. These articles focus on nursing contribution, nurses' managerial roles, nurses' job satisfaction and the clinical aspects of critical nursing.
The three research studies were undertaken in Hong Kong, Australia and Mainland China. The evaluation of a nurse-led midwifery clinic in Hong Kong is a good example demonstrating specific nursing contribution in midwifery care. In her article Hau describes an alternative choice for antenatal care taking place in Hong Kong and its effects on client outcomes and the teaching/learning process of midwifery care. The second article describes the development of a managerial model for nurse managers in Australia. Baber and Brown offer a new and systematic model as a framework to guide the investigation of various dimensions of managerial roles. Along with the managerial model, several dimensions of nurses' managerial roles in Queensland Health Care System, Australia are discussed. Results of this study help clarify appropriate managerial roles and responsibilities of nurse managers. The last research article outlines the job satisfaction. Cao, Yu & An developed a Chinese Nurse Job Satisfaction Scale. Cao et al. applied this scale to identify different levels and areas of job satisfaction of a sample of Shenyang Chinese nurses. Readers, practitioners and nurse managers alike, will find the three articles helpful in providing insight for the organization of midwifery care in Hong Kong, and understanding various dimensions of managerial roles of nurses working in Australia as well as job satisfaction among Chinese nurses.
One fundamental way to enhance nursing contribution to client outcomes is to engage in continuous learning. Chan & Kong, nurse specialists of two intensive care units in Hong Kong, underlining this view, share with us a case study of the nursing care of patients with broncho-pleural fistula and the application of high frequency jet ventilation in the Clinical Forum. Learning, applying and refining the nursing care, nurses can demonstrate the excellent delivery of physical and psychosocial aspects of care for patients and their families.
Ann Tak Ying SHIU
Angela Yee Man LEUNG
Issue Editors