Hamidreza Haririan

The slow code is a complex and ethically sensitive phenomenon in cardiopulmonary resuscitation (CPR), referring to a deliberately partial or delayed resusc

Gaslighting is a subtle and insidious form of psychological abuse in the workplace that operates through the distortion or denial of reality and the induction of cognitive doubt, ultimately undermining individuals' confidence in their perceptions and professional judgment. Although the concept has gained increasing attention in organizational and psychological literature, gaslighting remains theoretically underdeveloped and conceptually ambiguous within nursing practice. It is frequently conflated with related phenomena such as workplace bullying, psychological violence, or incivility, which limits accurate identification, measurement, and intervention. This study aimed to clarify the concept of gaslighting in nursing practice through a systematic concept analysis. This study employed Walker and Avant's eight-step concept analysis method. A comprehensive review of English- and Persian-language literature was conducted using databases including PubMed, Scopus, CINAHL, PsycINFO, Web of Science, SID, and IranDoc. All uses of the concept of gaslighting relevant to nursing and healthcare contexts were examined. Data were analyzed to identify defining attributes, antecedents, consequences, model cases, and empirical referents of gaslighting in nursing practice. The analysis revealed that gaslighting in nursing practice is a covert, processual, and power-based phenomenon. Its defining attributes include distortion or denial of reality, induction of cognitive doubt, persistent and patterned behavior, power imbalance, victim blaming, and a subtle, non-confrontational nature. Key antecedents were identified as hierarchical power structures, high workload and stressful clinical environments, and the absence of clear organizational policies and supportive reporting mechanisms. The consequences of gaslighting extend beyond individual psychological harm and include reduced professional self-confidence, burnout, organizational silence, decreased reporting of concerns, diminished quality of care, and potential threats to patient safety. Based on these findings, a conceptual model illustrating the relationships among antecedents, defining attributes, and consequences of gaslighting in nursing practice was developed. This concept analysis provides a clear and structured understanding of gaslighting in nursing practice and differentiates it from other forms of workplace mistreatment. The proposed conceptual framework offers a foundation for future empirical research, development of measurement instruments, and the design of educational and organizational interventions aimed at preventing and addressing gaslighting in nursing environments.

Background: In many countries, nurses serve as prescribers in the healthcare system to manage acute and chronic diseases. Nurse prescribing can be affected by specific variables, one of which is the nurses' self-efficacy. This study aimed to determine Iranian postgraduate nursing students’ attitudes and readiness for prescribing and its relationship ...

Introduction: Undergraduate nursing students often work part-time or even full-time while studying at university completing their bachelor’s degrees. The aim of this study is to explain the meaning of the lived experiences of nursing students working as students in clinical field. Methods: A phenomenological study was conducted at the nursing and midwifery school of Tabriz, Iran. Purposefully, 20 baccalaureate nursing students with experience working as student worker nurses were recruited. The sample size was determined according to data saturation. Semi-structured, face-to-face interviews were held with the participants over 3 months (April 2020 to June 2020), and Van Manen’s hermeneutic phenomenological approach was used to analyze the data. Results: Five main themes extracted from the data analysis, including "students’ clinical competency", "nurse-student relationships", "shift work", "mislearning", and "chaotic wards". A further 12 sub-themes extracted under the five main themes. Conclusion: The work of nursing students in clinical environments as student worker nurses is a two-dimensional phenomenon with advantages and disadvantages. The benefits are improving the nursing students’ clinical and communication skills, increasing their self-confidence, learning and practicing discipline and nursing responsibilities, and the disadvantages are facing reality shock stress, and mislearning.

Background: Understanding the experiences of patients’ family members witnessing resuscitation helps develop care plans. Accordingly, this study aimed to explore the experiences of witnessing resuscitation among the patients’ family members. Methods: A total of 15 patients’ family members were interviewed over a 4-month period (from April to July 2019). The participants were recruited through purposive sampling, and they were enlisted from three educational hospitals in Tabriz. Data were analyzed using Smith’s interpretative phenomenological analysis (IPA) via the MAXQDA12 software. Results: Data analysis led to the identification of four main themes and nine subthemes. The main themes included "the insistence on being present", "achieving calmness", "partnership and collaboration" and "hindrance". Conclusion: Although family members reported feelings of agitation towards the health professionals, there was also strong evidence of the benefits of witnessing resuscitation such as open communication, psychological support, and facilitating acceptance of the patient’s prognosis. The study highlighted the importance of developing formal policies based on a family-centered care (FCC) approach to observe family presence during resuscitation while maintaining the patient’s and family’s rights.

Nurses, as the most numerous human resources in the field of health, have many roles and responsibilities. The number of countries where nurse prescribing is common is increasing. Also, the legal, educational, and organizational conditions in which a nurse prescribes medication vary greatly from country to country, ranging from the fact that the nurse can only prescribe from a limited list and under the supervision of a physician to the case where the nurse is authorized to prescribe without any restrictions. In many countries, health policymakers have responded to increasing demand for care due to aging populations and the increasing prevalence of chronic disease, physician shortages, and budget constraints, through strategies such as modernizing roles and combining health professions, including the role development of nurses. Prescribing by nurses has been a historic move for the nursing profession and an important part of the health system solution in leading countries to improve access and reduce the waiting time for patients to receive medication. Other potential benefits of nurse prescribing are increased continuity of patient care and better access to medication, efficiency in drug delivery and patient comfort, and reduced patient waiting time.

Background & Aims One of the concerns of nurses and physicians is the adherence to treatment in patients with heart diseases. In Iran, there are no accurate statistics on the treatment adherence of patients with coronary artery stents, and the risk of cardiovascular diseases (CVDs) in these patients has not ...

Background: Patient handover in the emergency department (ED) is a 2-way communication process between the paramedics and in-hospital emergency personnel, which can result in miscommunication and delivery challenges. This study aimed to explore the lived experience of paramedics on patient handover to the ED. Methods: Over a period of 5 months, an interpretative ...

Introduction: COVID-19 has not only affected the physical health of people but it has also had a major impact on their mental health. Objective: To investigate the nursing, midwifery, and operating room students’ mental health and intention to leave during COVID-19 pandemic. Methods: This cross-sectional study was conducted at the nursing and midwifery school of Tabriz, Iran. Over a period of three months (February–May 2021) and through random sampling, 284 students were selected. The research tool consisted of three parts including demographic information, Depression Anxiety Stress scales, and a questionnaire on intention to leave. Results: More than 20% of the students experienced some degrees of depression, anxiety, and stress. Nearly one-third of participants mentioned a high level of intention to leave. Nursing students had a higher level of a turnover tendency than other students ( p = .004). Male students and who experienced moderate to high level of depression displayed greater intention to leave ( p = .005). Conclusion: Students suffered from some degrees of stress, anxiety, and depression during the COVID-19, and it strengthened the participants’ intention to leave. Relevant authorities are recommended to improve mental health of the students by providing psychological counseling sessions, reducing their direct contact with patients, and providing personal protective equipment.

Background: The career development of nursing preceptors is key to improving the quality of clinical education. However, there is a lack of sufficient and specific information about the career development of nursing preceptors in Iran. Objectives: This study aimed to investigate the nursing preceptors’ career development status. Methods: A descriptive cross-sectional study was carried out with the participation of 92 nursing preceptors. Participants were selected by census sampling method from 5 hospitals in Tabriz, Iran. Demographic and 6-dimension career development questionnaires were used to collect data. The collected data were analyzed using SPSS version 22, and the significance level for all statistical tests was determined to be less than 0.05. Results: Participants received the highest career development on ethical, cultural, and individual dimensions with mean scores of 3.55 ± 0.471, 3.41 ± 0.525, and 3.38 ± 0.540, respectively. However, they obtained the lowest career development on the organizational, research, and educational dimensions with mean scores of 2.68 ± 0.580, 2.28 ± 0.672, and 2.20 ± 0.690, respectively. Moreover, a comparison of career development based on demographic information showed that female preceptors, preceptors with more than 20 years of work experience, preceptors with master’s degrees, and contract employees had the highest mean scores for career development. Conclusions: Given the preceptors’ cooperation with nursing faculty as clinical nursing educators and their role in nursing education, officials of nursing faculties should develop specific career development programs (especially in organizational, research, and educational dimensions) and establish an effective relationship between preceptors and professors to enhance nursing students education.