Purpose: This qualitative study aimed to explore and interpret the meaning and essence of end-of-life care as experienced by nurses in internal medicine wards caring for patients who had completed advance directives (AD). It sought to understand the psychological conflicts, ethical dilemmas, and evolving perceptions of care encountered by nurses during the end-of-life process. Additionally, the study focuses on providing foundational data to support the clinical implementation of the AD system, thereby contributing strategies that improve the quality of end-of-life care and uphold patients' rights and dignity in hospital settings. Methods: A qualitative content analysis was conducted using in-depth, semi-structured interviews with 12 nurses from internal medicine wards in tertiary hospitals located in Seoul and surrounding metropolitan areas. Participants had direct experience in providing end-of-life care for patients with ADs. Interviews focused on capturing nurses’ real-life experiences and reflections related to such care. Data were analyzed systematically following the eight-step qualitative content analysis method proposed by Downe and Wamboldt, allowing for the identification of meaningful categories, themes, and patterns. Results: Analysis revealed five major themes and 16 subthemes. The major themes included: (1) Experiences of repeated end-of-life care and advance directives in internal medicine wards, reflecting the frequent encounters of nurses with terminally-ill patients and their ADs; (2) Multifaceted experiences of end-of-life care based on ADs, suggesting the complexities of care shaped by the presence or absence of ADs; (3) Limitations and dilemmas in AD implementation, highlighting the ethical conflicts arising from low public awareness and inconsistent clinical practices; (4) Shifts in perceptions of life and death, including the development of practical attitudes towards death through repeated exposure to dying patients, illustrating the evolving views of nurses; and (5) Hopes for improving end-of-life care in internal medicine wards, emphasizing the need for enhanced care environments, educational support, and institutional backing. Conclusion: The findings underscore the importance of increasing awareness and improving the clinical application of ADs. Establishing systematic support structures is essential to respect patient autonomy and enhance the quality of end-of-life care in internal medicine wards.

Purpose: This study was aimed to explore and analyze the experiences of nurses regarding department transfers following the sudden closure of a ward due to the collective resignation of residents. Methods: Data were collected from November 1 to 29, 2024, and a qualitative content analysis was employed. The participants were 11 nurses who were transferred to different departments following a ward’s sudden closure owing to the residents’ collective resignation. Results: A total of six themes and 24 sub-themes were identified. the first theme is ‘After the resident left, the ward was closed’. The second theme is ‘Various job placements were assigned after the ward’s unfortunate closure’. The third theme is ‘Difficulty adjusting to the new environment and leaning to adapt’. The fourth theme is ‘Changes in the nurse-physician relationships’, and the subtheme is ‘Surprised by doctors seeking nurses' opinions due to the absence of residents. The fifth theme is ‘Become an expert at adapting’. The sixth theme is ‘Worries about the future and a faint glimmer of hope’. Conclusion: This study highlights the challenges nurses encountered in adjusting to new departments following the unprecedented mass resignation of residents and the ensuing ward closure. Nurses initially faced difficulties, feeling expendable in the new environment. However, through the support and collaboration of their colleagues, they demonstrated resilience and adapted effectively. The study also noted that, despite the absence of residents, direct communication between medical staff and patients continued to function smoothly, facilitating their involvement in treatment planning alongside specialists and professors. Although departmental transfers can lead to increased job stress for nurses, successful adaptation during these transitions fosters professional growth by enhancing their knowledge, skills, and influence. Furthermore, knowledge sharing among nursing staff contributes to the overall development of the organization. To promote both personal growth and organizational advancement, nursing managers must actively listen to nurses’ perspectives about departmental transfers and provide compassionate support to assist in their adaptation. Creating an organizational culture that recognizes and values the contributions of colleagues who have undergone transfers is essential. By establishing a systematic approach that facilitates successful adaptation and fostering a positive, accepting nursing culture, departmental transfers can be transformed into an effective strategy for enhancing the professionalism and capabilities of nursing staff.

Purpose: The purpose of this study was to investigate the level of cultural competence of hospital nurses and identify factors influencing cultural competence based on general and cultural characteristics. Methods: This study used a cross-sectional descriptive design and 167 nurses who had been caring for foreign patients for past 1 year. Cultural competence, which is composed of four sub-dimensions (values related to cultural perception, cultural knowledge, cultural sensitivity, and cultural skills), personal and cultural characteristics were measured. Results: The participants were all women, with the mean age of 31.81±6.88 years, and clinical career was 8.76±6.81 years. Cultural competence score was 5.28±0.63 out of 7. Having a foreign friends, position, participation in foreign language classes, and working place had significant influence on hospital nurses’ cultural competence. The explained variance for cultural competence was 21.8%. Conclusion: The findings of this study indicate that nurses provide care by understanding patients with diverse cultural backgrounds and their health-related needs. To enhance the cultural competence of hospital nurses, systematic practical education and active organizational support based on standardized guidelines for caring for foreign patients are necessary.

The rapid spread of novel infectious diseases, driven by globalization and transportation, has caused significant global damage. This study aimed to deeply explore the meaning of nursing experiences from nurses who performed holistic care for COVID-19 patients. Methods: Nurses from a tertiary hospital's COVID-19 isolation ward from January 1 to March 31, 2021, were included. Data were collected through 1:1 in-depth interviews with 17 nurses who understood the research purpose and agreed to participate. The transcribed interview data were analyzed using thematic analysis. Results: Five themes and 13 sub-themes were derived from 47 codes. The five themes included 'The beginning of new nursing,' 'New nursing while wearing personal protective equipment,' 'End-of-life care for patients,' 'Fruitfulness of nursing for COVID-19 patients,' and 'Demands for better nursing.' Conclusion: Nurses provided holistic and high-complexity nursing care to COVID-19 patients, experienced personal growth, and recognized the importance of colleagues. The unique context of 'isolation' for COVID-19 patients has resulted in profound end-of-life care experiences for nurses, highlighting the demand for support programs to address this issue. Furthermore, it shows the necessity for staffing support tailored to patient care.

Purpose: This study aimed to explore and describe the experiences of helper nurses deployed in COVID-19 dedicated wards, seeking a deeper understanding of the significance inherent in their experiences. Methods: Sixteen nurses with over one month of experience working as helper nurses in dedicated COVID-19 wards were selected as participants. Individual interviews were conducted between July and August 2023 using a semistructured questionnaire. Data were analyzed using the methods described by Elo and Kyngäs (2007). Results: The analysis revealed two categories comprising six themes derived from helper nurses’ experiences. These categories include “Confronting Professional Challenges” and “Growing as a More Professional Nurse”. Conclusion: Further studies are necessary to explore helper nurses’ experiences of infectious disease disaster situations. Nurses experience role conflicts, knowledge gaps, and burnout. Therefore, developing protocols for tasks and education is essential in highly uncertain situations and when new responsibilities arise. Establishing systematic support systems for stress reduction and enhancing social support among nurses is crucial. Therefore, additional research is required to understand the growth and impact of helper nurses.

Recently, an unprecedented emerging infectious disease has rapidly spread, causing a global shortage of wards. Although various temporary beds have appeared, the supply of wards specializing in infectious diseases is required. Negative pressure isolation wards should maintain their function even after an earthquake. However, the current seismic design standards do not guarantee the negative pressure isolation wards’ operational (OP) performance level. For this reason, some are not included in the design target even though they are non-structural elements that require seismic design. Also, the details of non-structural elements are usually determined during the construction phase. It is often necessary to complete the stability review and reinforcement design for non-structural elements within a short period. Against this background, enhanced performance objectives were set to guarantee the OP non-structural performance level, and a computerized tool was developed to quickly perform the seismic design of non-structural elements in the negative pressure isolation wards. This study created a spreadsheet-based computer tool that reflects the components, installation spacing, and design procedures of non-structural elements. Seismic performance review and design of the example non-structural elements were conducted using the computerized tool. The strength of some components was not sufficient, and it was reinforced. As a result, the time and effort required for strength evaluation, displacement evaluation, and reinforcement design were reduced through computerized tools.

Purpose: The purpose of this study was to describe the perception of biomedical ethics in nurses and nurse’s aide of comprehensive nursing care service. Methods: The subjects were 287 registered nurses and 81 nurse’s aides who were working in comprehensive nursing care service. The data were collected from December 2 to 15, 2019 using a 4-point Likert scale questions. The data were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test and Dunnett T3 test, using the SPSS/WIN 23 program. Results: The average score of perception of biomedical ethics in nurses were 2.95±0.25 and nurse’s aides were 3.08±0.25 points. The perception of biomedical ethics by general characteristics related to age and marital status(p=.001), education(p=.007), a total career length and a career length of comprehensive nursing care service(p<.001), job satisfaction(p=.004) of the nurse biomedical ethics score was high and statistically significant. However, the higher the age of nurse’s aide, the higher the score was statistically significant(p=.007). The perception of biomedical ethics by characteristics related to biomedical ethics was statistically higher among nurses saying that the values of biomedical ethics were very firm (p =.002), those who have experience of having issues biomedical ethics (p =.001), those who believed that rules and procedures for biomedical ethics in a hospital were well organized (p =.003), those who believed that biomedical ethics problems would become more complex and increase in the future (p =.017), and those who experienced ethical dilemmas (p =.019). Conclusion: In the future, biomedical ethics education should be provided for nursing service teams.

Purpose: We conducted phenomenological qualitative research to provide in depth understanding on infectious disease management. Methods: Participants were 10 nurses working in an isolation ward, where only patients with infectious diseases were institutionalized in one general hospital in Seoul. Data were collected through individual interviews and analyzed according to Colaizzi data analysis method. Results: The main theme of the experience of the nurses who worked in the isolated ward was ‘Nurse's sense of duty to overcome the fear of infection’. Through 83 meaningful re-statements and 13 themes, three sub-themes including ‘Unstable isolation ward’, ‘Taking care of infected patients’ and ‘Insufficient isolation patient care system’. Conclusion: Nurses, working in the new isolation ward, work in a lonely and dangerous environment having fear of infection, being lack of supplies and overcoming various psychological difficulties. In-depth understanding of these needs require efficient infection management policies, measures, and societal recognition.

Purpose: This study aimed to examine the effects of simulation-based training for nurses on nursing stress and clinical competency of cardio-pulmonary emergency care at general wards. Method: A nonequivalent control group, with a pretest-posttest design was used. The experimental group (n=34) received a lecture and team simulation. The control group (n=36) received only lectures without simulation. Data were analyzed using Chi-square and t-test with SPSS program. Results: The participants in the experimental group reported significantly lower death and dying 13.14±1.50 (t=7.19, p<.001), conflict with physicians 7.06±2.51 (t=5.82, p<.001), inadequate preparation 6.16±4.17 (t=4.49, p<.001), problems with peers 13.33±7.05 (t=4.09, p<.001), problem relating to the supervisor 13.51±4.03 (t=2.09, p=.030), workload 17.08±6.19 (t=5.76, p<.001), uncertainty concerning treatment 12.13±6.45 (t=2.21, p=.020), patients and their families 16.37±6.38 (t=3.34, p<.001), discrimination 5.66±2.79 (t=2.39, p=.013) and higher clinical performance ability (t=5.14, p<.001) compared with the control group. Conclusion: This suggests that simulation-based training for cardio-pulmonary emergencycare for nurses at general wards is useful to decrease nursing stress and improve clinical competency.