Aims: To analyze the personal experiences of Jane Stuart Woolsey in Hospital Days (1868), an inspiring nurse who brought order, training and quality to nursing activities in the context of the American Civil War (1861-1865). Background: In a restrictive context where the general access of women to public sphere activities was rather limited and where nursing was not a formally regulated professional activity, Jane Woolsey wrote Hospital Days to recount her wartime nursing experiences as the superintendent of Fairfax Seminary Hospital in Virginia. Design: Historical research. Methods: Historical research methods were used to analyze Hospital Days. Data gathered from primary and secondary sources were synthesized and discussed in terms of their historical context and significance. Results: Unlike other triumphal narratives at the time, Woolsey develops a compelling account describing the work expected of a nurse and denouncing the lack of training among most nurses working in the war context. Conclusion: Jane Woolsey was a pioneering nurse who improved the quality of nursing care amidst the American Civil War. Her personal experiences collected in Hospital Days reflect her desire for the proper training of nurses and her contributions to emerging professional nursing activities built on the integration of previous domestic values, good training and good administration.

Aim: The aims of this paper are (1) to present the results of the development, content validation and imple-mentation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. Background: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, at-titudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented.Design: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation.Methods: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators.Results: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process.Conclusions: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a mea-surement tool.Tweetable abstract: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help eval-uate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/ families, as reflected by nurses' clinical narratives.

Mary Livermore's My Story of the War is a valuable piece of travel writing written from the point of view of a nurse who documented her unexpected personal and professional journey to administer the Sanitary Commission of the United States Union Army and provide nursing care during the American Civil War. Although Livermore's pre-war background had not been solely limited to the domestic sphere, her wartime experience involved a public negotiation between the traditional domestic realm assigned to women and new nursing professional functions that emerged during the war. In a context in which the general access of women to public writing was rather limited and in which nursing was not a formally regulated professional activity, Livermore's triumphal narrative reflects the increasing connection between progressively professional nursing functions that emerged in the context of war and a new women's rights leadership forged during her autobiographical journey.

Background: In a period of hopelessness motivated by a restrictive Victorian society that confined women to the domestic realm, Florence Nightingale wrote the cathartic Cassandra (1852) in an attempt to transform her despair into rebellion. Aims: To discuss Nightingale's approach to women's role in Cassandra. Methods: Historical Research was used to analyse Cassandra. Data gathered from primary and secondary sources were synthesised and reported in terms of their historical context and significance. Findings: Adopting the genre of `sage writing¿, Nightingale positions herself as a female messiah in an autoreferential narrative that projects women's future possibilities for release. Discussion: Assuming the identity of a prophetic Greek heroine cursed to never be believed, Nightingale's Cassandra claims professional work as the liberating solution for Victorian women. Conclusion: For the first time, Nightingale predicts in Cassandra some incipient prerequisites for a future nursing path for women's change.

Background. Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoreti-cal frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish con-text. Methods. We translated the PCPF following the Translation and cul-tural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. Results. We encountered no significant difficulties to reach agree-ments on most of the terms except for Having a sympathetic presence. Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (>= 0.90). Conclusions. The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better com-prehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.

Aims To analyse the evolving social role of female nurses in the American Civil War context in terms of gender, class and race and to examine whether their caring efforts correspond to the beginnings of a new nursing professional identity. Design Historical research. Methods Thirteen American Civil War nurses' triumphal narratives written between 1865-1902 were analysed. The search and work were carried out between 2012-2020. Women's history and thematic analysis provided, respectively, the theoretical and analytical frameworks. Results The arrival of the war was the catalyst for change. The nurses' autobiographies were written in a hostile environment where class and racial tensions had to be released. This analysis points to nursing care being transformed from its traditional domestic traits to a progressive and intentional professional dimension. Conclusion American Civil War nurses' autobiographies offer an innovative vision of their lives and their nursing work. Specifically, the autobiographical accounts provide new perspectives on the evolution of the authors' social dimension in terms of class, race and gender as well as the development of a new nursing professional identity in that context. Impact Illuminating overlooked meanings hidden in nurses' autobiographies improves women's visibility and their contribution to the history of nursing

Background: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. Purpose: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. Method: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. Results: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. Conclusions: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.

Aim To explore the literature regarding how nursing narratives have been used to enhance reflective practice. Design Theoretical review. Data sources A literature search from 1990 - 2017 was conducted in PubMed, CINHAL and PsycINFO databases. Review methods After applying the selection criteria, 13 studies were identified. The quality of articles was evaluated. Results Three themes were identified as the main components of an ongoing narrative process based on looking back to past clinical experiences, creating spaces for dialogue and bringing the worlds of theory and practice closer together. Conclusions This review provides a forum for exploring the use of narratives to enhance reflective practice, which may lead to the acquisition of professional competences.

AimTo show the development of an emerging nursing profession through the eyes of Louisa May Alcott and Hospital Sketches. BackgroundIn Hospital Sketches, Louisa May Alcott recounts her experiences when she worked as a nurse of injured soldiers during the American Civil War, in an autobiographically and masked-referential way, which allows her to negotiate between transgression and convention. Unlike other reviews, in this paper the relevance of nursing remains highlighted. DesignDiscussion paper. Data sourcesExisting literature in databases, history books and our own reading of facts. Implications for nursingIlluminating overlooked meanings hidden in nurses' personal sources enables to approach their contribution to history, improve their visibility and project the future of nursing. Nursing care, whether domestic or professional, was and remains a catalyst for change. ConclusionThrough Alcott's words, we understand the transition of nursing care as a gradual extension of the middle-class woman's domestic role and a progressive definition of nurses' identity. In particular, we highlight how certain professional nursing nuances which appear in the text are compatible with the gradual extension of the boundaries of women's domesticity. Furthermore, Alcott's use of literary devices reveals the delicate balance between women's domestic role and some new nursing professional features, which anticipates nursing professionalization.

Independientemente del lugar, la Enfermería es una disciplina en construcción debido a una serie de escollos históricos por los que ha atravesado. Ante esta situación de dificultad, acudir a la historia de su profesionalización refuerza su identidad y colabora en la explicitación de su estatus disciplinar. Partiendo de lo anterior, el objetivo de este trabajo es realizar una aproximación conceptual al proceso de profesionalización de la Enfermería en el contexto anglosajón, mediada por la perspectiva que proporciona la historia de los conceptos, que aborda desde el punto de vista teórico los conceptos que han participado en esa historia. A tenor de dicho acercamiento, se vislumbra un intrincado proceso materializado en una conciencia común en Enfermería a la hora de entender y desarrollar la realidad de los cuidados y la realidad personal, así como un desarrollo paralelo del rol femenino en la sociedad. Por lo tanto, se puede concluir que abordar la historia de la profesionalización de Enfermería se perfila como una herramienta que favorece la consolidación de identidades, así como el desarrollo de su práctica asistencial.