2022年6月，在醫(yī)院的支持和幫助下，在北京華通國(guó)康公益基金會(huì)（BHGF）的組織安排下，懷著對(duì)留學(xué)的向往和對(duì)護(hù)理科研的追求，我有幸參加了為期一年的愛(ài)爾蘭芒斯特省理工大學(xué)國(guó)際護(hù)理碩士學(xué)習(xí)項(xiàng)目。因?yàn)橐咔樵?，此次學(xué)習(xí)上半學(xué)期是在國(guó)內(nèi)通過(guò)線上學(xué)習(xí)的方式參加的，下半學(xué)期是前往愛(ài)爾蘭線下學(xué)習(xí)的。時(shí)光飛逝，一年的時(shí)間轉(zhuǎn)眼而過(guò)，回顧這一年的日子，經(jīng)歷多多，收獲滿滿，感觸頗豐。這一年的學(xué)習(xí)讓我感受到了學(xué)習(xí)機(jī)會(huì)來(lái)之不易和持續(xù)學(xué)習(xí)的重要性，這都要?dú)w功于醫(yī)院鼓勵(lì)員工持續(xù)學(xué)習(xí)。通過(guò)這一年的研究生學(xué)習(xí)，我對(duì)護(hù)理和護(hù)理科研有了更深刻的認(rèn)識(shí)和理解，學(xué)習(xí)了如何通過(guò)反思判斷自己的臨床實(shí)踐，還學(xué)習(xí)了運(yùn)用科研知識(shí)解決護(hù)理臨床問(wèn)題，而且知曉了如何運(yùn)用科研知識(shí)指導(dǎo)我們臨床實(shí)踐，以及使用循證的方法為患者提供更高質(zhì)量的護(hù)理?，F(xiàn)將這一年學(xué)習(xí)期間的所見(jiàn)、所聞、所思、所想分享給大家，與大家共勉。

1. 愛(ài)爾蘭概況

愛(ài)爾蘭是位于西歐的島嶼國(guó)家，教育體系完善，教育水平領(lǐng)先歐洲國(guó)家，得到國(guó)際的廣泛認(rèn)可。加之愛(ài)爾蘭的官方語(yǔ)言為英語(yǔ)，前往愛(ài)爾蘭學(xué)習(xí)的學(xué)生不用再單獨(dú)學(xué)習(xí)其他小語(yǔ)種。愛(ài)爾蘭的護(hù)理教育世界聞名。

1. 在校學(xué)習(xí)情況

我們的學(xué)習(xí)分為兩部分，英語(yǔ)語(yǔ)言學(xué)習(xí)和專業(yè)課程學(xué)習(xí)。雖然在參加課程之前已經(jīng)通過(guò)了語(yǔ)言考試，但是學(xué)校還是在專業(yè)課之前安排了為期兩個(gè)月的語(yǔ)言培訓(xùn)。老師都是來(lái)自語(yǔ)言學(xué)校的專職老師，其內(nèi)容類似于雅思培訓(xùn)，包含聽(tīng)說(shuō)讀寫(xiě)，涉及日常溝通、飲食、人物、愛(ài)爾蘭文化歷史等，以及一些簡(jiǎn)單的護(hù)理專業(yè)情景對(duì)話。課堂形式多樣，包括小組討論、游戲、PPT演講比賽等。課后還會(huì)有作業(yè)鞏固課堂所學(xué)內(nèi)容。通過(guò)這些學(xué)習(xí)，加深了我的語(yǔ)言能力，為后期的專業(yè)課做好準(zhǔn)備。通過(guò)語(yǔ)言培訓(xùn)，使得學(xué)員之間有了更多的了解，建立了深厚的同學(xué)情誼。在專業(yè)課程開(kāi)始之后，我們的語(yǔ)言課程由一周五天改為了一周兩次。老師還會(huì)根據(jù)我們不同的學(xué)習(xí)要求而更改學(xué)習(xí)內(nèi)容。

專業(yè)課程分為上、下兩學(xué)期，一共有八門(mén)課程，此外，還有一門(mén)課程為學(xué)術(shù)指導(dǎo)，旨在幫助我們解答關(guān)于課程的任何問(wèn)題，幫助完成學(xué)業(yè)。與國(guó)內(nèi)教育不同，老師沒(méi)有固定的教材，所有的PPT內(nèi)容均從經(jīng)典書(shū)籍或者文獻(xiàn)中截取的篇章。為了幫助我們更好地理解老師課堂所講的內(nèi)容，老師還會(huì)推薦很多文獻(xiàn)和專業(yè)書(shū)籍供我們閱讀。每門(mén)課程都以論文為考評(píng)標(biāo)準(zhǔn)，字?jǐn)?shù)從1500到10000字。

第一學(xué)期的四門(mén)課程為護(hù)理理論（Nursing Theory）、研究方法學(xué)和設(shè)計(jì)（Research Methodology and Project Design）、領(lǐng)導(dǎo)力（Leadership）和反思實(shí)踐（Transforming Practice through Reflection）。因?yàn)橐咔榈脑?，我們這學(xué)期的課程全部采用線上教學(xué)。每門(mén)課程均由兩名老師負(fù)責(zé)，雖然通過(guò)了語(yǔ)言考試和語(yǔ)言培訓(xùn)，但是對(duì)于母語(yǔ)非英語(yǔ)的我來(lái)說(shuō)還是很難一下子跟上老師的語(yǔ)速，因此還是借助了一些實(shí)時(shí)翻譯軟件幫助理解。第二學(xué)期的四門(mén)課程為循證實(shí)踐（Evidence-Based Practice）、倫理決策力（Ethical Judgment In Professional Leadership）、護(hù)理信息學(xué)（Healthcare Informatics）和畢業(yè)論文（Dissertation Project）。幸運(yùn)的是，第二學(xué)期我們?nèi)サ搅藧?ài)爾蘭，可以真切感受課堂教學(xué)。以下是八門(mén)課程的詳細(xì)講解：

1. 護(hù)理理論Nursing Theory（5學(xué)分）：一方面，老師們讓我從理論的角度重新理解了護(hù)理學(xué)。也讓我知曉了護(hù)理理論在護(hù)理學(xué)科的重要性。這門(mén)課也解答了困惑我很久的疑惑，醫(yī)院眾多中標(biāo)課題項(xiàng)目的理論來(lái)自于哪里。但是在開(kāi)始學(xué)習(xí)的時(shí)候，我一頭霧水，自己還在B站上找了一些視頻幫助我理解護(hù)理理論。最終，通過(guò)這門(mén)課程，我知道了什么是廣域理論、中域理論，也正是這些理論，支撐著護(hù)理作為一門(mén)學(xué)科的發(fā)展。通過(guò)閱讀相關(guān)書(shū)籍，我也知曉了中域理論的運(yùn)用范圍，不同于廣域理論，它們可以直接指導(dǎo)護(hù)理臨床實(shí)踐和研究。另一方面，此門(mén)課程旨在通過(guò)對(duì)某一護(hù)理問(wèn)題的前因后果的分析，對(duì)其促成因素的詳細(xì)剖析，從而形成概念，最后這些概念融合形成護(hù)理理論。在這門(mén)課程中，通過(guò)使用護(hù)理概念分析的八大步驟，完成了關(guān)于“道德困境”的概念分析。
2. 研究方法學(xué)和設(shè)計(jì)Research Methodology and Project Design（5學(xué)分）：該課程從方法學(xué)的角度講解了如何完成一個(gè)研究設(shè)計(jì)，但又不僅僅是方法學(xué)。因?yàn)樽菲涓词鞘澜缬^，不同的世界觀確定了不同的研究類型。在研究設(shè)計(jì)方面，老師特別強(qiáng)調(diào)理論對(duì)研究的重要性，因?yàn)橘|(zhì)性研究有助于構(gòu)建護(hù)理知識(shí)，幫助一個(gè)理論的發(fā)展；而量性研究又可以對(duì)理論進(jìn)行驗(yàn)證。兩位老師分別從質(zhì)性研究和量性研究的角度為我們講解了如何完成一個(gè)研究設(shè)計(jì)，其主要內(nèi)容包括了文獻(xiàn)檢索、科研設(shè)計(jì)、倫理審核、抽樣、文獻(xiàn)寫(xiě)作等。通過(guò)學(xué)習(xí)，我完成了一篇關(guān)于ICU護(hù)士對(duì)于臨終護(hù)理態(tài)度的文獻(xiàn)回顧，這些內(nèi)容也是為了下學(xué)期的畢業(yè)論文做準(zhǔn)備。
3. 領(lǐng)導(dǎo)力Leadership（10學(xué)分）：這門(mén)課程幫助我區(qū)分了管理和領(lǐng)導(dǎo)力，并且詳細(xì)講解了四類領(lǐng)導(dǎo)力：仆人式領(lǐng)導(dǎo)力、真實(shí)領(lǐng)導(dǎo)力、變革型領(lǐng)導(dǎo)力和集體領(lǐng)導(dǎo)力。每一種領(lǐng)導(dǎo)力風(fēng)格各有所長(zhǎng)，不同的領(lǐng)導(dǎo)力對(duì)領(lǐng)導(dǎo)者的能力和要求均不一樣。該課程作業(yè)分為兩部分，第一個(gè)作業(yè)是批判性分析“l(fā)eadership involves the use of interpersonal skills to influence others to accomplish specific goals.”這句話。老師為了讓我們更好地完成作業(yè)，進(jìn)行了小組討論，讓大家發(fā)表自己的看法，激發(fā)出我們的靈感。第二個(gè)作業(yè)是關(guān)于領(lǐng)導(dǎo)如何面對(duì)當(dāng)今社會(huì)的機(jī)遇和挑戰(zhàn)，以便該組織的成員感到自己是受到重視和授權(quán)的。通過(guò)該課程的學(xué)習(xí)，我知道了每一種領(lǐng)導(dǎo)力方式在組織實(shí)踐中扮演的角色和作用均不同，我們需要根據(jù)組織的現(xiàn)狀采用不同的領(lǐng)導(dǎo)方式，幫助每個(gè)成員積極投入到工作中，從而促進(jìn)組織的變革與發(fā)展，以面臨當(dāng)今社會(huì)的機(jī)遇與挑戰(zhàn)。
4. 反思實(shí)踐Transforming Practice through Reflection（10學(xué)分）：看到課程名字時(shí)，我以為這個(gè)反思和我們平時(shí)的反思是一樣的，但是通過(guò)學(xué)習(xí)后發(fā)現(xiàn)大有不同。這門(mén)課程通過(guò)講解批判性解放性反思在護(hù)理實(shí)踐中的重要作用，并使用了泰勒模型幫助自己對(duì)以往實(shí)踐進(jìn)行反思。該課程通過(guò)老師講課、研討會(huì)和PPT匯報(bào)等形式開(kāi)展。通過(guò)這些方式的學(xué)習(xí)，我完成了“NCU護(hù)士可持續(xù)發(fā)展的解放性反思”的論文。泰勒模型讓我認(rèn)識(shí)到自己的行為不僅受到我自己的影響，還受到我身處的環(huán)境、社會(huì)和文化的影響。

5.循證實(shí)踐Evidence-Based Practice（5學(xué)分）：是指將最佳研究證據(jù)與臨床專業(yè)知識(shí)和患者價(jià)值相結(jié)合，幫助患者做出最佳決策的能力。該課程需要對(duì)某專業(yè)問(wèn)題進(jìn)行全面的檢索并評(píng)價(jià)文獻(xiàn)的質(zhì)量。為了進(jìn)行全面的檢索，老師教導(dǎo)我們使用PICO檢索原則來(lái)構(gòu)建一個(gè)可回答的問(wèn)題，并推薦和講解了一些不同的文獻(xiàn)質(zhì)量評(píng)價(jià)工具。這門(mén)課程需要進(jìn)行PPT匯報(bào)，因此，通過(guò)系統(tǒng)地檢索，我發(fā)現(xiàn)護(hù)理學(xué)生的考試焦慮較其他專業(yè)的學(xué)生更高，但是缺乏有效減輕考試焦慮的證據(jù)總結(jié)，并在這之后完成了“芳香療法是否可減輕護(hù)理學(xué)生考試焦慮”的論文。以前看文章，都不知道從哪些角度去評(píng)價(jià)文章質(zhì)量的高低，通過(guò)對(duì)五篇文章的質(zhì)量評(píng)價(jià)，了解了眾多評(píng)價(jià)工具，自己知道了可以從哪些方面去評(píng)價(jià)一篇文章，從哪些角度去判斷一篇文章的好壞。此外，通過(guò)循證，我們可以去尋找對(duì)臨床問(wèn)題最好的解決辦法，發(fā)現(xiàn)哪些干預(yù)措施有效或無(wú)效，從而減少醫(yī)療成本，使病人得到最好的護(hù)理，提高護(hù)理質(zhì)量。以后還需要繼續(xù)學(xué)習(xí)，在有一定的輸入后能做到輸出一些內(nèi)容。

6. 倫理決策力Ethical Judgment in Professional Leadership（5學(xué)分）：倫理決策力的課程是由兩名老師教授的，一名負(fù)責(zé)從哲學(xué)的角度告知我們關(guān)于患者人權(quán)的內(nèi)容，一位老師則負(fù)責(zé)將這些抽象的哲學(xué)內(nèi)容從行為準(zhǔn)則等方面具體化。這門(mén)課程讓我對(duì)問(wèn)題的思考角度更廣闊。也就是說(shuō)我不再是僅僅是從護(hù)士或醫(yī)療的角度去看待一些臨床問(wèn)題，而是從患者和家屬的角度去思考他們對(duì)于醫(yī)療和護(hù)理的選擇，而且會(huì)更加尊重患者和家屬的決定。此外，通過(guò)該學(xué)習(xí)，我發(fā)現(xiàn)中國(guó)護(hù)理人員在倫理方面的行為準(zhǔn)則要求并不詳細(xì)且側(cè)重點(diǎn)不一樣。愛(ài)爾蘭護(hù)理及助產(chǎn)士管理委員會(huì)頒布的《Code of Professional Conduct and Ethics For Registered Nurses and Registered Midwives》則對(duì)護(hù)士的行為從倫理方面進(jìn)行了規(guī)范，也詳細(xì)指導(dǎo)了護(hù)士及助產(chǎn)士關(guān)于倫理問(wèn)題在臨床上如何做出決策，促進(jìn)了護(hù)士職業(yè)能力的發(fā)展。

7. 護(hù)理信息學(xué)Healthcare Informatics（5學(xué)分）：這門(mén)課程向我們展示了電子健康的發(fā)展和在醫(yī)療環(huán)境中的重要性，也告訴了我護(hù)士在電子健康的發(fā)展和管理中的現(xiàn)況和角色。作為一名護(hù)士，我們不僅僅是電子健康的使用者，我們還可以是開(kāi)發(fā)者。因?yàn)檫@門(mén)課程分為理論和實(shí)踐兩部分，其作業(yè)任務(wù)分為小組作業(yè)和個(gè)人作業(yè)。小組作業(yè)要求我們以小組為單位設(shè)計(jì)一個(gè)APP。我們小組由五名同學(xué)組成，其中包括一名來(lái)自印度的同學(xué)，通過(guò)大家的合作和配合，我們完成了“術(shù)前訪視APP”項(xiàng)目。通過(guò)這個(gè)項(xiàng)目，我了解了APP的制作過(guò)程，雖然我們遇到了很多問(wèn)題，但是通過(guò)我們的合作和密切的溝通，最終解決了那些困難。此外，這門(mén)課程使我對(duì)護(hù)理信息化建設(shè)有了興趣，覺(jué)得自己能通過(guò)更多的方法去提高護(hù)理工作效率，解決臨床護(hù)理問(wèn)題。

8. 畢業(yè)論文Dissertation Project（15學(xué)分）：畢業(yè)論文則是大綜合，是對(duì)我們整個(gè)學(xué)年內(nèi)容的總結(jié)，因?yàn)槠湟笫菍?xiě)一份研究計(jì)劃書(shū)，包含了兩部分：文獻(xiàn)回顧和對(duì)研究問(wèn)題提出可操作的詳細(xì)方案，字?jǐn)?shù)要求為10000字。而且老師在新學(xué)期一開(kāi)始就公布了這門(mén)課程的進(jìn)度要求，我們每個(gè)人需要按照這個(gè)進(jìn)度去完成這個(gè)作業(yè)。在這份計(jì)劃書(shū)里，我需要考慮以下幾個(gè)方面：①研究設(shè)計(jì)：包括研究方法、抽樣等；②理論框架；③倫理考慮。雖然要求高，內(nèi)容多，但是學(xué)校為我們每位學(xué)生安排了一名指導(dǎo)老師協(xié)助我們完成這門(mén)作業(yè)。經(jīng)過(guò)與我指導(dǎo)老師的商量，確定了我的畢業(yè)論文主題為“探討西南某三級(jí)醫(yī)院重癥監(jiān)護(hù)病房護(hù)士心理賦權(quán)與工作倦怠的關(guān)系：橫斷面調(diào)查”。在完成畢業(yè)論文的過(guò)程中，每周我和指導(dǎo)老師會(huì)保持密切的聯(lián)系，除了每次的單獨(dú)討論，我們還會(huì)在郵件里溝通寫(xiě)作情況。老師也會(huì)根據(jù)我的完成進(jìn)度對(duì)我的草稿進(jìn)行修改并給出建議，并安排下一周的寫(xiě)作任務(wù)。我需要閱讀大量的文獻(xiàn)，讓我對(duì)橫斷面研究有了深入的了解，對(duì)我以后的工作有很大的幫助。

三、總結(jié)和展望

在學(xué)習(xí)之余，我看完了《精益醫(yī)療》這本書(shū)，它雖然不厚，但是內(nèi)容很豐富。讓我知道了醫(yī)療是一個(gè)追求精益的職業(yè)。此外，尊重員工，讓員工主動(dòng)參與變革也是其中很重要的內(nèi)容。這也就要求我們要持續(xù)學(xué)習(xí)，接受變化才能不被時(shí)代淘汰。

在學(xué)習(xí)最后，我們有幸參觀了Kerry郡的醫(yī)院，但是為了保護(hù)病人的隱私，我們只能進(jìn)入空的病房。即使這樣，我們也了解了他們的醫(yī)院布局和相關(guān)科室的設(shè)備設(shè)施情況，以及感受到了他們對(duì)病人保護(hù)的強(qiáng)烈意識(shí)，這是非常值得我們學(xué)習(xí)的地方。

在這一年的學(xué)習(xí)過(guò)程中，我時(shí)刻提醒自己要珍惜機(jī)會(huì)，不能浪費(fèi)時(shí)間，努力學(xué)習(xí)，與老師和同學(xué)們建立了深厚的感情，并順利通過(guò)了所有課程，取得了畢業(yè)證書(shū)。通過(guò)一年的脫產(chǎn)學(xué)習(xí)，讓我對(duì)護(hù)理和護(hù)理科研知識(shí)有了較系統(tǒng)的了解。讓我明白了護(hù)理科研與臨床實(shí)踐是相同重要的，他們都是為了促進(jìn)護(hù)理學(xué)科的發(fā)展，為了給患者提供更好地護(hù)理服務(wù)，也提升護(hù)理人員的滿意度。通過(guò)這一年的學(xué)習(xí)，我掌握了文獻(xiàn)檢索策略，文獻(xiàn)管理工具和文獻(xiàn)評(píng)價(jià)工具的使用，知曉了護(hù)理理論的相關(guān)知識(shí)，這些都為我以后的臨床和科研工作提供了幫助。此外，作為科室科研小組的一員，我將所學(xué)的科研理論知識(shí)分享給大家，促進(jìn)大家科研知識(shí)的儲(chǔ)備。我將從以下幾方面開(kāi)展工作：①護(hù)理理論相關(guān)知識(shí)的培訓(xùn)：護(hù)理理論是支撐護(hù)理為護(hù)理學(xué)科的一個(gè)重要方面，了解護(hù)理理論可以更好地指導(dǎo)我們的護(hù)理實(shí)踐?；诖耍覍榇蠹医榻B一些護(hù)理理論，供科室科研小組老師學(xué)習(xí)，為我們的科研發(fā)展提供理論支持，也給大家提供一些資源，讓大家在寫(xiě)標(biāo)書(shū)時(shí)不再為找不到理論支撐而煩惱。②循證護(hù)理培訓(xùn)：這一年的學(xué)習(xí)讓我對(duì)循證護(hù)理知識(shí)有了掌握和了解，循證護(hù)理也是護(hù)理實(shí)踐和科研的重要組成部分。因此，我將給大家分享不同文章類型的評(píng)價(jià)工具，幫助他們?nèi)绾伍喿x和評(píng)價(jià)一篇文章。③在科室成立英語(yǔ)角，為大家英語(yǔ)學(xué)習(xí)提供幫助，提升大家的英語(yǔ)水平。④將對(duì)我們科室的護(hù)士進(jìn)行倫理決策能力的提升培訓(xùn)，提高他們的倫理警覺(jué)，更富有同理心，做到尊重患者，從他們的角度思考問(wèn)題，提升護(hù)理滿意度。

The learning experience of the International Master's Program in Ireland

Deyang People's Hospital Neurological Intensive Care Ward Hu Yue

In June 2022, with the support and help of the hospital and the organization and arrangement of Beijing Huatong Guokang Foundation (BHGF), with the yearning for studying abroad and pursuit of nursing research, I had the honor to participate in the one-year International Master of Nursing study program at Munster Technological University, Ireland. Due to the epidemic, the first half of the study was online in China, and the second half of the study was offline in Ireland. Time flies, a year of time in a twinkling of an eye, looking back on the days of this year, a lot of experience, full of harvest, a lot of feelings. This year's study made me feel the hard-won learning opportunities and the importance of continuous learning, which is thanks to the hospital's encouragement of employees to continue learning. Through this one-year postgraduate study, I have gained a deeper understanding of nursing and nursing research, learned how to judge my clinical practice through reflection, learned to use scientific research knowledge to solve nursing clinical problems, and learned how to use scientific research knowledge to guide our clinical practice, and use evidence-based methods to provide higher quality care for patients. I would like to share with you what I saw, heard, and thought during this year's study.

一、Overview of Ireland

Ireland is an island country located in Western Europe, has a complete education system, leading European countries in terms of education level, and has been widely recognized internationally. In addition, the official language of Ireland is English, so students who travel to Ireland to study do not have to learn other minor languages separately. Nursing education in Ireland is world-renowned.

二、Study in school

Our study was divided into English language learning and professional courses. Although I had passed the language exam before taking the course, the school still arranged a two-month language training before the professional course. The teachers are all full-time teachers from language schools, and the content was similar to IELTS training, including listening, speaking, reading and writing, covering daily communication, food, people, Irish culture and history, and some simple nursing professional situational dialogues. The classes were in a variety of formats, including group discussions, games, PPT speech contests, etc. After class, there would also be homework to consolidate what you learned in class. Through these studies, I deepened my language skills and prepared for later professional courses. Through the language training, I had more understanding and established a deep friendships with classmates. After the start of the professional course, our language course was changed from five days a week to twice a week. Teachers would also change the learning content according to our different learning requirements.

The professional program was divided into two semesters, a total of eight courses. In addition, there was another course called academic support to help us answer any questions about the course and help us complete our studies. Different from Chinese education, teachers had no fixed textbooks, and all the PPT content was intercepted from classic books or literature. In order to help us better understand what the teacher said in class, the teacher would also recommend a lot of literature and professional books for us to read. Each course was judged on a thesis basis and had a word count ranging from 1,500 to 10,000 words.

The four courses in the first semester were nursing Theory, Research Methodology and Project Design, Leadership, and Transforming Practice through Reflection. Due to the epidemic, all of our courses for this semester were online. Two teachers were in charge of each course. Although I passed the language test and language training, it was difficult for me to keep up with the teacher's speech speed at once for a non-native English speaker, so I still used some real-time translation software to help me understand. The four courses in the second semester are Evidence-Based Practice, Ethical Judgment in Professional Leadership, Healthcare Informatics and Dissertation Project. Fortunately, we went to Ireland in the second semester, where we could really feel the classroom teaching. Here are the details of the eight courses:

1. Nursing Theory (5 credits): On the one hand, the teachers let me re-understand nursing from a theoretical perspective. It also made me aware of the importance of nursing theory in the nursing discipline. This course also answers my confusion for a long time, where the theory of many hospital-winning projects comes from. But when I began to study, I was confused, and I also found some videos on Bilibili to help me understand the theory of nursing. Finally, through this course, I knew what is a wide-area theory, middle-area theory, and it is these theories that support the development of nursing as a discipline. Through reading relevant books, I also knew the scope of the application of middle-area theory. Different from wide-area theory, middle-area theory can directly guide the clinical practice and research of nursing. On the other hand, this course aimed to form concepts through the analysis of the causes and consequences of a nursing problem and the detailed analysis of its contributing factors, and finally these concepts merge to form a nursing theory. In this course, the conceptual analysis of "moral distress" was completed by using the eight steps of nursing concept analysis.

1. Research Methodology and Project Design (5 credits): The course explained how to complete a research design from a methodological perspective, but not just the methodology. Because the root cause is the worldview, different worldviews determine different types of research. In terms of research design, the teacher emphasized the importance of theory to research, because qualitative research helped to construct nursing knowledge and help the development of a theory, and quantitative research could verify the theory. The two teachers explained how to complete a study design from the perspective of qualitative research and quantitative research respectively, whose main contents included literature review, research design, ethical consideration, sampling, literature writing, and so on. Through the study, I completed a literature review of ICU nurses' attitudes toward end-of-life care, which is also prepared for my dissertation project in the next semester.

1. Leadership (10 credits): This course helped me distinguish between management and leadership, and explained in detail four types of leadership: servant leadership, authentic leadership, transformational leadership, and collective leadership. Each leadership style has its own strengths, and different leadership has different abilities and requirements for leaders. The course assignment was divided into two parts, and the first assignment was a critical analysis of the sentence "Leadership involves the use of interpersonal skills to influence others to accomplish specific goals". In order to let us finish the homework better, the teacher held group discussions, allowing everyone to express their views and inspire us. The second assignment was about how leaders face the opportunities and challenges of today's society so that members of the organization feel that they are valued and empowered. Through the study of the course, I learned that each leadership style plays a different role in organizational practice, we needed to adopt different leadership styles according to the current situation of the organization to help each member actively participate in the work, so as to promote the change and development of the organization, to face the opportunities and challenges in today's society.

1. Transforming Practice through Reflection (10 credits): When I saw the name of the course, I thought that this reflection was the same as our usual reflection, but I found that it was very different after learning. This course taught me the important role of critical emancipatory reflection in nursing practice and used the Taylor model to help me reflect on past practices. The course was conducted through teacher lectures, seminars, and PPT presentations. Through these methods, I completed the paper "Emancipatory Reflection on the Sustainable Development of NCU Nurses". The Taylor model led me to realize that my actions were influenced not only by myself but also by the environment, society, and culture where I live in.

1. Evidence-based (5 credits): The ability to combine the best research evidence with clinical expertise and patient value to help patients make the best decisions. This course requires a comprehensive search and evaluation of the quality of literature on a professional issue. To conduct a comprehensive search, the teacher taught us to use the PICO retrieval principle to construct an answering question and recommended and explained a number of different literature quality evaluation tools. This course required PPT presentation, so, through a systematic search, I found that nursing students had higher test anxiety than students in other majors, but there is a lack of evidence summary to effectively alleviate exam anxiety, and then completed the paper "Does aromatherapy can reduce nursing students' exam anxiety". In the past, I did not know from what angle to evaluate the quality of the article, through the quality evaluation of the quality of the five articles, I learned about many evaluation tools and knew from what aspects to evaluate an article and judge the quality of an article. In addition, through evidence-based research, we can find the best solution to clinical problems, and find out which interventions are effective or ineffective, thus reducing medical costs, providing the best care and improving nursing quality for patients. In the future, we still need to continue learning and to output some content after certain inputs.

1. Ethical Judgment in Professional Leadership (5 credits): The course was taught by two teachers, one is responsible for informing us about patients' human rights from a philosophical perspective, while the other teacher focuses on making these abstract philosophical concepts more concrete through ethical code, guidelines and behavior standards. This course broadened my thinking perspective on issues. That is to say, I no longer just approach clinical issues from a nursing or healthcare perspective, but consider the choices and decisions made by patients and their families, and I will respect the decisions of patients and their families more. In addition, through this study, I found that the ethical code of conduct for Chinese nursing professionals is not as detailed and focused as those for Irish nursing and midwifery professionals. “The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives” issued by the Irish Management Council of Nursing and Midwives regulates the ethical behavior of nurses and also guides nurses and midwives on how to make clinical decisions on ethical issues, which promotes the development of nurses' professional competence.

1. Healthcare Informatics (5 credits): This course showed us the development of e-health and its importance in the medical environment. It also taught us the current status and role of nurses in the development and management of e-health. As a nurse, we are not just users of electronic health, we can also be developers. The course was divided into theoretical and practical parts, with group and individual assignments. The group work required us to design an APP as a team. Our group was composed of five students, including one student from India. Through our cooperation and coordination, we completed the "Preoperative Visit APP" project. Through this project, I learned about the process of making an APP. Although we encountered many problems, we finally solved those difficulties through our cooperation and close communication. In addition, this course made me interested in the construction of nursing information, and I think I can improve the efficiency of nursing work and solve clinical nursing problems through various methods.

1. Dissertation Project (15 credits): It is a comprehensive summary of the content we have learned throughout the year. It required us to write a research plan, including two parts: a literature review and a detailed plan for addressing research questions, with a word count requirement of 10,000 words. In addition, the teacher announced the schedule requirements of this course at the beginning of the new semester, and each of us needed to complete the homework according to this schedule. In this plan, I needed to consider the following aspects: ① Research design: including research methods, sampling, etc.; ② theoretical framework; ③ ethical considerations. Although the requirements were high and the content was extensive, the school has arranged a supervisor for each student to assist us in completing this assignment. After consulting with my supervisor, the theme of my thesis was determined. It was "To Investigate The Relationship Between Psychological Empowerment And Job Burnout Among Intensive Care Unit Nurses At A Tertiary Hospital In Southwest China: A Cross-Section Survey". In the process of completing the graduation thesis, I kept a close contact with the instructor every week, in addition to individual discussions, we also communicated about the writing situation through email. The supervisor would also modify my drafts and provide suggestions based on my progress, and arrange the writing task for next week. I needed to read a lot of literature so that I had a deep understanding of cross-sectional research, which will be of great help to my future work.

三. Summary and outlook

In my spare time, I finished reading the book "On The Mend" which is not thick, but very rich in content. This book let me know that medical care is a profession that pursues leanness. In addition, respecting employees and allowing them to actively participate in change is also an important part. This also requires us to continue to learn, to accept the change is not to be eliminated by the Times.

At the end of the study, we had the honor to visit the hospital in Kerry County, but to protect the privacy of the patients, we had to enter the empty wards. Even so, we also learned about their hospital layout and the equipment and facilities of related departments, as well as feel their strong awareness of patient protection, which is very worthy of our learning.

In this year, I always remind myself to cherish the opportunity, not to waste time, to study hard, and established a deep relationship with teachers and students, and successfully passed all the courses and obtained the graduation certificate. Through a year of off-job study, I have a more systematic understanding of nursing and nursing scientific research knowledge. This study make me understand that nursing research and clinical practice are equally important, they are all to promote the development of nursing discipline, in order to provide better nursing services for patients, and also improve the satisfaction of nursing staff. Through this year's study, I have mastered the use of literature retrieval strategies, literature management tools and literature evaluation tools and known the relevant knowledge of nursing theory, these have provided help for my future clinical and scientific research work. In addition, as a member of the nursing research team of the department, I will share the theoretical knowledge of scientific research with my colleagues to promote the reserve of their research knowledge. I will carry out the work from the following aspects: ① nursing theory related knowledge training: nursing theory is an important aspect of supporting nursing for the nursing discipline, understanding the nursing theory can better guide our nursing practice. Based on this, I will introduce some nursing theories to our research group of the department to learn, provide theoretical support for our nursing research development, and provide them with some resources, so that they will no longer worry about finding theoretical support when writing project plan.② Evidence-based nursing training: this year's study make me master and understand of evidence-based nursing knowledge, evidence-based nursing is also an important part of nursing practice and research. So I'll share with our colleagues different article type evaluation tools to help them with how to read and appraise an article.③ Set up an English corner in the department to help our colleagues learn English and improve their English level.④ The nurses in our department will be trained to improve their ethical decision-making ability, improve their ethical vigilance, have more empathy, respect patients, think about problems from patients and their families’ perspective, and improve nursing satisfaction.

和英語(yǔ)老師合影 和護(hù)理信息學(xué)老師合影 課后討論

循證作業(yè)選題匯報(bào) 學(xué)校圖書(shū)館一角 參觀ICU

日間病房 與導(dǎo)師合影