The place of research and development in nurse education

The National Health Service (NHS) document Research for Health , a research and development strategy for the NHS, provides a starting point to explore the place of research and development in nurse education The thesis focuses on whether research and development in nurse education is the concern of education or nursing Some parallels are drawn between nursing and teaching A way forward for the realization of a place for research and development in nurse education is suggested     

Conflicting paradigms of health visiting: a continuing debate for professional practice

The interpretation of health visiting practice has formed the focus of a professional debate amongst practitioners and those involved in health visiting education for many years. More recently, changes in nurse education, government legislation and general anxiety about the future of health visiting have added to the intensity of the debate. In re-examining the conceptual origins of health visiting, this paper proposes one possible explanation for this phenomenon in which the author describes four conflicting paradigms of practice. The author argues that it is the tendency of practitioners to adopt one specific paradigm of practice which has contributed to the continuing debate and current professional uncertainty experienced by health visitors. The authors goes on to suggest a conceptual framework for practice developed from an epistemology of practice grounded in reflection in practice and the principles of health visiting. It is argued that this approach to practice allows practitioners to reconsider their practice in terms of the values and beliefs underpinning health visiting rather than identified tasks and client groups. It may also provide practitioners with the opportunity of developing and adapting strategies to meet current health needs rather than the traditions of practice.     

Patient participation in psychiatric services: a literature review and proposal for a research strategy

There is a trend in nursing policy and practice towards patients participating actively in their treatments and the services they use. Nursing theorists often attempt to describe the phenomena of patient participation from a psychological perspective while neglecting sociological issues, such as power, ideology and moral status. This paper commences by examining policy and ethical issues in relation to patient participation. Studies examining immediate patient participation, for example active participation in treatments, and distant patient participation, namely participation in psychiatric service planning, are then reviewed. Various settings of psychiatric services are examined, including the initial interview, primary health care, hospitalization and clinical innovation, in order to uncover common themes. These studies often fail to pay attention to the patient's experience of participation, even when clinically innovative schemes are being described, and also fail to develop hypotheses and theories about participation. The importance of a sociological perspective in future studies is indicated. The author concludes that psychiatric patients want a more active role in treatments and service planning, and that psychiatric clinicians, including nurses, find more active patient participation threatening. Nevertheless, there is evidence of more rewarding alliances being formed between patients and nurses in some settings. The nurse's role in democratizing psychiatric services, thus permitting greater patient participation, while fulfilling statutory obligations is a considerable challenge to nursing practice in the future. This paper concludes by discussing some current limitations of nursing research and the value of some ideas taken from critical theory, in particular reflection, dialogue and praxis, as a practical basis for social action and nursing research.     

Empowerment in welfare markets

The NHS and community care reforms have been promoted as a means of boosting efficiency and making services more responsive to clients. The government has urged health and social services to establish processes by which clients’ views are identified but with no firm requirement that these are prioritized within the commissioning process. Whilst it is expected that the NHS and local authorities will respond to government exhortations, this paper suggests that there are compelling political, financial and organizational reasons why the opportunities for power sharing may differ between the two types of authority.     

Towards a model of the expert practice educator – interpreting multi-professional perspectives in the literature

The health and social care professions all rely on the use of practice placements for a substantial element of their pre-qualifying professional education, and these practice-based professions have roles for existing practitioners to oversee the education and training of students when they are on practice placements. Practice educators play a vital role in the development of new practitioners and also in the development and perpetuation of professional values and standards. In this paper, we argue that the practice educator role is thus fundamentally an ethical function, requiring moral commitment from the practice educator but also playing a critical role in maintaining the ethical values of the profession.