Developing information literacy: a key to evidence-based nursing

This report describes the evaluation of a curriculum-integrated programme designed to help students develop an awareness of the nursing literature, the skills to locate and retrieve it, and skills required in its evaluation; in other words'information literacy'. Positive changes in student performance on objective measures of information-literacy skills were revealed as well as a significant increase in the levels of confidence of the student in performing those skills. Students who had undertaken the information-literacy programme ('programme' students) performed better on a range of objective measures of information literacy, as well as reporting higher levels of confidence in these skills, than students who had not participated in the programme ('non-programme' students). Evaluation of this programme provides evidence of the potential usefulness of a curriculum-integrated approach for the development of information-literacy skills within nursing education. With these underlying skills, students will be better equipped to consolidate and extend their key information-literacy skills to include research appreciation and application. These are vital for effective lifelong learning and a prerequisite to evidence-based practice.     

Entering a World with No Future: A phenomenological study describing the embodied experience of time when living with severe incurable disease

Scand J Caring Sci; 2013; 27; 165–174 A phenomenological study describing the embodied experience of time when living with severe incurable disease This article presents findings from a phenomenological study exploring experience of time by patients living close to death. The empirical data consist of 26 open‐ended interviews from 23 patients living with severe incurable disease receiving palliative care in Norway. Three aspects of experience of time were revealed as prominent: (i) Entering a world with no future; living close to death alters perception of and relationship to time. (ii) Listening to the rhythm of my body, not looking at the clock; embodied with severe illness, it is the body not the clock that structures and controls the activities of the day. (iii). Receiving time, taking time; being offered – not asked for – help is like receiving time that confirms humanity, in contrast to having to ask for help which is like taking others time and thereby revealing own helplessness. Experience of time close to death is discussed as an embodied experience of inner, contextual, relational dimensions in harmony and disharmony with the rhythm of nature, environment and others. Rhythms in harmony provide relief, while rhythms in disharmony confer weakness and limit time.     

Students'' expectations of postregistration degree programmes

The needs of postregistration students pursuing degree-linked clinical courses have received little attention and there are few insights concerning their aspirations when they enrol on such courses. Thus the aim of this study was to explore postregistration students' perceptions of the specific needs of their patient/client group and to examine how they envisaged the course on which they had just enrolled might help them to meet these needs in addition to their own requirements for professional and personal development. Data were collected by group interview from 62 students enrolling on eight different postregistration courses, all employed in an acute hospital trust. The results were analysed inductively. They indicated that students had internalized the state of the healthcare market and were keenly aware of the need to fulfil the expectations of employers and the public, while fulfilling their own needs for education and pursuing their own professional and career trajectories. They appeared ambitious and yet appeared to demonstrate empathy for patients and their families and felt a tremendous desire to provide care of a high quality through the optimal development of technical expertise. Students' emphasis on the importance of keeping abreast of technological developments should not be lightly dismissed considering its prominent position within the acute areas where they were employed, especially as it did not replace their desire to promote the caring aspects of their work.     

From educational philosophy to educational practice: fidelity and the curriculum in context

As part of a higher degree on research methods, exploratory work was undertaken concerning educational philosophy and educational practice using an ethnographic approach. This author discusses, using this exploratory work, the difficulties of attempting fidelity to an educational philosophy, through curriculum practice. Schools of nursing are increasingly adopting a rational approach to education, without considering the wider social context within which education occurs. The attempt to establish and pursue a single philosophy, ignores the plurality of ideological commitments held by nurse teachers. Further research is proposed using naturalistic methods in order to understand the processes of interpretation and implementation of educational philosophy.     

The rhizome and the tree: a response to Holmes and Gastaldo

Abstract  This paper both welcomes and explores the recent article in Nursing Philosophy by Dave Holmes and Denize Gastaldo. Holmes and Gastaldo's paper introduced us to Deleuze and Guattari's philosophical concepts of 'arborescent thought' and 'rhizomatic thought', respectively. These concepts were used to illuminate and critique certain aspects of contemporary nursing theory and educational practice. Arborescent thought is held to stifle and constrain the development of the discipline of nursing, while rhizomatic thought is presented as a more fitting way forward across a diversity of knowledges and methods of inquiry. We are thus urged to engage in a metamorphosis from an arborescent way of thinking to a rhizomatic one. The paper below, while applauding the introduction of these concepts into nursing thought, raises some questions as to their proposed utility and relationship as given in the paper by Holmes and Gastaldo. This is done in a spirit of collaboration, motivated by a desire to further explore the philosophy of Gilles Deleuze (and Felix Guattari).     

Self-sacrifice, self-transcendence and nurses' professional self

Abstract  In this paper I elaborate a notion of nurses' professional self as one who is attracted towards intrinsic value. My previous work in 2003 has shown how nurses, who see intrinsic value in their work, experience self-affirmation when they believe that they have made a difference to that which they see to have value. The aim of this work is to reveal a further aspect of nurses' professional self. I argue that nurses' desire towards that which they see to have intrinsic value, is a necessary and self-transcending aspect of a nurses' professional self. I argue further that nurses' desire towards intrinsic value inevitably involves their vulnerability. Nurses who see intrinsic value are shown to be vulnerable to self-sacrifice in their inclination to work for the good of their patients, at the expense of themselves. Yet an ability to transcend their self in this way remains a necessary aspect of a nurse's professional self, which requires nurture and support through nurse education.     

Listening as a method of addressing psychological distress

Aims  This paper discusses the values of therapeutic listening and ways that emotional difficulties can impact palliative nurses' abilities to provide psychological care.
Background  Recent literature indicates that providing psychological care can burden some healthcare professionals including nurses; who may lack the necessary competencies or organizational resources to carry out their roles.
Evaluation  References drawn from the databases: all EBM reviews, BRITISH NURSING INDEX, CINAHL, PSYCH INFO and MEDLINE and EMBASE are discussed.
Key issues  Psychological care is considered critical to providing holistic care. Yet the literature suggests engaging in such work makes emotional demands on the professionals attempting to carry it out and is associated with psychological difficulties including burnout.
Conclusion  Clinical supervision can help reduce the distress caused by emotionally charged situations. Thoughtful clinical supervision can also contribute to safe and effective health care.
Implications for Nursing Management  Nursing would benefit from understanding more about the effects on healthcare professionals of repeated exposure to emotionally charged situations and benefits that clinical supervision can offer to health care.     

Health care managers' perspectives on new nursing and midwifery roles: perceived impact on patient care and cost effectiveness

Aims  The aim of this study was to explore new nursing and midwifery roles and associated levels of practice from the health care providers' perspective. This paper will present findings relating to the perceived cost effectiveness of these roles and their impact on patient care.
Background  Profound changes in the way the health care systems are organized, managed and financed have resulted in the proliferation of new nursing and midwifery roles. However, the evidence base for these workforce developments is limited, especially with regard to health care providers' perspectives on cost effectiveness and patient outcomes.
Method  Qualitative interviews were carried out with all Directors of Nursing in the 18 Health and Social Services (HSS) Trusts and the Chief Nurses and Directors of Primary Care in the four HSS Boards in Northern Ireland.
Results  Key findings were as follows: there was widespread support for the development of these roles, they are perceived to have a positive impact on patient care; however, the need for support was recognized to ensure the continuation of such roles. Securing funding was problematic and this was influential on the kind of new roles that were developed.
Implications for Nursing Management  Issues relating to effective implementation and the need for further research into the efficacy and effectives of such initiatives is required.