Patient participation: its meaning and significance in the context of caring

The ideal that patients should be participants in their own care has found wide acceptance amongst nurses. Yet within the academic discipline of nursing little has been done to clarify the nature of participation. In this paper, a phenomenology of participation is presented as it applies to the caring work of nursing. Participation requires: (a) attunement to a mutual 'stock of knowledge at hand'; (b) emotional and motivational attunement to the other's concerns; (c) taking for granted (and implicitly assuming the other takes it for granted) that one can contribute worthily; (d) feeling that one's identity is not under threat. Though it is difficult to attain, participation appears to embody many of the ideals central to current thinking in nursing. Moreover, the attempt to build participatory relationships with patients is ethically required of members of a 'caring' profession.     

Intuition: a critical review of the research and rhetoric

This paper will explore the concept of intuition in nursing from an acute care and community nursing perspective. It will consider definitions of intuition and examine the research which can inform our understanding of this important component of decision making. In the current health service climate, which demands measurable research-based evidence, the involvement of intuition as an element of judgement is often denigrated. The result is that many nurses are being forced to be covert in their use of this crucial aspect of judgement and focus solely on the conscious elements of decision-making. However, research evidence would suggest that intuition occurs in response to knowledge, is a trigger for action and/or reflection and thus has a direct bearing on analytical processes in patient/client care. The authors therefore argue that the essential nature of intuition cannot be ignored in the practice, management, education and research of nursing.     

The changing academic role of the nurse teacher in the United Kingdom

This paper presents findings from a national study conducted over a 3-year period (1991–94) which examined the changing role of the nurse teacher The study used multiple methods to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) This paper presents the findings relating to the development of the nurse teacher's academic role following the introduction of Project 2000 The issues presented and discussed include specialization within the nurse teacher's role, the nature of this specialization and the development of academic credibility and scholarship The implications of these changes in terms of the development of nursing as an academic subject area and the opportunity to contribute to the establishment of research based practice are explored     

Does the distinction between killing and letting die justify some formsof euthanasia?

Nurses will often be at the forefront in a health care team which decides that it is ethically acceptable to allow a particular patient to die butthe possibility of actually killing another patient who requests his own death is met with heartfelt resistance This paper explores the distinction between killing and letting die and the connection these arguments have withjustifications for euthanasia Two practical examples of killing and lettingdie are analysed Various issues are examined including the active-passive distinction, the difference between causing and preventing a death and the probability of outcome Justifications for euthanasia are then revisited and some concluding remarks made     

A qualitative evaluation of the post accident notification system to health visitors

Childhood accidental injuries are a major public health problem, whether measured in terms of morbidity or mortality, and accident prevention is subsequently a priority issue The Accident and Emergency Notification System to health visitors provides them with vital information and statistics with which to plan accident prevention work, both on an individual basis or in group work This small study aimed to look at this system from the health visitor's perspective and explore the action taken The grounded theory approach was used to uncover the processes used by the health visitors Data were collected using unstructured interviews and by writing notes These were transcribed on the same day as recorded Nine categories were identified and an analysis of the processes involved when receiving the notification slip is presented The categories included'knowing the family','age and development','pressure of work'and'gut feeling/extra sensory perception'This study is a small contribution to our understanding of the processes involved in everyday health visiting practice     

Project 2000: a review of published research

The findings of research into the implementation of the Project 2000 reforms of nurse education in England and Wales are reviewed in this paper The work of nine research teams who have published their findings between 1990 and 1994 is reviewed Following a brief summary of the major Project 2000 recommendations, the findings of the various research teams are presented Both successes and difficulties in implementing Project 2000 are highlighted The findings are discussed in the light of the original Project 2000 proposals, and it is concluded that, notwithstanding'teething'difficulties, the Project 2000 reforms are proving workable in practice