Analysis of job-share as a process of change

This paper describes the introduction of a district nursing job-share in a primary health care team. Exploring change theory and different strategies for organizational change, the implications for members of the team are considered. In addition, changes in the balance of power which resulted in conflict within the district nursing team are discussed.     

Trusting patients, trusting nurses

Abstract  The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier's requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and 'trust pretenders' on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist.     

Developing nurse practitioners to develop practice: the experiences of nurses working on a Nursing Development Unit

Aim To elicit nurses' accounts of their involvement with nursing research and their interpretations of the meaning of these projects for their practice.
Background The links between research and practice development in health care are poorly understood and require further exploration in the light of the emerging research and development agenda within the National Health Service.
Methods Semi-structured interviews were conducted with 15 qualified nurses working on a Nursing Development Unit. The interviews were tape recorded, transcribed and analysed thematically.
Findings Data analysis identified two distinct groups—a core group of nurses actively engaged in the research projects and a peripheral group involved in data collection. The characteristics of the core group mirror the characteristics of those involved in non-research-based practice development activities.
Conclusions Engaging in research activities does not always result in the development of practice, however, there appears to be a link between practice development and critical thinking.     

‘Listening to Patients’: what is the value of age‐appropriate care to teenagers and young adults with cancer?

MARRIS S., MORGAN S. & STARK D. (2010) European Journal of Cancer Care 20 , 145–151 ‘Listening to Patients’: what is the value of age‐appropriate care to teenagers and young adults with cancer? Current healthcare policy increasingly recognises the importance of patient experience in determining care. The 2005 UK National Institute for Health and Clinical Excellence Improving Outcomes Guidance encompasses caring for young people with cancer in an age‐appropriate model of care developing regional principal treatment centres for this purpose. When published this was based upon limited outcomes evidence, and only a small amount of teenage and young adult patient and parent opinion. We have systematically reviewed the literature between 1996 and 2008, examining how far the experiences of this patient group support or refute the current policy. The recent literature describes with increasing consistency that teenage and young adult cancer patients have specific care needs, and gain benefits from an age‐appropriate environment of care, including peer group support, age‐appropriate information, recreational and vocational support, and staff expert in both the cancer and care of their age group. Many patients are prepared to travel to receive such care, if services are not in place to deliver excellent shared care between principal treatment centres and services nearer home. Some of these needs are unmet in non‐specialist units. There remains, however, a paucity of rigorous comparative studies quantifying the value of specialist cancer care for this patient group.     

Hardship, dedication and investment: an exploration of Irish mothers commitment to communicating with their children with cerebral palsy

This qualitative study investigated the experiences of mothers who have a child with communication difficulties resulting from cerebral palsy (CP). There is a dearth of information about parents' experiences of having a child with CP and communication difficulties. Three participants, whose children had moderate or severe CP and communication difficulties, were recruited from a voluntary organization. Participants were interviewed using an in-depth, semi-structured interview guide. Interviews were audio-recorded, then transcribed and subsequently analysed using Grounded Theory methods. Five main themes emerged, combining to form the core category of mothers dedicating their attention to their children . The information gleaned from this study could have important implications for nurses involved in facilitating communication, including speech and language therapists, occupational therapists and registered nurses. By becoming more aware of the experiences of parents with a child with CP and communication disorders, nurses may be better able to plan and implement therapy and also support communication aims. The study concludes with a discussion of further research avenues, suggesting that a study investigating the experiences of parents of children with other types of physical disabilities affecting communication should be conducted to determine the similarities and differences of parents of children with other kinds of disability. A similar study with a larger sample could be conducted to validate the findings of the current study.     

The growing role of football as a vehicle for interventions in mental health care

In recent years there has been a growing interest in the use of football as a vehicle for mental health interventions. This paper outlines some of the ways that mental health service providers have begun to develop strategies with football clubs, the Football Association and government departments that involve playing or watching football and placing mental health services in football clubs. The paper also looks at how some attempts are being made at regional and national levels to develop and bring together services that use football as a vehicle for mental health service delivery.     

Use of educational games in the health professions: A mixed-methods study of educators' perspectives in the UK

Educational games have been shown to be effective in supporting learning, especially to reinforce knowledge, and students are generally positive about the use of games. The aim of this mixed-methods study that was conducted in the UK was to explore educators' views towards the use of educational games in the health sciences. The data were collected via semistructured interviews with 13 health educators and an online survey that was completed by 97 health educators. Three factors influence the use of classroom games: reflective practice, the impact of games on students, and the impact of logistical factors. Educators assess their own performance and the impact of the games on students when planning their use; however, large classes and the need for preparation time have a negative impact on educators' willingness to use games. Similar constraints might restrict the use of active learning strategies, such as simulation, that are crucial for enabling health professionals to develop competence. These issues require consideration when planning educational methods.     

A historical perspective on maternity services and the Leicester Royal Infirmary Approach to the Winterton Report's Recommendations

The House of Commons Select Committee 2nd Report on Maternity Services (1992) provides recommendations to the future structuring of Maternity Services. The explicit messages provided by this report indicate that services should be woman centred, placing the Midwife as the Central Care Provider. Politically this places midwives in a strong position to lead future maternity services. The current culture that maternity services are operating needs to be examined by Managers before the recommendations can become operational policy. Attention also needs to focus on those elements of practice and organization that currently meet the report's recommendations. This is essential to ensure that any re-organization required builds upon the strengths within maternity services whilst addressing the weaknesses. At Leicester Royal Infirnlary the development of a Midwifery Managed Service has evolved over a period of 5 years. The developments at this Unit have provided foundations to take the Winterton Committee's recommendations forward in a positive structured process that will guarantee consumer controls whilst establishing midwives as leaders in maternity service provision.