1,721,019 research outputs found
Researching the implementation of pioneering roles in nursing and midwifery
No full textThis paper presents research on the implementation of pioneering roles in nursing and midwifery in the United Kingdom—namely lecturer practitioners, consultant nurses and nurse registrars. It seeks to critique the empirical insights gained from studying new roles aimed at better integrating distinct aspects of nursing and midwifery, at solving long-standing ‘problems’ in nursing and midwifery, at extending traditional roles and at improving and advancing practice, education and research. The paper draws upon knowledge derived from three empirical projects—an ethnographic study and survey of the role of lecturer practitioners, conducted in one setting in the UK (Lathlean, 1997), a study of the role of consultant nurses within healthcare Trusts (Lathlean and Masterson, 2004) and an action-based evaluation of an innovative work based pilot training programme for the development of nurse registrars as aspiring consultant nurses (Surridge and Lathlean, 2006). The paper sets these within the context of an extensive literature on lecturer practitioners and consultant nurses, and encompasses both a national and international perspective through the inclusion of UK, North American and Australian experiences. The theoretical understandings gleaned from these studies include the apparent inevitability of certain challenges in new roles such as role ambiguity and role overload, the need for organisational commitment to establish and sustain such roles, the variability of roles and the uncertainty as to the achievements of these posts or, at the very least, the extent to which these achievements can be measured. Conclusions drawn include the value of longitudinal studies over short-term cross-sectional research, incorporating approaches that reflect the diversity of the roles; the complexity of ascertaining role impact; and the value of undertaking a qualitative meta-analysis or meta-ethnography of existing studies
Family history of premature cardiac heart disease: exploring the experience
No full textEvidence confirms that a family history of coronary heart disease is an independent risk factor for coronary heart disease. Having a close family relative diagnosed with heart disease has lasting implications and repercussions for the family. This qualitative study aimed to explore the issues and challenges that people face when aclose relative is diagnosed with heart disease and their own future risk for developing heart disease subsequently increases. Using narrative enquiry, participants told their stories associated with this event. They spoke about the period leading up to the diagnosis and what happened during this acute phase; they described the processof coming to terms with this diagnosis and how it has affected them and their family. This study shows how awareness of key issues associated with this group of people may have the potential to enhance preventive strategies
Using action research to stimulate organisational change within health services: experiences from two community-based studies
No full textThe relevance of action research to organisational change within contemporary health services in the United Kingdom is discussed in this article. Two examples of collaborative community-based studies are presented: one exploring ways to encourage community participation within a health and regeneration programme and the other considering the types of knowledge used within a ‘community of practice’ to develop services for older people. The studies highlight the value of action research in bringing together citizens and health professionals to reflect on practice and to explore ways of improving service delivery. The article concludes that such ‘time-out’ is important in supporting staff to internalise and shape processes of change. Furthermore, the forum which action research provides to bring staff and citizens together to plan, reflect on and evaluate their actions helps not only to develop services but also to challenge some of the traditional organisational processes which have excluded users and citizens
Technician or artisan? Nurses’ experience of practising within a randomised controlled trial.
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Service user involvement in giving mental health students feedback on placement: a participatory action research study
Full text linkBACKGROUND: Although the drive to engage service users in service delivery, research and education has mainstream acceptance, it is not easy to achieve meaningful involvement. The contribution that could potentially be made by users whilst accessing services is often overlooked.OBJECTIVES AND PARTICIPANTS: This study involved stakeholders (mentors, service users and a lecturer) working together to design, evaluate and refine a system enabling students to seek feedback from service users. The feedback concerned mental health students' interpersonal skills and occurred whilst on practice placement. This research aimed to explore the experiences of those concerned when nine students attempted to learn from rather than about service users.DESIGN: A 2-year study, encompassing five cycles of participatory action research (PAR).SETTING: A small island community in the British Isles, adopting UK standards for pre-registration nurse education.METHODS: Data came from interviews with service users and mentors and a series of reflective group discussions with students who volunteered to try out the feedback mechanism. The deliberations of the PAR stakeholder group informed the research cycles and added to the data, which were subject to thematic analysis.FINDINGS: Findings indicated that service users volunteering to give feedback had unanimously positive experiences. Students' experience lay on a continuum: those with a stronger sense of self were more willing and able to ask for feedback than less confident students. Cultural adjustment to the role change needed was challenging, requiring self-awareness and courage. Over time, all students achieved deep learning and, for some, learning appeared transformative.CONCLUSION: Although contextual, the study concluded that the feedback initiative encouraged the development of more equitable relationships, in which mental health nurses respected the expertise of service users. This potentially benefits student development, recovery-orientated practice, service users and HEIs searching for meaningful ways to involve service users in learning and formative assessment<br/
The ‘ascent to competence’ conceptual framework: an outcome of a study of belongingness
No full textAimThis paper presents qualitative findings from a study that explored nursing students' experience of belongingness when undertaking clinical placements. The aim is to locate the professional and practical implications of the research within an Ascent to Competence conceptual framework.Background The need to belong exerts a powerful influence on cognitive processes, emotional patterns, behavioural responses, health and well-being and failure to satisfy this need can have devastating consequences. The literature suggests that diminished belongingness may impede students' motivation for learning and influence the degree to which they are willing to conform rather than adopt a questioning approach to clinical practice.Design A mixed methods, cross national, multi-site case study approach was adopted with third-year preregistration nursing students from three universities (two in Australia and one in England) participating; 362 in the quantitative phase and 18 in the qualitative phase.FindingsQualitative findings demonstrated that, although the primary purpose of clinical education is to facilitate students' progress towards the attainment of competence, the realisation of this goal is impacted by a wide range of individual, interpersonal, contextual and organisational factors which can be conceptualised hierarchically. By this structuring it is possible to see how belongingness is a crucial precursor to students' learning and success.Conclusion The framework demonstrates that students progress to a stage where attainment of competence is possible only after their previous needs for safety and security, belongingness, healthy self-concept and learning have been met.Relevance to clinical practice. The future of the nursing profession depends upon the development of confident, competent professionals with a healthy self-concept and a commitment to patient-centred care and self-directed learning. This paper demonstrates that the realisation of this goal is strongly influenced by the extent to which students' clinical placement experiences promote and enhance their sense of belonging
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