1,722,219 research outputs found
Different ways of thinking about patients in critical care: an ethnographic study
No full textNursing is argued to have a characteristic focus on the whole person (Royal College of Nursing 2003), yet it is known that critical care nurses may experience moral distress arising from the difficulty they experience in thinking about patients as persons ( Lawrence 2011). This paper presents findings from an ethnographic study undertaken within one critical care unit in the United Kingdom which examined how critical care nurses do think about patients. Data were collected through participant observation and interview over a period of 8 months during 2006 to 2007. Seven critical care nurses participated in the study. Data analysis adopted the perspective of linguistic ethnography. Participants thought about patients in seven ways, each of which was associated with a pattern of nursing practice that was essential to the delivery of safe and effective care. Despite the essential role played by these patterns of practice, critical care nurses themselves characterised it as ‘impersonal’ and not ‘nursey’ to think about patients as ‘routine work’, as a ‘set of needs’, as a ‘body’, as ‘(un)stable’ or as a ‘medical case’. Participants therefore struggled to describe, reflect upon or celebrate the practice associated with these ways of thinking. These findings reveal a dissonance between the expectation that nurses should think about patients as persons, and the fact that critical care nurses are required to think about patients in many ways. This is a potential source of distress to critical care nurses, and is of wider significance given that emotional exhaustion and burnout can arise from disparity between nurses’ ideals and the realities of care (Maben et al. 2007). It is concluded that nursing leaders, scholars and policy makers must recognise and legitimise the fact that that nurses think about patients in many different ways<br/
A linguistic perspective on “whole person” care: challenges for healthcare ideals and nursing identity
No full textHealthcare policy suggests that the quality of healthcare is dependent upon practitioners thinking about patients as “whole persons”, whilst a focus on the whole person is frequently argued to be particularly characteristic of nursing practice. This presentation highlights findings from an ethnographic study undertaken within one critical care unit in the United Kingdom which examined how critical care nurses do think about patients. A purposive sampling strategy recruited 7 participants representing both experienced and inexperienced critical care nurses. Data were collected over a period of 8 months during 2006 to 2007, and primarily comprised the field notes from 92 hours of participant observation supplemented by 13 tape recorded interviews. Data analysis was influenced by Foucault and Goffman and adopted the perspective of linguistic ethnography. Analysis revealed that all participants thought about patients in seven distinct ways: as ‘social beings’, as ‘valued individuals’, as ‘routine work’, as a ‘set of needs’, as a ‘body’, as ‘(un)stable’ or as a ‘medical case’. Drawing on the work of Polanyi, an interpretation of these findings makes clear that whilst practitioners may have a tacit understanding that these different ways of thinking relate to aspects of one coherent whole, they may not at any moment in time be described as thinking about this ‘whole person’. This presentation particularly focusses upon a secondary set of findings from this study which related to the ways in which nurses talked about their practice. Analysis of interview data made clear that, in maintaining their identities as nurses, participants’ could only legitimately talk about themselves as giving care to persons. Participants characterised some of the ways in which they had to think about patients as impersonal, and this actively hindered these nurses from describing or reflecting upon elements of their practice. There is therefore conflict and dissonance between nurses’ expectation that they should think about patients as persons, and the fact that delivering nursing care requires them to think about patients in different ways. These findings demonstrate that quality in healthcare practice may not be guided or explained by the idea that practitioners should think about patients as persons, but rather that expert practice is characterised by moving fluidly and appropriately between different ways of thinking about patients. There is therefore conflict and dissonance between the (nursing?) ideals of delivering care to persons, and the fact that practice requires practitioners to think about patients in different ways. This is of major significance given that dissonance between practitioners’ ideals and the realities of care delivery is a primary cause of burnout or moral distress. It is concluded that there is a need for scholarship and healthcare policy which articulates a vision of person centred care clearly, and in ways which avoid constructing dissonance between professional ideals, and the ways in which practitioners do and must think about patient
Reflexivity, the ‘ethnographic vignette’ and the (rehabilitation of the?) research interview
No full textThis presentation will explore ways in which approaches from LE have informed the analysis and integration of different forms of data collected during an ethnographic study examining the practice of intensive care nurses.Within this research environment it was not possible to obtain the audio or video recordings of naturally occurring interaction that is typical of LE approaches. The research has therefore drawn upon ethnographic field notes and audio recorded research interviews as the primary forms of data. This presentation will focus on how linguistic approaches have informed the analysis and integration of these forms of data. The presentation will briefly explore three interrelated problems / challenges in approaching these data from a linguistic perspective. The first of these is to examine the need for, and implications of, adopting a highly reflexive stance in analysing data which reflects or incorporates the subjective impressions of the observer / researcher. Secondly, data extracts will be presented and discussed in order to analyse the degree to which ‘micro’ linguistic approaches may inform the analysis of ethnographic field notes where those notes record the close observation of interpersonal interaction in a clinical context. Thirdly, the status of the ethnographic interview will be examined in order to explore how discourse elicited within an interview context may inform the analysis of naturally occurring interaction. The issues arising from these three issues come together to advance an argument that the perspective of linguistic ethnography may legitimately inform the analysis of the ‘ethnographic vignette’, and to offer insights into the role of the research interview within LE work
Mclean, C J, VX24172
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/403967Surname: MCLEAN. Given Name(s) or Initials: C J. Military Service Number or Last Known Location: VX24172. Missing, Wounded and Prisoner of War Enquiry Card Index Number: 43049.240027
Item: [2016.0049.36259] "Mclean, C J, VX24172
Mclean, C A E, VX27189
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/403969Surname: MCLEAN. Given Name(s) or Initials: C A E. Military Service Number or Last Known Location: VX27189. Missing, Wounded and Prisoner of War Enquiry Card Index Number: 23805.240030
Item: [2016.0049.36261] "Mclean, C A E, VX27189
The yellow brick road: a values based curriculum model
No full textWithin the United Kingdom, the Nursing and Midwifery Council (NMC) requires that Nurses and Midwives are of ‘good character’ at the point of registration. This paper sets out how good character has been conceptualised within one UK Higher Education Institution and presents a model of “Values Based Enquiry” which aims to develop the ‘character’ of students. The paper presents three qualities (“the heart”, “the nerve” and “the brain”) which represent ‘good character’ and which are believed to underpin values based Nursing or Midwifery practice. The development of these qualities is argued to be reliant upon helping students to develop intrinsic professional values of care and compassion.The role of these character qualities in nursing practice and education is outlined, as are the ways in which they have led to the development of a model for Values Based Enquiry. This model represents a vision of the nature of professional education which may be shared by staff and students, whilst offering a model for learning and teaching based upon recognised educational principles. An argument is advanced that the adoption of a Values Based Enquiry model may develop and nurture the habits of mind which are necessary for the development of ‘good character’
General -- 1960 -- Correspondence, OPV Miscellaneous -- letter, 1960?
No full textLetter from McLean, C. C. dated 1960?.Sabin Collection Fair Use Policy</a
Vaccine -- 1955 -- Correspondence, Polio -- letter, 1955-06-29
No full textLetter from McLean, C. C. to Sabin, Albert B. dated 1955-06-29.Sabin Collection Fair Use Policy</a
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