Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually... more Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members' needs during resuscitation in adult critical care settings.
Nursing philosophy : an international journal for healthcare professionals, 2014
As a system of knowledge, nursing has utilized a range of subjects and reconstituted them to refl... more As a system of knowledge, nursing has utilized a range of subjects and reconstituted them to reflect the thinking and practice of health care. Often drawn to a holistic model, nursing finds it difficult to resist the reductionist tendencies in biological and medical thinking. In this paper I will propose a relational approach to knowledge that is able to address this issue. The paper argues that biology is not characterized by one stable theory but is often a contentious topic and employs philosophically diverse models in its scientific research. Biology need not be seen as a reductionist science, but reductionism is nonetheless an important current within biological thinking. These reductionist currents can undermine nursing knowledge in four main ways. Firstly, that the conclusions drawn from reductionism go far beyond their data based on an approach that prioritizes biological explanations and eliminates others. Secondly, that the methods employed by biologists are sometimes weak...
During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to s... more During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such policies yet. This study explores family members' needs during resuscitation in adult critical care settings. This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study. The study findings revealed three main categories: families' need for reassurance; families' need for proximity; and families' need for support. The need for information about patient's condition was the most important need. Updating family members about patient's condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one. This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.
The concept of social structure is ill defined in the literature despite the perennial problem an... more The concept of social structure is ill defined in the literature despite the perennial problem and ongoing discussion about the relationship between agency and structure. In this paper I will provide an outline of what the term social structure means, but my main focus will be on emphasizing the value of the concept for nursing research and demonstrate how its erasure in some research negatively effects on our understanding of the nurses' role in clinical practice. For example, qualitative research in nursing has largely focused on agency through such theories as phenomenology, hermeneutics, and symbolic interactionism. The result is that social structure may be erased or seen as epiphenomena of agency. My purpose is to provide a theoretical discussion of social structure and how such a discussion can help us to understand how nurses live and experience clinical practice. While not denying the importance of agency, I will argue that the thinned out approach to social structure places limits on our understanding of the constraints nurses experience in their working lives. The result is that nurses' attitudes and clinical failings are individualized, resulting in ever more calls for improved education, when a more thorough examination of structural issues may elucidate more fundamental problems.
A critical realist approach to knowledge: implications for evidence-based practice in and beyond ... more A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing This paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter-related. On one side, there is the view that all healthcare interventions should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge.
Nursing knowledge is a composite of many influences. In an attempt to strengthen nursing knowledg... more Nursing knowledge is a composite of many influences. In an attempt to strengthen nursing knowledge and practice, there have been significant developments in the codification of nursing knowledge as part of the evidence-based practice movement. Using established research techniques; this has the capacity to enhance clinical practice. However, not all knowledge can be incorporated into this type of academic discourse, and there is growing interest in narrative knowledge. This paper contributes to this sometimes implicit and sometimes explicit critique of dominant paradigms. The aim of this paper is to examine the usefulness of narrative as a means of exploring the world of emergency nursing practice and its contribution to the emotional lifeworld of clinicians. A discourse analysis of nursing narratives in their natural settings was carried out. This involved exploration of stories that were not produced for the purposes of research. Narratives can open up social worlds, which escape or be deliberately erased by more formal methods. Contingent and subversive knowledge can contribute to understanding the emotional impact of emergency care. These narratives have their own 'truth', which should be incorporated into an understanding of what constitutes the lifeworld of emergency nurses.
To deepen our understanding of the perceptions of health professionals regarding family witnessed... more To deepen our understanding of the perceptions of health professionals regarding family witnessed resuscitation in Jordanian adult critical care settings. The issue of family witnessed resuscitation has developed dramatically in the last three decades. The traditional practice of excluding family members during cardiopulmonary resuscitation had been questioned. Family witnessed resuscitation has been described as good practice by many researchers and health organisations. However, family witnessed resuscitation has been perceived by some practitioners to be unhealthy and harmful to the life-saving process. The literature showed that there are no policies or guidelines to allow or to prevent family witnessed resuscitation in Jordan. An exploratory qualitative design was adopted. A purposive sample of 31 health professionals from several disciplines was recruited over a period of six months. Individual semi-structured interviews were used. These interviews were transcribed and analysed using thematic analysis. It was found that most healthcare professionals were against family witnessed resuscitation. They raised several concerns related to being verbally and physically attacked if they allowed family witnessed resuscitation. Almost all of the respondents expressed their fears of patients' family members' interfering in their work. Most of the participants in this study stated that family witnessed resuscitation is traumatic for family members. This was viewed as a barrier to allowing family witnessed resuscitation in Jordanian critical care settings. The study provides a unique understanding of Jordanian health professionals' perceptions regarding family witnessed resuscitation. They raised some views that contest some arguments in the broader literature. Further research with patients, family members, health professionals and policy makers is still required. This is the first study about family witnessed resuscitation in Jordan. Considering multi-disciplinary healthcare professionals' views would be helpful when starting to implement this practice in Jordanian hospitals.
There is a clear body of evidence which indicates that a substantial number of people who have ex... more There is a clear body of evidence which indicates that a substantial number of people who have experienced domestic violence and abuse attend the emergency department (ED). However, many individuals do not receive effective identification or support. The present study sought to explore the perceptions of ED staff about the perceived value and utilisation of a new domestic abuse nurse specialist role that has been created in one ED in the UK. A qualitative design was used and involved sixteen in-depth interviews with a range of practitioners. The findings highlight that staff highly valued the role of the nurse specialist as one which offered support both professionally and personally. However, the study has also drawn attention to the conundrum that surrounds identification and management of abuse and of enquiry more generally. The ED is ideally suited to identify at risk individuals but is not institutionally organised in a way that prioritises the social concerns of their patients...
In this article we analyse, via a critical review of the literature, the development of a relativ... more In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources.
Patients undergoing sedation in emergency departments (EDs) must be monitored carefully to ensure... more Patients undergoing sedation in emergency departments (EDs) must be monitored carefully to ensure that, when they are being transferred to different departments, they are safe and that information about them is accurate. However, sedation scoring, for which several tools are available, should not be confused with assessment of consciousness, which is undertaken using the Glasgow Coma Scale. This article considers the validity and reliability of sedation scoring tools, and discusses how ED staff can choose and integrate them into patient care pathways.
... New Horizon 5(2): 120–127. Dager, WE, Sanoski, CA, Wiggins, BS and Tisdale, JE (2006) Pharmac... more ... New Horizon 5(2): 120–127. Dager, WE, Sanoski, CA, Wiggins, BS and Tisdale, JE (2006) Pharmacotherapy considerations in advanced Cardiac life support. ... Journal of General Internal Medicine 1: 155–158. | Article | PubMed; Dorian, P., Cass, D., Schwartz, B., Cooper, R ...
This paper is a report on a qualitative study which considered the issue of how lecturers feel ab... more This paper is a report on a qualitative study which considered the issue of how lecturers feel about teaching and managing the topic of culture and racism within their role as nurse educators. The issue of cultural diversity and the related issue of racism within nursing and society more generally means that the problem cannot be ignored since one of the central tenets of nursing is that care should be delivered in nondiscriminatory ways. We interviewed a group of lecturers within a UK university to explore their views on the topic. We produced six themes: Culture; the existence of racism within nursing; challenging racism; political correctness; strategies adopted to address issues in the classroom and the presence of cultural diversity within the curriculum. We identified that the lecturers in our study were keen to address the issue but were also very concerned about their own abilities and confidence in this area.
There are many conceptual and practical difficulties in teaching culturally sensitive issues to s... more There are many conceptual and practical difficulties in teaching culturally sensitive issues to student nurses. There is little clear evidence about the most effective way that the subject of racism can be explored in the classroom setting. This critical appraisal is a collation of the evidence as a means of identifying current practice and the theoretical difficulties and debates that characterise this area. The evidence is based on English language material, largely if not exclusively, from the United States of America and the United Kingdom. We used CINAHL 1982 and MEDLINE 1993 using the search terms 'curriculum', 'educacation', 'nursing', 'teaching', 'minority groups', 'race relations', 'prejudice', and 'ethnic groups'. The central tension lies between a multicultural and an anti-racist approach, which reflects philosophically diverse opinions about what should be included in the nursing curriculum. The outcome of this tension is reliant on providing evidence about the experiences of students and tutors and whether the problem is one of difficulties in cross-cultural communication or racism. Recommendations from the literature for the teaching of multiculturalism and/or antiracism are synthesised and discussed in light of the tension existing between the two philosophies.
Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the e... more Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the early and latter stages of their training and how they compare with their lecturers' perceptions. Background. Portfolios are used widely in nurse education. There has been research into how portfolios are perceived and understood, but there is little evidence into how student nurses and lecturers compare quantitatively in perceptions of portfolio use. Design. Survey. Method. Forty-eight nursing lecturers and 413 nursing students, from a multi-centred School of Nursing in the UK, completed a questionnaire. Data were analysed with exploratory factor analysis, varimax rotation of the factor solution, internal consistency analysis, and analysis of variance. Results. Five factors were extracted, which were labelled: (1) portfolios as a means of skills acquisition, (2) other means of teaching and learning beyond using portfolios, (3) processes of showing the portfolio to others, (4) having favourable attitudes towards portfolios and (5) lecturers' ability to share knowledge about portfolios. Scales developed from these five factors had high levels of internal consistency. Lecturers were the most positive of the three respondent groups in their views of portfolios, whereas third-and fourth-year students were the least positive. There were significant differences between student nurses and their lecturers, concerning how information on portfolios is communicated by the lecturer. Conclusion. There were significant discrepancies between lecturers and student nurses in their views on how portfolios are used. The value of portfolios becomes less salient to student nurses towards the end of their training. Relevance to clinical practice. Lecturers and clinical mentors need to look at students' perceptions and why some nursing students' views on portfolios deteriorate. There could be regular discussions with students to see how and why the students begin to see portfolios as less useful for their education and continual professional development.
Background: Hip-fracture is a common orthopaedic injury presenting to the Emergency Department, p... more Background: Hip-fracture is a common orthopaedic injury presenting to the Emergency Department, particularly within the elderly population. Standards of practice dictating the care of these patients include the early administration of analgesia and an accurate clinical assessment. Once a hip-fracture has been confirmed with diagnostic-imaging, the patient should be transferred to an orthopaedic ward as soon as possible. These standards have been identified from a range of national policies and evidence-based literature. Aim: To identify standards of best-practice for the care of patients with a suspected hip-fracture in the Emergency Department and to audit compliance with these standards. Method: A retrospective-audit of 185 Emergency Department Information System records for adult patients admitted with a suspected hip-fracture was conducted using a purpose-designed data-extraction spread-sheet based on discrete standards of audit. Findings: It was found that the Emergency Department performed well on some audit standards, such as the medical assessment of patients. However, some problems of assessment were identified in relation to pressure-care, the timely transfer of patients to a suitable ward and the delivery of pain-relief.
Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually... more Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members' needs during resuscitation in adult critical care settings.
Nursing philosophy : an international journal for healthcare professionals, 2014
As a system of knowledge, nursing has utilized a range of subjects and reconstituted them to refl... more As a system of knowledge, nursing has utilized a range of subjects and reconstituted them to reflect the thinking and practice of health care. Often drawn to a holistic model, nursing finds it difficult to resist the reductionist tendencies in biological and medical thinking. In this paper I will propose a relational approach to knowledge that is able to address this issue. The paper argues that biology is not characterized by one stable theory but is often a contentious topic and employs philosophically diverse models in its scientific research. Biology need not be seen as a reductionist science, but reductionism is nonetheless an important current within biological thinking. These reductionist currents can undermine nursing knowledge in four main ways. Firstly, that the conclusions drawn from reductionism go far beyond their data based on an approach that prioritizes biological explanations and eliminates others. Secondly, that the methods employed by biologists are sometimes weak...
During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to s... more During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such policies yet. This study explores family members' needs during resuscitation in adult critical care settings. This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study. The study findings revealed three main categories: families' need for reassurance; families' need for proximity; and families' need for support. The need for information about patient's condition was the most important need. Updating family members about patient's condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one. This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.
The concept of social structure is ill defined in the literature despite the perennial problem an... more The concept of social structure is ill defined in the literature despite the perennial problem and ongoing discussion about the relationship between agency and structure. In this paper I will provide an outline of what the term social structure means, but my main focus will be on emphasizing the value of the concept for nursing research and demonstrate how its erasure in some research negatively effects on our understanding of the nurses' role in clinical practice. For example, qualitative research in nursing has largely focused on agency through such theories as phenomenology, hermeneutics, and symbolic interactionism. The result is that social structure may be erased or seen as epiphenomena of agency. My purpose is to provide a theoretical discussion of social structure and how such a discussion can help us to understand how nurses live and experience clinical practice. While not denying the importance of agency, I will argue that the thinned out approach to social structure places limits on our understanding of the constraints nurses experience in their working lives. The result is that nurses' attitudes and clinical failings are individualized, resulting in ever more calls for improved education, when a more thorough examination of structural issues may elucidate more fundamental problems.
A critical realist approach to knowledge: implications for evidence-based practice in and beyond ... more A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing This paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter-related. On one side, there is the view that all healthcare interventions should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge.
Nursing knowledge is a composite of many influences. In an attempt to strengthen nursing knowledg... more Nursing knowledge is a composite of many influences. In an attempt to strengthen nursing knowledge and practice, there have been significant developments in the codification of nursing knowledge as part of the evidence-based practice movement. Using established research techniques; this has the capacity to enhance clinical practice. However, not all knowledge can be incorporated into this type of academic discourse, and there is growing interest in narrative knowledge. This paper contributes to this sometimes implicit and sometimes explicit critique of dominant paradigms. The aim of this paper is to examine the usefulness of narrative as a means of exploring the world of emergency nursing practice and its contribution to the emotional lifeworld of clinicians. A discourse analysis of nursing narratives in their natural settings was carried out. This involved exploration of stories that were not produced for the purposes of research. Narratives can open up social worlds, which escape or be deliberately erased by more formal methods. Contingent and subversive knowledge can contribute to understanding the emotional impact of emergency care. These narratives have their own 'truth', which should be incorporated into an understanding of what constitutes the lifeworld of emergency nurses.
To deepen our understanding of the perceptions of health professionals regarding family witnessed... more To deepen our understanding of the perceptions of health professionals regarding family witnessed resuscitation in Jordanian adult critical care settings. The issue of family witnessed resuscitation has developed dramatically in the last three decades. The traditional practice of excluding family members during cardiopulmonary resuscitation had been questioned. Family witnessed resuscitation has been described as good practice by many researchers and health organisations. However, family witnessed resuscitation has been perceived by some practitioners to be unhealthy and harmful to the life-saving process. The literature showed that there are no policies or guidelines to allow or to prevent family witnessed resuscitation in Jordan. An exploratory qualitative design was adopted. A purposive sample of 31 health professionals from several disciplines was recruited over a period of six months. Individual semi-structured interviews were used. These interviews were transcribed and analysed using thematic analysis. It was found that most healthcare professionals were against family witnessed resuscitation. They raised several concerns related to being verbally and physically attacked if they allowed family witnessed resuscitation. Almost all of the respondents expressed their fears of patients' family members' interfering in their work. Most of the participants in this study stated that family witnessed resuscitation is traumatic for family members. This was viewed as a barrier to allowing family witnessed resuscitation in Jordanian critical care settings. The study provides a unique understanding of Jordanian health professionals' perceptions regarding family witnessed resuscitation. They raised some views that contest some arguments in the broader literature. Further research with patients, family members, health professionals and policy makers is still required. This is the first study about family witnessed resuscitation in Jordan. Considering multi-disciplinary healthcare professionals' views would be helpful when starting to implement this practice in Jordanian hospitals.
There is a clear body of evidence which indicates that a substantial number of people who have ex... more There is a clear body of evidence which indicates that a substantial number of people who have experienced domestic violence and abuse attend the emergency department (ED). However, many individuals do not receive effective identification or support. The present study sought to explore the perceptions of ED staff about the perceived value and utilisation of a new domestic abuse nurse specialist role that has been created in one ED in the UK. A qualitative design was used and involved sixteen in-depth interviews with a range of practitioners. The findings highlight that staff highly valued the role of the nurse specialist as one which offered support both professionally and personally. However, the study has also drawn attention to the conundrum that surrounds identification and management of abuse and of enquiry more generally. The ED is ideally suited to identify at risk individuals but is not institutionally organised in a way that prioritises the social concerns of their patients...
In this article we analyse, via a critical review of the literature, the development of a relativ... more In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources.
Patients undergoing sedation in emergency departments (EDs) must be monitored carefully to ensure... more Patients undergoing sedation in emergency departments (EDs) must be monitored carefully to ensure that, when they are being transferred to different departments, they are safe and that information about them is accurate. However, sedation scoring, for which several tools are available, should not be confused with assessment of consciousness, which is undertaken using the Glasgow Coma Scale. This article considers the validity and reliability of sedation scoring tools, and discusses how ED staff can choose and integrate them into patient care pathways.
... New Horizon 5(2): 120–127. Dager, WE, Sanoski, CA, Wiggins, BS and Tisdale, JE (2006) Pharmac... more ... New Horizon 5(2): 120–127. Dager, WE, Sanoski, CA, Wiggins, BS and Tisdale, JE (2006) Pharmacotherapy considerations in advanced Cardiac life support. ... Journal of General Internal Medicine 1: 155–158. | Article | PubMed; Dorian, P., Cass, D., Schwartz, B., Cooper, R ...
This paper is a report on a qualitative study which considered the issue of how lecturers feel ab... more This paper is a report on a qualitative study which considered the issue of how lecturers feel about teaching and managing the topic of culture and racism within their role as nurse educators. The issue of cultural diversity and the related issue of racism within nursing and society more generally means that the problem cannot be ignored since one of the central tenets of nursing is that care should be delivered in nondiscriminatory ways. We interviewed a group of lecturers within a UK university to explore their views on the topic. We produced six themes: Culture; the existence of racism within nursing; challenging racism; political correctness; strategies adopted to address issues in the classroom and the presence of cultural diversity within the curriculum. We identified that the lecturers in our study were keen to address the issue but were also very concerned about their own abilities and confidence in this area.
There are many conceptual and practical difficulties in teaching culturally sensitive issues to s... more There are many conceptual and practical difficulties in teaching culturally sensitive issues to student nurses. There is little clear evidence about the most effective way that the subject of racism can be explored in the classroom setting. This critical appraisal is a collation of the evidence as a means of identifying current practice and the theoretical difficulties and debates that characterise this area. The evidence is based on English language material, largely if not exclusively, from the United States of America and the United Kingdom. We used CINAHL 1982 and MEDLINE 1993 using the search terms 'curriculum', 'educacation', 'nursing', 'teaching', 'minority groups', 'race relations', 'prejudice', and 'ethnic groups'. The central tension lies between a multicultural and an anti-racist approach, which reflects philosophically diverse opinions about what should be included in the nursing curriculum. The outcome of this tension is reliant on providing evidence about the experiences of students and tutors and whether the problem is one of difficulties in cross-cultural communication or racism. Recommendations from the literature for the teaching of multiculturalism and/or antiracism are synthesised and discussed in light of the tension existing between the two philosophies.
Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the e... more Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the early and latter stages of their training and how they compare with their lecturers' perceptions. Background. Portfolios are used widely in nurse education. There has been research into how portfolios are perceived and understood, but there is little evidence into how student nurses and lecturers compare quantitatively in perceptions of portfolio use. Design. Survey. Method. Forty-eight nursing lecturers and 413 nursing students, from a multi-centred School of Nursing in the UK, completed a questionnaire. Data were analysed with exploratory factor analysis, varimax rotation of the factor solution, internal consistency analysis, and analysis of variance. Results. Five factors were extracted, which were labelled: (1) portfolios as a means of skills acquisition, (2) other means of teaching and learning beyond using portfolios, (3) processes of showing the portfolio to others, (4) having favourable attitudes towards portfolios and (5) lecturers' ability to share knowledge about portfolios. Scales developed from these five factors had high levels of internal consistency. Lecturers were the most positive of the three respondent groups in their views of portfolios, whereas third-and fourth-year students were the least positive. There were significant differences between student nurses and their lecturers, concerning how information on portfolios is communicated by the lecturer. Conclusion. There were significant discrepancies between lecturers and student nurses in their views on how portfolios are used. The value of portfolios becomes less salient to student nurses towards the end of their training. Relevance to clinical practice. Lecturers and clinical mentors need to look at students' perceptions and why some nursing students' views on portfolios deteriorate. There could be regular discussions with students to see how and why the students begin to see portfolios as less useful for their education and continual professional development.
Background: Hip-fracture is a common orthopaedic injury presenting to the Emergency Department, p... more Background: Hip-fracture is a common orthopaedic injury presenting to the Emergency Department, particularly within the elderly population. Standards of practice dictating the care of these patients include the early administration of analgesia and an accurate clinical assessment. Once a hip-fracture has been confirmed with diagnostic-imaging, the patient should be transferred to an orthopaedic ward as soon as possible. These standards have been identified from a range of national policies and evidence-based literature. Aim: To identify standards of best-practice for the care of patients with a suspected hip-fracture in the Emergency Department and to audit compliance with these standards. Method: A retrospective-audit of 185 Emergency Department Information System records for adult patients admitted with a suspected hip-fracture was conducted using a purpose-designed data-extraction spread-sheet based on discrete standards of audit. Findings: It was found that the Emergency Department performed well on some audit standards, such as the medical assessment of patients. However, some problems of assessment were identified in relation to pressure-care, the timely transfer of patients to a suitable ward and the delivery of pain-relief.
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Papers by Stuart Nairn