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Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff recruitment and staff retention. Although the nursing literature has begun to address the issue of moral distress and how to respond to it, much of this literature has typically focused on high acuity areas, such as intensive care nursing. However, with an ageing population and increasing demand for resources and services to meet the needs of older people, it is likely that nurses in long‐term care are going to be increasingly affected by moral distress in their work. This paper briefly reviews the literature pertaining to the concept of moral distress, explores the causes and effects of moral distress within the nursing profession and argues that many nurses and other healthcare professionals working with older persons may need to become increasingly proactive to safeguard against the possibility of moral distress.

Examines health‐care restructuring activities undertaken across North American hospitals over the past decade related to hospital care by nursing professionals (i.e. hospital nurses versus practical nurses or aides). Identifies fundamental lessons learned and highlights important priority research areas that must be undertaken to ensure that future initiatives achieve the intended effect of improving patient outcomes.

The aim of this paper is to demonstrate how a historical event packaged as an iconic heritage cultural brand can be marketized and modified over time to ensure brand longevity and continued emotional commitment and loyalty through the leverage of stories and associations more closely aligned with modern-day audiences. The authors do this through examining the marketization of the New Zealand World War 1 (WWI) nurse to today’s audiences. The periods of study are WWI (1914–1918) and then the modern day. The New Zealand Army Nursing Service (NZANS) during WWI has previously had little attention as a key actor in the Australia and New Zealand Army Corp (ANZAC), Today ANZAC is held as pivotal in the birth of New Zealand’s perception of nationhood and as an iconic heritage cultural brand. The history and legend of the ANZAC plays an important role in New Zealand culture and is fundamental to the “Anzac Spirit”, a signifier of what it means to be a New Zealander.

A historical case study method is used. The primary source of data is 1914–1918, and includes contemporaneous articles, and personal writings: diaries, letters and published memoirs. More contemporary works form the basis for discussion of marketization as it relates to the NZANS. The article first presents conceptual framing, then the development of the Anzac brand and the history of the NZANS and its role in WWI before turning to discussion on the marketization of this nursing service to today’s audiences and as part of the ANZAC/Anzac brand.

Today the story of the WWI NZANS nurse, previously seldom heard, has been co-opted and is becoming increasingly merged as an integral part of the Anzac story. The history of the NZANS during WWI has a great deal of agency today as part of that story, serving many functions within it and providing a valuable lever for marketization.

To date, there is a scarcity of marketing analysis that examines the marketization of history. By focusing on New Zealand WWI nursing as a contributor to the Anzac story, the authors contribute to the understanding of how marketers package and contemporize history for appeal to audiences through both sustaining and reworking cultural branding.

Describes using drama to raise some of the main health issues facing young people, inform them about local services and give them an opportunity to explore their fears and anxieties about accessing services in a rural area. The drama was targeted at 14‐15‐year‐olds on two consecutive years. In the first year, the drama was performed by actors; and the second year, the script was re‐written and performed by college students. The effectiveness of each year’s production was evaluated. Both years’ productions were seen by about 800 young people. In both years the evaluation showed that the drama was successful in informing young people about local health services and addressed their main anxieties; but in the second year, many of the young people commented positively on the age of the cast and how they identified with both them and their portrayal of the issues. As a result, the drama has become a regular yearly event in the secondary schools in this rural area.

Reporting to the police incidents of challenging behaviour displayed by inpatients with autism spectrum disorders (ASD) and learning disability (LD) represents an important but often controversial issue. The purpose of this paper is to contribute to this topic through a brief literature review and the presentation of a clinical case.

Case study and literature review.

The action of reporting to the police can be a useful tool within the therapeutic input provided to patients with ASD and LD who present with challenging behaviour. This can enable staff to feel legally supported, and can promote patients’ learning of social rules, in respect of their rights and duties. The clinical case highlighted that reporting to the police can be effective when it is part of a comprehensive, multi‐professional therapeutic process. This should aim at directing patients towards rehabilitation rather than incarceration. This should also entail the identification of clear pathways and ongoing involvement of patients and families.

Despite the relevance for clinical practice of the above debate, little has been published on this topic. This paper contributes to this discussion through the presentation of a clinical case and by describing how this issue was addressed within a secure inpatient setting.

The purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.

An 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.

Triadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.

These changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.

Structures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.

Contributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

The purpose of this paper is to evaluate the impact of knowledge and understanding framework (KUF) awareness-level training with mental health staff in a UK NHS Mental Health Trust.

In total, 181 mental health professionals completed three day KUF awareness-level training to promote understanding and positive attitudes in working with personality disorder (PD). Attitudes to PD were evaluated using the PD – Knowledge and Skills Questionnaire (Bolton et al., 2010) at pre and post training and at three and six months follow up. Quantitative data were analysed and descriptive statistics were obtained. Qualitative methods were also used to evaluate the integration of learning into work-based practice with five participants.

Participants reported a favourable reaction to the training. Understanding and positive emotions about working with PD increased significantly post training (gains maintained at three and six months follow up). Capability in working with PD was increased post training and at three, but not six months. Qualitative analysis suggests clinical practice was positively impacted upon three months following training.

This research suggests awareness-level KUF training can have a positive impact on the attitudes, understanding and clinical practice of mental health practitioners towards people with a PD. It confirms earlier research on a decrease in capability post training, and explores strategies to further develop capability with this client group.

Despite the promotion of KUF awareness-level training by the Department of Health there is limited evaluation of the approach with mental health professionals in practice. This study reports on an evaluation of KUF training within a large mental health trust with three and six months follow up data. Qualitative evaluation three months after course completion indicates improved practice and application of course principles when working with individuals with PD.

In years past, when life seemed simpler and the Law much less complicated, jurists were fond of quoting the age‐old saying: “All men are equal before the Law.” It was never completely true; there were important exemptions when strict legal enforcement would have been against the public interests. A classic example was Crown immunity, evolved from the historical principle that “The King can do no wrong”. With the growth of government, the multiplicity of government agencies and the enormous amount of secondary legislation, the statutes being merely enabling Acts, this immunity revealed itself as being used largely against public interests. Statutory instruments were being drafted within Ministerial departments largely by as many as 300 officers of those departments authorized to sign such measures, affecting the rights of the people without any real Parliamentary control. Those who suffered and lost in their enforcement had no remedy; Crown immunity protected all those acting as servants of the Crown and the principle came to be an officials' charter with no connection whatever with the Crown. Parliament, custodian of the national conscience, removed much of this socially unacceptable privilege in the Crown Proceedings Act, 1947, which enabled injured parties within limit to sue central departments and their officers. The more recent system of Commissioners—Parliamentary, Local Authority, Health Service—with power to enquire into allegations of injustice, maladministration, malpractice to individuals extra‐legally, has extended the rights of the suffering citizen.