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croghan e. & johnson c. (2004) Journal of Advanced Nursing 45(2), 155–161 Occupational health and school health: a natural alliance? The United Kingdom National Health Service aims to provide a holistic ‘cradle to grave’ service. In order to achieve this, systems are in place for effective communication between providers of services for babies and children. However, when children leave school, communication between the school health services and workplace health services to protect and promote the health of the new workforce is rare. Working together is a commonly-stated rhetoric of contemporary nursing theory, but often this is not applied in practice. School health and occupational health have similar aims and objectives and, by working together, may be able to improve the health of large populations for a lifetime. This paper aims to examine the similarities in principles and practices between school health and occupational health nurses, and to identify areas of overlap in which collaboration could improve care for clients of both services. The paper examines the nature of nursing in occupational and school settings, and similarities and differences in policy, law and principles. It also examines these two areas of practice within a public health framework, looking for areas of overlap. A basis is suggested for collaborative working between the two areas, and barriers, facilitators and benefits of this practice are examined. We conclude that there does exist a natural alliance between occupational and school health nursing, and that the two should work together to provide continuity of care for clients on leaving school, and to prepare children and young people for the workplace and any special health issues in their chosen careers. [ABSTRACT FROM AUTHOR]

clouder l. & sellars j. (2004) Journal of Advanced Nursing 46(3), 262–269 Reflective practice and clinical supervision: an interprofessional perspective In the United Kingdom, the drive to encourage reflective practice through clinical supervision, as a means of ensuring quality of provision in nursing and other health care professions, is now well-embedded, not only in policy but also in practice. However, debate and critique of these concepts is limited. The aim of this paper is to draw on research, conducted with undergraduate occupational therapy students and qualified physiotherapists, in order to contribute to the debate about the functions of clinical supervision and reflective practice in nursing and other health care professions. Upholding the notion that clinical supervision has the potential to constitute a form of surveillance, we counter the assumption that it is inevitably confessional in nature. A social constructionist perspective is used to illustrate how clinical supervision might involve a complex interplay of factors that dispel notions of predictability, control and rationality. Despite acknowledging tensions, we argue that clinical supervision is both necessary and beneficial. It can be advantageous to individual practitioners and professional groups in enhancing practice and accountability, and promoting professional development. [ABSTRACT FROM AUTHOR]

andrews j. manthorpe j. & watson r. (2004) Journal of Advanced Nursing 46(3), 303–310 Involving older people in intermediate care Intermediate care has become a crucial part of the United Kingdom government's programme for improving services for older people. Older people comprise a substantial part of the user base for these services, and it is increasingly recognized that there is a need for greater user involvement in service development for intermediate care. National initiatives undertaken in intermediate care have sought to widen and deepen the remit of such services, and in this way promote greater independence and improved quality of care for older people. In particular, the government has set out clear plans for reshaping services for older people in the National Health Service Plan and the rationale for greater involvement of older people in service development. This article considers ways in which these national and local objectives may be achieved and considers some of the implications for nursing. This paper aims to explore the concept of intermediate care and to identify trends and existing evidence of user involvement in care. In this way it charts a possible way forward for the development of a more ‘user sensitive’ approach. The following databases were searched: Medline, Cochrane Library, the Social Science Citation Index and CINAHL. Key words were ‘intermediate care’, ‘older people’, ‘formal care’, ‘primary care’, ‘social services’ and ‘geriatrics’, used in combination. The findings from this study indicate that there is considerable scope for increased user involvement in service development for intermediate care. Such challenges may be more effectively met through greater clarity of the concept of intermediate care, and a bridging of user involvement at the practice and policy levels. Nurses are key providers of intermediate care in the community. The involvement of older people in intermediate care service development must be premised on a shared comprehension of the purpose and function of intermediate care. Nurses must be involved in shifting intermediate care from being service-focused to patient-centred. Effective participation eschews the application of global constructs for older people, while supporting greater participation at all levels and robust implementation processes. [ABSTRACT FROM AUTHOR]

In 1994, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) completed its framework for post-registration education and practice. The UKCC's strategy was based upon the two principles of compulsory re-registration for all practising nurses and graduate-level (or equivalent) entry to specialist practice. It may be seen as the culmination of a gradual process of professionalization, as well as a response to changes in the organization and delivery of health care in the late 20th century. This paper uses both primary and secondary sources to trace the development of the new strategy, and its wider implications for the profession. [ABSTRACT FROM AUTHOR]

Mixed messages in nursing research: their contribution to the persisting hiatus between evidence and practice The current emphasis in the United Kingdom on evidence-based health care requires that medical and non-medical professionals ensure that their clinical practice is founded on scientifically derived findings rather than on intuition and ritual. To this end, many initiatives have been introduced which are intended to increase both the corpus of available research evidence and the extent to which it informs practice. To date, however, there has been a disappointing shortfall in published research in the paramedical domain, which has been largely attributed to a number of structural and organizational issues. This paper suggests that confusion about what constitutes valid and useful research may be an additional significant contributory factor in the documented research/practice hiatus. Moreover, the emphasis on experimentation and Randomized Controlled Trials (RCTs), with the relative marginalization of alternative, more qualitative forms of research may seriously limit the nursing research data-base because of its inappropriateness for many nursing investigations. It is suggested that a more eclectic approach to evidence-based care is considered, with more attention being diverted to qualitative methodologies at the funding and dissemination stages. In this way, a comprehensive and balanced overview of relevant information can be obtained which has the potential to influence some of the less quantifiable aspects of care delivery. [ABSTRACT FROM AUTHOR]

In July 1992, the British government published its White Paper 'The Health of the Nation, a Strategy for Health in England' (HON). The authors contend that this initiative has largely been accepted by the nursing profession with critical response to the HON being minimal. The authors argue that the medicalized negative interpretation of health and the narrow individualistic lifestyle-orientated definition of health promotion contained within the strategy ought to be rejected by nurses in favour of both a positive, holistic conception of health and a more humanistic health promotion methodology acknowledging the impact of structural-material factors influencing individual health related behaviour. [ABSTRACT FROM AUTHOR]

This paper reports a study of nurses' perceptions of the positive and negative features of the work environment and their contribution to satisfaction with nursing. The concept of a 'work space' was developed to describe nurses' mental images of the features of their work environment. Eighty-four final-year student nurses and 75 registered nurses rated questionnaire items designed to examine perceptions of opportunities for professional development, sources of satisfaction, difficulties, time constraints and problematic interactions with other hospital personnel. There was general agreement among nurses about the aspects of their work that they found satisfying, but student nurses were more pessimistic than registered nurses that nursing would give them the opportunities for recognition of their worth. Students returning from practica in critical care wards reported more stressful interactions with other personnel than students returning from general ward practica. Structural equation modelling of the causal relations between sources of satisfaction with nursing revealed that recognition and self-perceptions of work as a nurse were the strongest predictors of overall satisfaction with nursing. Caring for patients contributed only indirectly through its influences on nurses' feelings about themselves. The data indicate the significance of personal and social implications of nursing careers. [ABSTRACT FROM AUTHOR]

Nurses in the United Kingdom spend much time attempting to fit British nursing practice into the theoretical framework of American nursing models. This is often a manipulative process in that it seeks to establish positive links with a care delivery system totally unlike our own. In the present paper the authors detail the process of establishing a new nursing model which integrates nursing curricula, education and practice to meet the needs of patients, staff and students within their own health district. An over-emphasis on lower levels of human need is common within nursing practice, which, although often blamed upon lack of human and financial resources, is also due to practitioners' misconceptions. The latter are invariably the result of a lack of an adequate or overt, practice orientated, conceptual framework. The Human Needs Model of Nursing adapts Maslow's concept of human needs to create such a conceptual framework for practice. It places equal emphasis on those patient problems which arise as the result of unmet needs at higher levels as well as those at lower levels, thereby acknowledging the holistic and dynamic nature of man. [ABSTRACT FROM AUTHOR]

This paper is based on the Nursing Lecture 1977, delivered on the occasion of the Annual General Meeting of the Royal College of Nursing in London on November 23, 1977. The author traces the history and discusses the implications of the EEC Nursing Directives, put into the perspective of the nursing histories of the nine countries within the European Economic Community. She focuses, in particular, on the strengths of the nursing profession in the United Kingdom and argues that the Nursing Directives can lead to enhancement of nursing services and nursing education, better cooperation between health care professions and a stronger voice for the nursing profession, throughout the EEC. [ABSTRACT FROM AUTHOR]

There is widespread discussion at the present time of participation--allowing members of an organization to exert an influence on the processes of decision-making. The National Health Service is not isolated from this debate and already a number of experiments have been carried out at various levels of the service to allow a wider range of opinion to influence decisions than hitherto. This paper reports on a study the author carried out into one such exercise, designed to assist a Health Board reach decisions about the long-term pattern of health care in its area. Nurses, paramedical staff and local authority staff, as well as doctors, were appointed to a series of programme planning committees to advise the Health Board on issues of long-term policy. After 2 years of operation, a study was carried out into the operation of the committees and the lessons drawn from the experience should be relevant to actual and potential members of any consultative or decision-making body. [ABSTRACT FROM AUTHOR]

In this paper the author, who is a member of the Royal College of Nursing of the United Kingdom (Ren) Council, discusses the functional and dysfunctional aspects of organizational behaviour and applies this discussion to the organizational problems of the Ren, the main professional organization of nurses in the United Kingdom. In particular, three concepts are considered in some detail: the concepts of oligarchy, elitism and plurality of goals. It is argued that problems which are ignored do not disappear and that dysfunctions which are by definition latent must be made manifest before they can be remedied. The existence of opposition, it is further argued, is essential to keep democracy alive, to buffer oligarchy and to promote change essential for the organization's survival. [ABSTRACT FROM AUTHOR]

This article presents information related to nursing. At a reception given by Her Majesty Queen Elizabeth the Queen Mother at St James's Palace, London to mark the thirtieth birthday of The British Commonwealth Nurses War Memorial Fund, future plans were announced. The Council of the Royal College of Nursing of Great Britain has decided to create fellows from amongst its members of at least five years' standing who have made exceptional contributions to the advancement of the science and art of nursing. Fellows will be expected to have completed a course in post-basic nursing education where appropriate, and to present a paper or thesis and/or demonstrate innovation or exceptional competence in advancing nursing.

This article presents consultation papers of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. Consultation papers prepared by the working groups are now being given a wide distribution throughout the professions of nursing, midwifery and health visiting. The task of the working groups, in considering comments will be greatly assisted if views on the recommendations and proposals in the consultation paper are channelled back through an appropriate professional organization or trade union. The Council has set up seven working groups. Each working group is looking at a particular aspect of the 1979 Act and the related future responsibilities which the Council will inherit.

Reflects on the 50th anniversary of the creation of the British National Health Service (NHS) in July 1998. Thoughts on changes in nursing care from the 1940's to the 1990's; The author's experience as a nurse treating tuberculosis patients in the 1950's; Progress in nursing scholarship; Quality of papers submitted to the 'Journal of Advanced Nursing.'