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Current health policy, high‐profile failures and increased media scrutiny have led to a significant focus on patient experience in Britain's National Health Service (NHS). Patient experience data is typically gathered through surveys of satisfaction. The study aimed to support a better understanding of the patient experience and patients' expression of it through consideration of the aspects of the patient experience on NHS wards which are by their nature impossible to capture through patient satisfaction surveys. Existential phenomenology was used to develop an in‐depth exploratory narrative, expressed through the voices of the participants. Data collection involved in‐depth face‐to‐face interviews with 12 purposively sampled participants, with analysis by means of hermeneutics. Though the individuality of each experience was apparent and cannot be overemphasised, common factors emerging from the data included uncertainty and unexpectedness, suffering and finitude, the futility of feedback and bureaucracy and absurdity. Overall, participants demonstrated how their individual personalities and expectations affected their response both to illness or injury and to their hospital admissions, highlighting feelings of vulnerability and voicelessness as a response to hospitalisation. The findings of this study provide useful insight into the patient experience on British hospital wards, and the value of an existential–phenomenological approach is demonstrated. [ABSTRACT FROM AUTHOR]

The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009–2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid‐Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high‐profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re‐evaluated in the current Covid‐19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy‐in to strategy documents. [ABSTRACT FROM AUTHOR]

Aim: To describe the life and work of the international nurses of the International Brigades during the Spanish Civil War and to examine their role in relation to their contribution to Spanish nursing in this period. Methods: This historical study is based primarily on the memoirs of the international nurses who joined the war health services of the International Brigades during the Spanish Civil War. The evidence that was elicited from these sources was compared and contrasted with other contemporary documents in order to compare their perspectives with those of other contemporaries. Results: The nurses of the International Brigades joined the front line health services as part of the mobile medical and surgical teams that were attached to the fighting units. They lived and worked under extreme conditions, often under fire. Their work while in Spain was not limited to care delivery but also included managerial and educational aspects. The international nurses' observations of Spanish nursing at the time were not always accurate, which might be explained by a lack of contact with qualified Spanish nursing staff due to a shortage of fully qualified nurses. Conclusion: In the absence of the voices of the Spanish nurses themselves, the written records of the international nurses were invaluable in analyzing Spanish nursing in this period. Their testimonies are, in essence, the international nurses' legacy to the Spanish nurses who stayed behind after the departure of the International Brigadists in 1938. [ABSTRACT FROM AUTHOR]

This historical study aims to refine understanding of the nature of nursing work. The study focuses on the 1880 crisis at Guy's Hospital in London to examine the nature and meaning of nursing work, particularly the concept of nursing work as many 'little things.' In this paper, an examination of Margaret Lonsdale's writing offers an original contribution to our understanding of the ways in which nursing work differs from medical practice. In this way, we use the late-nineteenth-century controversy at Guy's Hospital as a prism through which to examine the contested nature of nursing work. Lonsdale's ideas are corroborated by examination of writings by nurse leaders Florence Nightingale and Eva Luckes. Luckes, in particular, elaborated what was meant by nursing as the performance of a thousand little things, which are specific to nursing work. While physicians had been performing much of what was considered to be nursing work, nurses developed some of these and other interventions into a unique body of work characterized by meticulous attention to significant details. Some implications regarding current nursing practice are discussed. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Patients within the adult intensive care unit have the potential to develop delirium and agitation. This can result in the patient displaying unwanted behaviours such as attempting to remove the medical devices to which they are attached. Some adult intensive care units within the UK are starting to adopt physical restraint as a method of managing unwanted behaviours. Aim To determine the experiences, attitudes and opinions of adult intensive care nurses in relation to the application of physical restraint. Design Questionnaire survey. Methods A postal questionnaire was distributed to all nurses ( n = 192) within two purposefully selected large adult intensive care units in the UK. Results Data were collected between November 2012 and February 2013. The questionnaire was completed by 38·9% ( n = 75) of the nurses contacted. All believed that physical restraint had a place, with the majority of the view that the reason for its application was to maintain patient safety. Some expressed discomfort about the use of physical restraint. Nurses were happy to discuss the use of restraint with families. There was a perceived need for training and support for nursing staff as well as the need for medical staff to support the decision-making process. Conclusion Nurses require more support and evidence to base their decision-making upon. They require guidance from professional bodies as well as support from medical colleagues. The findings have limited generalizability as they can only be applied to the units accessed and the response rate was poor. Relevance to clinical practice Alternative approaches such as pain management, sleep promotion and the involvement of relatives need to be explored before physical restraint policy can be written. Further research is required into the safety of physical restraint, alternative methods of managing the risk of agitation and identifying predisposing factors to accidental device removal. [ABSTRACT FROM AUTHOR]

This study aimed to examine the meanings that nurses attached to the 'treatments' administered to cure 'sexual deviation' ( SD) in the UK, 1935-1974. In the UK, homosexuality was considered a classifiable mental illness that could be 'cured' until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of their SD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered 'acceptable practice'. [ABSTRACT FROM AUTHOR]

HALLETT C and WAGNER L. Nursing Inquiry 2011; 18: 359-368 Promoting the health of Europeans in a rapidly changing world: a historical study of the implementation of World Health Organisation policies by the Nursing and Midwifery Unit, European Regional Office, 1970-2003 The World Health Organisation (WHO) was inaugurated in 1948. Formed in a period of post-war devastation, WHO aimed to develop and meet goals that would rebuild the health of shattered populations. The historical study reported here examined the work of the Nursing and Midwifery Unit (NMU) of WHO's European Regional Office during the later part of the twentieth century. The study examined archive sources lodged at the NMU archive. The sources included manuscripts relating to important NMU initiatives, reports and papers published by WHO, and a range of secondary sources. The study identified three main driving forces in the work of the NMU of the European Regional Office of WHO. One of the strongest of these was a drive to develop and promote the nursing profession within the countries of the European Region. The second was the promulgation and implementation of the positive public health strategies of WHO, particularly its '38 Targets for Health for All by the Year 2000'. The third focussed on securing equity across the European continent and on promoting the development of the nursing professions in poorer and less-developed countries. The study concludes that the nursing professions in European states grew in strength and influence, and that the health of populations improved throughout the continent between 1970 and 2003. It discusses the extent to which the role of the NMU in these advances may have been significant. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to identify the extent to which community nurses incorporate patient involvement in decision-making into their everyday clinical practice. Background. The complexity underlying the concept of patient participation is not always recognized. It links the notions of ‘passive patient’ and ‘active participant’, hence its usage along with those of similar terms such as ‘partnership’, ‘involvement’ and ‘collaboration’ is often ambiguous. The literature on this subject is fairly extensive and often contradictory; it encompasses the participation of potential as well as actual patients. Hierarchical structures have been proposed to offer an understanding of the current nature of patient participation, and these have sometimes linked the level of participation to the quality of the nurse–patient relationship. Much work has been done in the area of cancer care, where it has been noted that the role of ‘passive patient’ may in itself be a deliberate choice. Methods. The approach was ethnographic and data were collected during 2000 and 2001 by participant observations with 22 nurses and 107 patients; 137 interactions were observed in all. Detailed field notes were kept and then carefully interpreted. The approach to rigour was primarily concerned with ensuring credibility. Findings. The extent to which nurses involved patients in making decisions about their care, and the manner in which this was achieved, varied considerably. Collectively, the behaviour of participants is presented as the ‘involving–non-involving continuum’, with five typologies of behaviour: ‘completely involving’; ‘partially involving’; ‘forced involving’; ‘covert non-involving’ and ‘overt non-involving’. The findings highlight that caring for people in their own home does not necessarily mean that patients are involved in care and treatment decisions. Conclusion. This observation study of the extent to which community nurses involved patients in decision-making in nursing care offers some useful insights into one aspect of nursing work. The implications of the study are far-reaching. The findings suggest that it could be important for nurses and their managers to devote more time to relationship-building in nursing practice. They also offer a perspective – the involving–non-involving continuum – that could usefully be incorporated into nurse education at both pre- and postregistration levels. [ABSTRACT FROM AUTHOR]

The Diploma in Community Nursing at the University of Manchester began in 1959, after a long period of planning and negotiation. It was the earliest pre-registration nursing education programme in a British university. The paper reports on a historical study which examined its foundation and development. The history of the ‘Manchester Scheme’, as it came to be known, is placed into the context of wider reforms and modifications in British nursing education. The methods used for the study were a broad-based literature review, examination of material from the 1950s to the present day, five oral history interviews with some of those who were influential in developing the diploma, and the interpretation of relevant documentary source materials. The Diploma in Community Nursing at the University of Manchester was important and innovative in its time, combining as it did nurse and health visitor training with a university-based education. The paper traces the struggle to establish the course, which was largely due to the efforts of one charismatic individual, Fraser Brockington, Professor of Social and Preventive Medicine. It then goes on to examine the reforms and modifications the programme underwent from 1959 to 1969, as it was developed into the prototype for the ‘Bachelor of Nursing Degree’. [ABSTRACT FROM AUTHOR]

hallett c.e., abendstern m.&wade l. (2004) Journal of Advanced Nursing48(3), 257–265The struggle for sanitary reform in the Lancashire cotton mills, 1920–1970This paper reports one aspect of a larger study. The aim of this aspect was to explore the role of the‘welfare officer’ in promoting the health of cotton mill workers during this period.The paper considers one element of a broad exploratory study of the health of women cotton mill workers in the North West of England. The original purpose of the study, which was conducted in 2002 in two towns, Oldham and Ashton-under-Lyne, was to explore the women's own perceptions of the impact of their work on their health, and to find out what, if any, help and support they obtained. During the course of the study it was discovered that‘welfare officers’, some of whom were trained nurses, had an important role in promoting the health of these workers. The study was therefore expanded to incorporate data obtained directly from interviews with a small sample of welfare officers. The present paper focuses on the issue of sanitary reform and considers the role of the‘welfare officer’ in promoting public health in the workplace.The study employed a combination of archive searches and oral history interviewing. In total, 31 interviews were undertaken between June 2001 and October 2002. The interpretive process focussed both on the ideological power structures which influenced the perspectives of participants, and on evidence for those aspects of participants’ experiences which impacted on their health.In considering their health, female cotton-mill workers recalled that the poor sanitary conditions in their workplaces during the middle years of the 20th century had been a source of some concern to them. They also observed that mill welfare officers took a hand in promoting improvement in available facilities. Welfare officers themselves recounted their own concern regarding the poor sanitary conditions in the mills, and their efforts to improve conditions for the mill workers.The paper demonstrates the role of a little-known group of health workers in the middle years of the 20th century, and demonstrates the importance of oral history work in re-capturing elements of nursing work and experience, which do not appear extensively in the written record. The study's relevance to contemporary practice lies in the insight it offers into the autonomy with which these occupational health workers defined their roles and performed their work. [ABSTRACT FROM AUTHOR]

hopkinson j.b., hallett c.e. & luker k.a. (2003) Journal of Advanced Nursing 44(5), 525–533 Caring for dying people in hospital Fifty-four per cent of people who die in England and Wales do so in hospital. Evidence suggests that care delivered to dying people in hospital does not match up to the ideal of a good death. These studies have provided organizational and structural explanations of nurses’ behaviour that support argument for change at the macro level, in order to improve the quality of care delivered to dying people. There has been little study of the perceptions of nurses working in acute medical settings in relation to their experience of caring for dying people. Therefore, there is little evidence on which to base supportive strategies at the level of individual nurses. In this study we set out to develop an understanding of care for dying people in hospital, from the perspective of newly qualified staff nurses in the UK. The purpose was to build a theory of how nurses might be helped to deliver quality care to dying people in hospital. This paper is based on an exploratory study underpinned by phenomenological philosophy. In-depth interviews were conducted with 28 newly qualified nurses, focusing on their experiences of caring for dying people on medical wards in two acute hospitals in England in 1999. The interview transcripts were interpreted using a phenomenological approach. The findings presented in this paper relate to commonalities found to underlie study participants’ perceptions of their experiences. All the nurses’ stories were found to be built around six essences – the personal ideal, the actual, the unknown, the alone, tension and anti-tension. These essences, and the relationships between them, were used to build a model of the experience of caring for dying people in hospital. This descriptive study of the experience of individual nurses does not examine the wider social context. It attempts to complement existing sociological theory of death and dying. The study revealed how a group of newly qualified nurses experienced caring for dying people. We theorize that the model developed has utility as a tool for gaining understanding of the experience of caring for dying people. It is assumed that nurses, through using this model to find explanations for their emotions and behaviours, may gain emotional support that might have a positive impact on the quality of care delivered to dying people in hospital. [ABSTRACT FROM AUTHOR]

This article provides information on children's rights. Recent decades have witnessed a growing interest in and articulation of children's rights. The attention to children's rights has stemmed, in part, from a growing concern with human rights generally, reflected for example in the 1948 Universal Declaration of Human Rights, and from consideration of the rights of oppressed social groups, for example in the civil rights and liberation movements. The recognition of children's rights was also shaped by the disaggregation of the patriarchal family, particularly the identification of the nuclear family as a contradictory phenomenon; a potential source of security and happiness but also, for some, a site of oppression and violence both across gender (between men and women) and generation (between adults and children). In these circumstances, the rights of individual family members (particularly of women and children) came to be recognized as existing separately from and at times in conflict with those of the family unit as a whole. A parallel trend has been changing views of the status and nature of childhood. Associated particularly with the new sociology of childhood there has been increasing emphasis placed on children's individualism, autonomy, capacity and competence. In this paradigm, children's agency has been stressed.

• The number of community staff nurses working in district nursing teams in the UK has increased in recent years as a result of organizational and educational initiatives such as skill mix and the Diploma in Professional Studies in Nursing (Project 2000). • Although the wider economic, philosophical and educational arguments for the role creation has been discussed in the literature, little has been written on the reality of the role from the viewpoint of the staff nurse or the relationship between the role and service requirements. The researchers conducted 16 interviews with district staff nurses from two NHS Trusts. The interpretation was guided by phenomenology and focused on the subjective perceptions of the nurses. • The data revealed dissatisfaction with their role among this group of staff nurses. Having been given a considerable degree of autonomy and responsibility as staff nurses in the hospital setting, they found that their role was limited and their skills ‘suppressed’ in the community. • They recognized that nurses in ‘F’, ‘G’ and ‘H’ Grades had greater experience and more education than they, yet they believed that they had the ability to participate more in the assessment and planning of care than was currently permitted. • They saw two factors as being mainly implicated in limiting their role: the tendency of district nurses to want to retain their ‘authority’ as assessors of care; and the Trust policy guidelines, which were somewhat inflexible on this issue. D Grade nurses also expressed their need for continuing education and support and for clearer career opportunities. • Although these data cannot be generalized to the population of staff nurses as a whole, the authors make tentative suggestions relating to the insights which may be taken from them. [ABSTRACT FROM AUTHOR]

This paper considers some of the initiatives taken by community nurses in England in implementing Project 2000 placements. The data were obtained during an English National Board funded study in two phases. The first phase involved a series of exploratory interviews, a postal questionnaire survey, and semi-structured interviews with 15 managers. In phase two, one Project 2000 demonstration district was studied in depth by means of interviews complemented by small-scale questionnaire studies. Community nurses had confronted a number of difficulties in implementing Project 2000. Among the most serious of these were shortage of time, poor communication with the colleges of nursing and lack of preparation. As a consequence, community nurses took what they saw as independent approaches to students’ placements. Many set their own aims and objectives for placements and produced written guidelines and teaching plans for students. Many also asserted the importance of their role in the assessment of students’ practical work. [ABSTRACT FROM AUTHOR]

The author addresses the connection between historical inquiry and the nursing practice. He traces the history of nursing in the U.S. He considers the role of nursing as a social practice. He believes nurses rarely possess a socially strong position in negotiating the social and institutional power structures.

The article comments on the periodization that the author would like to propose for nursing. First, nursing is based less on knowledge than on ethics and values. The heroic era is the time in which the role of the nurse was to fight battles. The third period was the professionalizing era in which the abortive attempt to forge a knowledge base took place. She suggests that the most effective means by which nursing can lay claim to its own identity is to step back from society's expectations.