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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]

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]

Aims and objectives. The study aimed to examine the experiences of patients and meanings attached to 'treatments' of sexual deviations, which included homosexuality and transvestism, in the UK (1949-1992), exploring reasons for such treatments, experiences and how individual lives were affected. Background. Male homosexuality remained illegal in England until 1967 and, along with transvestism, was considered an antisocial sexual deviation that could be cured. Homosexuality remained classifiable as a mental illness until 1992. Nurses were involved in administering treatments to cure these individuals; however, there is a paucity of information about this now-discredited mental health nursing practice. Design. A nationwide study based on oral history interviews. Methods. Purposeful and snowball sampling was utilised when selecting participants for the study. Participants were recruited via adverts in gay establishments/media. All participants gave signed informed consent. Face-to-face oral history interviews were conducted and transcribed for historical interpretation. Results. Seven former male patients made contact, aged 65-97 years at interview. All reported that the treatments had been unsuccessful in altering their sexual desires or behaviour. Most sought treatment owing to unsupportive and negative attitudes from friends, family and wider society. Others selected treatments instead of imprisonment. Most eventually found happiness in same-sex relationships. However, all were left feeling emotionally troubled by the treatments they received. Conclusion. Defining homosexuality and transvestism as mental illnesses and implementing what could be argued to be inefficient treatments to eradicate them appears to have had a lasting negative impact on the patients who received them. Relevance to clinical practice. Nurses who care for older gay, lesbian, bisexual and transgender patients need to be mindful of their potential past treatment by healthcare services and ensure that they are non-judgmental and accepting of their sexual orientation and current gender. [ABSTRACT FROM AUTHOR]