Search

Nurse‐led clinics are known to positively impact and benefit patients; however, there is little understanding of the role of the nurse in a nurse‐led male Lower Urinary Tract Symptoms (LUTS) clinic. LUTS affect up to 30% of males over 65 in the United Kingdom and can significantly impact the quality of life of the person experiencing them. LUTS can be managed with conservative changes, as well as with medication and surgical intervention. The aim of this scoping review is to map what is known about the role of the nurse in a nurse‐led male LUTS clinic and what research tells us regarding, the barriers and enablers in nurses leading a male LUTS clinic. This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐SCR) checklist and the methodological guidelines set out by the Joanna Briggs institute. A literature search was carried out over three databases (CINAHL, Medline Ovid, ProQuest health and medical collection) and systematically searched from 2000 to 2021. Grey literature was also searched, and citation chaining was undertaken. Following a systematic review of the literature, four papers met the inclusion criteria for this scoping review. The emergent themes across the four papers consisted of structure, assessment and resources, and effectiveness of the nurse‐led male LUTS clinic. There was clear agreement across the literature regarding the investigations and assessment the nurse should carry out. Ongoing practical, theoretical, and observational training and education is required to ensure the nurse is competent in running a male LUTS clinic. The papers reviewed showed the nurse provided a supportive role to the consultant. However, there is evidence indicating there is a move towards autonomous practice. There is a dearth of the current research relating to the role of the nurse in nurse‐led male LUTS clinics and the enablers and barriers in nurses leading male LUTS clinics. Further research should be considered to gain a better understanding of where nurse‐led male LUTS clinics currently take place, what the role of the nurse is in leading a LUTS clinic and what enablers and barriers exist. [ABSTRACT FROM AUTHOR]

Background: People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services. Methods: A traditional literature review design was followed to map evidence (2000-2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically. Results: Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management. Conclusion: Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management.

Aims A discussion on the case for nurse-led community delivery of health and social care interventions to ex-offenders. Background Ex-offenders re-enter their communities with limited pre-release preparation for the continuity of access to health care once outside prison. Once released, these individuals become hard to reach, do not consider health a priority and consequently use services to address their health and social care needs in a crisis-led way. Nevertheless, how nurses can best support these health-excluded group of individuals in the community remains vague and requires discussion. Design Discussion paper. Data sources Several databases were searched for papers published in English from 1990-2012 using the Population, Intervention and Outcome framework to help structure search. Discussion It is argued that current dominant discourses around equity of care are contradicted in the provision of health and social care services to ex-offenders in the community. Effective engagement with community interventions may be achieved if ex-offenders maintain contact with frontline providers who can support both their structural and health needs. Implication for nursing Nurses are uniquely positioned to initiate and sustain contact with ex-offenders, intervening at points of greatest need in the community to address the socially significant health and social care issues that plague them. Conclusion The use of nurses in the provision of health and social care interventions to ex-offenders is a strategy, which could increase equity in access to health care, reduce reoffending and improve both the health and life chances of these individuals. [ABSTRACT FROM AUTHOR]

Aim: To explore and summarise published literature with regards to secondments to clinical research and to identify the gaps in research to inform further work. Design: Systematic scoping review. Method: A scoping review was undertaken in accordance with the Patterns, Advances, Gaps, Evidence and Research framework. Databases searched included CINAHL, PubMed, Medline and Embase. Inclusion/exclusion criteria were applied by two independent reviewers. Two reviewers independently retrieved full‐text studies for inclusion and applied the framework as a tool for synthesising Patterns, Advances, Gaps, Evidence and Research recommendations. Results: Six papers and one abstract published between 2003 and 2018 were included. All secondees (n = 34) were released from NHS posts, with secondments (where specified) ranging in duration from 0.25 to 2 years and for 40%–100% of their working hours. All seven papers reported benefits for personal and professional development, predominantly in the form of personal reflections. Few described involvement with research delivery teams. Conclusion: Published initiatives vary in nature and lack standardised reporting and measurement of impact. Further research is required to identify benefits at a departmental or organisational level, the facilitators for setting up secondments and the application of knowledge gained from secondment opportunities. Implications for the Profession: Undertaking a research secondment is reported to offer professional and personal benefit for clinical staff. Research secondments are one way in which a research culture can practically be embedded within clinical settings. Impact: This scoping review identified a lack of published empirical research seeking to understand research secondments as a tool to enhance research and evidence engagement. Although there is a suggestion that secondments could positively impact staff retention, there is limited evidence about the benefit for the organisation or for patient care. These findings have implications for staff, managers and their organisations. Reporting Method: The PRISMA‐ScR guidelines were used to guide reporting. No Patient or Public Contribution: This was not relevant to the research design. [ABSTRACT FROM AUTHOR]

Collecting biological data in representative surveys is becoming more common due to their potential to inform research and policy. Nevertheless, using nurses to collect these data can lead to unintended effects. In this paper, we investigate how nurses influence the non-response process by looking at five waves of data coming from two surveys in the UK: Understanding Society and the English Longitudinal Study of Ageing. We find that nurses explain between 5 and 14% of the variance in non-response to biological data collection. We also find that older nurses are more successful in obtaining cooperation and consent to biological data collection and nurses with more survey experience are more likely to successfully collect blood samples. Finally, we show that including nurse characteristics in non-response weighting models leads to modest changes in population estimates of biological markers.

Aims: To synthesise evidence regarding organisational practice environment factors affecting healthcare workforce development, recruitment, and retention in the UK. Methods/data sources: A systematic search of PubMed, Web of Science, EMBASE, and PsycINFO yielded ten relevant studies published between 2018 and 2023 and conducted in the UK (the last search was conducted in March 2023). Adhering to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two independent reviewers conducted screening, sifting, and data extraction, applying the quality assessment tool for risk of bias. Results: Results highlight key factors associated with staff intention to leave/turnover/retention: workplace challenges, aggression, moral distress, on-the-job embeddedness, leadership involvement, organisational support, and flexible shift patterns. Notably, aggression from colleagues, including clinical staff but not interdisciplinary personnel, has a more detrimental impact on staff intention to leave than aggression from patients. Conclusion: The complex and context-dependent impacts of these organisational factors on the UK healthcare workforce underscore the need for tailored interventions. The review acknowledges limitations, including bias from excluding qualitative studies, a small pool of included studies, and nurse overrepresentation. Summary statement: What is already known: Securement and retainment issues affect different aspects of health and care services. Moreover, healthcare workforce shortages persist in the UK. What this paper adds: Our findings on the importance of workplace challenges and aggression, moral distress, on-the-job-embeddedness, leadership, flexible shift pattern, and organisational support in staff retention are important to addressing the current UK healthcare workforce crisis. Implications for practice/policy: The findings of this review are important to healthcare commissioners, policymakers, and stakeholders, offering valuable insights for dealing with factors contributing to shortages in the healthcare workforce and enhancing staff satisfaction and retention. [ABSTRACT FROM AUTHOR]

An introduction to this issue of this issue of "Journal of Advanced Nursing," in which the authors discuss contributions to JANForum, is presented.

The paper develops the concept of language awareness (LA) by considering the material-social-discursive nexus of the communicative situation that affords professional practice. It also presents a mixed-methods study that provides a deeper and multi-layered understanding of LA in action and sets out a methodological framework for similar research in healthcare communication. Our study addresses: (i) the need for LA (re)conceptualisation in research on healthcare contexts, (ii) the ways in which a mixed-methods approach provides a deeper understanding of both implicit and explicit LA and (iii) the opportunities raised for reflection on practice through researcher-practitioner contact. Drawing on our linguistic ethnography of nurse shift-change handover meetings in a hospital unit, we draw on and expand van Lier's model by demonstrating the shortcomings of limiting LA to awareness of language as system rather than as activity embedded in particular socio-discursive situations. Regarding nursing handovers, we argue that handover practice and ongoing patient safety not only require the implementation of communication protocols, but also depend on nurses' reflective practice as the different types of interactions address crucially different levels of awareness. We conclude by discussing the theoretical and methodological contribution of our study to the fields of LA and healthcare communication.

Background: Women with intellectual disability (ID) are surviving to the age group at greatest risk of developing breast cancer (50-69 years). These women are more likely to experience a greater number of risk factors placing them at an advanced threat of developing breast cancer. However, as a result of cognitive deficits and communication difficulties these women are dependent upon staff to support them to attend the breast screening clinics. Aim: The aim of this paper was to examine how community nurses and residential staff support women with ID to access breast screening services. Methodology: Six focus groups were held with community nurses and residential staff who work in the field of ID in one region of the UK. The focus groups were tape recorded and the transcriptions were subjected to a thematic content analysis. Findings: Although many of the participants recognised the risk factors and signs/symptoms of breast cancer, there was still a deficit of knowledge. Both positive and negative experiences of women with ID attending for breast screening were reported; however, greater discussion focused on the latter. The participants identified "a lack of health educational material" and also negative "emotions, attitudes and physical barriers" as inhibiting factors for attendance. Discussion: This paper highlights the need for developing a health promotion programme for women with ID focusing on breast awareness and information on screening, and also healthier lifestyles. Breast awareness via visual checks was identified for women with ID who refused to attend the breast clinics; however, issues of informed "consent" and "vulnerability" were raised for staff and also family carers having to undertake these checks. Development of user-friendly health educational literature using "pictures, symbols, signs" and simplified words should be accessible to all ID staff, healthcare staff, and also women with ID. (Contains 2 boxes.)

The concept of the independent learner has become increasingly important within the higher education sector. However, there appears to be no consensus and rarely any clarification of what is meant by the term. As a result, students may fail to understand what is expected of them as independent learners, with implications for retention, progression and the student experience. This paper describes a research project that aimed to clarify what students and staff understood by the phrase. The results suggest that while most staff and students were familiar and comfortable with the concept, there remains potential for misunderstanding and confusion. (Contains 4 tables and 1 figure.)

Recruitment onto pre-registration learning disability nursing courses has decreased considerably over the last decade. This paper reports the findings of the first stage of a longitudinal study that investigated the factors that influence students to train as learning disability nurses, and those that influence their decision to continue or leave the course. Semi-structured interviews were conducted with one cohort of learning disability student nurses (n = 19) within the first 6 months of their starting the Common Foundation Programme. A number of unexpected issues emerged. These revolved around the negativity displayed by some practitioners and tutors about learning disability nursing and how this in turn was impacting on the decision made by four of the students in particular to transfer to other branches of nursing. The paper concludes with some recommendations for Schools of Nursing to ensure that the speciality is seen as an attractive and worthwhile career option.

Purpose: The purpose of this paper is to report a work-based learning innovation developed in response to the skills agenda affecting post-registration continuing professional development for nurses. Design/methodology/approach: The experience of learners, mentors and assessors using the "Skills Bank" are illustrated as part of an ongoing evaluation of work-based learning. This was captured by semi-structured interviews and the observations of the author as innovation was implemented and to the quality issues for academic rigour were addressed. The study is set in the context of the debate about skills and competence. Findings: The study finds that learners responded well to the innovation because they were motivated and self-directed. The experience exceeded their expectations of continuing professional education. Some did not engage with the database of skills and learner-generated skill design was consequently of poor quality. The assessment strategy is well-defined and rewards excellence in practice with the use of a grading tool. Practical implications: Content of skills templates reflect current evidence-based practice, which can be mapped to Skills for Health workforce competences. Maintaining the Skills Bank in terms of currency and authenticity is challenging. Originality/value: This paper will be of interest to education and training providers keen to address the preparation of health care staff fit for purpose and practice. It attempts to articulate skills as a notion of competence. (Contains 5 figures.)

Purpose: The paper comprises an evaluation of the inclusion of art-related education within a health promotion course for student nurses, which ran for four cohorts from 2001 to 2005, and a description of a project to introduce art into a clinical skills laboratory as part of the course. Design/methodology/approach: The art-related aspects of the course were evaluated by analysing qualitative comments from a questionnaire completed by a total of 83 students from the four cohorts. In addition, lecturers were invited to write their reflections. Only the 2003-2004 cohort worked on the clinical skills laboratory art project in which students acted as a focus group, and later carried out interviews with patients. Findings: The art-related education was positively evaluated by most students, and appeared to have increased their awareness of health care environments. For some, it had promoted emotional awareness, empathy for patients and had been a therapeutic and enjoyable experience. A specification for art work to be introduced to the university's clinical skills laboratory was produced. Originality/value: Using the arts in pre-registration nurse education is relatively new in the UK, and this work provides an example of its potential to encourage empathy among student nurses for the experience of patients in health care settings. The paper provides an example of how art work could be introduced into health care settings. (Contains 3 figures.)

This paper discusses using action learning with different professional groups in the UK--nurses and educators. It addresses the question: To what extent is action learning an effective approach in relation to professional development, and, if so, in what way/s? The formulation and developmental processes of action learning sets are examined. The paper provides examples of the professional and personal development of these individuals as a result of experiencing the action learning process, as well as some positive impacts (outcomes) they achieved at an organisational level. It is also argued, however, that current tensions and challenges within professional groupings, cultures and contexts can impede action learning and, hence, have a negative impact on professional development. For example, political agendas and the psychodynamics of organisational life were found to hinder, or discourage, the learning process, i.e. the likelihood of bringing about change, in favour of maintaining the status quo for the individuals themselves and within their organisational structures. (Contains 3 notes and 1 figure.)

An exploration of health professionals' perceptions of the concept of shared learning and of the belief that shared learning can improve professional relationships in practice. A shared learning event was arranged as a forum for information exchange within an NHS trust. Ten per cent of total staff (87 people) attended. Questionnaires were completed by the delegates on the day of the event and repeated 10 weeks later. Thematic analysis of the questionnaire data guided the development of an interview schedule for two focus groups, carried out three months later. This paper reports on the findings from the focus group interviews. The main finding is that shared learning events can give health professionals the opportunity to learn about other professionals' roles. Patient-focused, work-based learning within a multi-disciplinary team is the most realistic way of implementing shared interprofessional learning successfully. The paper concludes that shared learning can positively influence effective interprofessional working. However, the focus may need to be on work-based learning opportunities rather than on formal events, thus leading to the promotion of interprofessional learning.

Purpose--The purpose of this paper is to investigate the dramatic reforms in the health service in recent years. Design/methodology/approach--Examines management development in health care, and explores the experiences of clinical nurse managers. Findings--Duplication of agencies and multiplication of roles have led to tensions in terms of both the management and organisation of the health service and pressures to accommodate local and national agendas have proved difficult and, as such, a complex, bureaucratic organisation is seen to be the resultant outcome. Originality/value--This paper fulfils the need of exploring the experiences of clinical nurse managers in the NHS. (Contains 2 figures and 1 table.)

The education of nurses, midwives and allied health care professionals in the UK is guided by professional bodies and the over arching Health Professionals Council (HPC)/Nursing and Midwifery Council (NMC). Each of these professional bodies provides regulatory frameworks and guidance notes on the educational content of the degree level programmes that underpin the included profession. The professional and regulatory bodies oversee the educational requirements of the individual professions and suggest the key topics and curriculum content that have to be both studied and completed in order for the individual student to be considered a proficient practitioner in that area. These regulatory frameworks and the guidance from the professional bodies all mention the need for psychology to be contained within the educational experience. However, as a general rule there is, unsurprisingly, a greater focus on other topics within the curriculum for health care professionals. Why is this? Why isn't psychology a core subject? Why shouldn't psychology be a central focus within the health care curriculum? In this paper, the author explores these issues, with a focus on the place of psychology within the health care professionals' curriculum. Specifically, the author examines (1) the nature of curriculum content of the health care professionals; (2) why curriculum content is important; (3) studies of curriculum content; and (4) how the curriculum content should be chosen. (Contains 1 table and 1 figure.)

The main aim of this paper is to explore and discuss the interesting juxtaposition of patient involvement within a standardised Enhanced Recovery After Surgery care programme (ERAS). We address our aim by examining the work and strategies of nursing staff caring for patients during postoperative recovery from surgery, exploring how these two potentially competing priorities might effectively co‐exist within a hospital ward. This was a qualitative exploratory study, with data generated through 42 semi‐structured interviews with patients and nurses who had taken part in an ERAS programme in one of three hospital wards in the United Kingdom, adopting a reflexive thematic approach to data analysis. We shine a light on the work undertaken by patients and nurses during the navigation of postoperative recovery, identifying strategies of collaboration and negotiation during this journey. Furthermore, we also identify and consider patients engaged in peer‐peer support during postoperative recovery. This paper adds to the existing literature and current ways of thinking in relation to the quest for standardised, clinically effective care balanced with the aspirations for individualised, patient‐centred care. This paper also helps inform thinking about the use of care pathways in relation to service delivery, considering how best to initiate and deploy best practice aimed at safe and effective postoperative recovery. [ABSTRACT FROM AUTHOR]

In order to become a UK Nurse Prescriber, a First Level Registered Nurse must undergo an approved University based educational programme, which consists of theory, and a period of practice supervised by doctors. The Nursing and Midwifery Council (NMC) requires nurses undertaking this programme to have some formal university attendance and to be assessed in practice. Successful students are recorded on the national NMC register. Since October 2004, the University of Winchester has used blended learning incorporating e-learning for the delivery of the Nurse Prescribing Programme using online material developed by Emap Publishing in conjunction with the University of Stirling. This paper discusses the effectiveness of the programme and the evaluation of the initial six cohorts ("127 students") who studied the Nurse Prescribing Programme undertaken by e-learning through the University of Winchester.

This paper presents qualitative research completed in two groups of hospitals in the United Kingdom, as part of a larger mixed methods study. It involved eight qualified nurses caring for patients with gastro-intestinal cancer in general surgical wards. It explored the nurses' experiences of using an online programme and their perceptions of the impact of learning on patient care delivery. The nurses volunteered to complete an online open source package www.cancernursing.org. and meet for focus group discussions and interviews following a lapse of six weeks. Two of the participants experienced difficulties completing the package and following changes to the previously attained ethical approval, a focus group was conducted with these staff. Analysis of the transcripts identified a number of issues for those considering the adoption of such modes of delivery within healthcare. Nurses referred to a lack of information technology skills and competence in computer use, access issues, organizational barriers and lack of protected study time. In spite of difficulties they gave examples of how their learning had impacted on patient care.

Doctoral research considered whether healthcare students were able to develop characteristics of Communities of Practice when engaged in an interprofessional online module. Using a case study approach the research included two phases. Within phase one a questionnaire was administered to the group of 109 healthcare students. These were analysed to gain information on which to base sampling for the subsequent phase. Phase two employed three strands of data collection; five students completed an online diary, the online interaction of seven students was captured on a discussion board and three students were interviewed. Data were analysed using a form of pattern matching. The results suggested students were able to develop the essential elements of Communities of Practice. This was not uniformly seen however, and particular issues emerged for the online community. This paper focuses on discussing the contribution of the research to the development of the Communities of Practice framework for online learning. The discussion will review the main findings of the research, showing how these have led to the development of the theory. It offers an augmented framework, in which the elements of mutual engagement, joint enterprise and shared repertoire are enhanced to include those facets necessary to support an online learning community. Finally, it is suggested that the augmented framework may have applicability to other professional groups engaging in online learning and working, with consideration given to how it might support e-based communities.

Introduction: The role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role. Aims: The aim was to gain consensus opinion to answer the research question: 'What is the role of the clinical nurse specialist in stoma care?' Design: Delphi consensus. Methods: Previous data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session. Results: All 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one. Conclusions: The four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously. Implications for Practice: Consideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred. Patient or Public Contribution: No patients or public were involved in any aspect of this paper—in hindsight this might have been useful. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot. Aims: This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken. Method: A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes. Results: The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork. Conclusion: This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible. [ABSTRACT FROM AUTHOR]

The article explores the advantages and disadvantages of the white paper on primary care released by the British government in 2006. The white paper entitled, Our Health Our Care Our Say: A New Direction for Community Services, could create opportunities for nurses to ape community health and social care services. However, nursing leaders fear that primary care nurses may be overlooked as additional provider enter the National Health Services with new facilities.

District nursing services are relentless in adapting to change and continuously seek different methods to improve the care they offer to service users. One of the relatively new changes where adaptation has been necessary is the use of digital devices to record assessments and work in real time. As documented in The NHS Long Term Plan (NHS) (2019), the NHS is being required to grow into the new digital age and, subsequently, district nurses (DNs) have needed to embrace the use of a paper-lite system. Although beneficial overall, the use of technology is a threat to the person-centred nursing approach used in assessment, which is the highest fundamental value in nursing. This article will seek to conceptualise the importance of a person-centred initial assessment with a service user who has either a long-term and/or a lifelong condition whilst considering the use of digital devices, benefits, and drawbacks of their use. It will emphasise the role of the DN, encompassing the multidisciplinary services throughout, whilst also considering any recommendations for further development. [ABSTRACT FROM AUTHOR]

This paper responds to the Alpine Rendez-Vous "crisis" in technology-enhanced learning. It takes a contested area of policy as well as a rapid change in the National Health Service, and documents the responses to "information overload" by a group of general practitioners practices in the North of England. Located between the spaces identified by Traxler and Lally as "competitive industrialisation" and web 1.0, and the consumer/customer focus and ubiquitous ownership enabled by portable and devices and web 2.0, in this work we see the parallels of the responses of publicly funded bodies moving towards privatisation as part of a neo-liberal agenda. Interviews with health professionals (HPs) revealed marginalised spaces for informal learning in their workplaces, and a desire to build a community that would enable them to overcome the time/space barriers to networking. The EU Learning Layers Integrating Project develops mobile and social technologies that unlock and enable peer production within and across traditional workplace boundaries. Through the HP narratives, we capture insights into their daily life, which enable the articulation of their needs for an online "Help-seeking" networking service, underpinned by their desire to consult what Vygotsky calls "the more capable peer."

There is conflict between the views projected by nurses and by policy directives about what constitutes care and caring. While there is a plethora of works on the conceptualization of care and caring, the influence of discourse remains unexplored. There is a small number of studies from the perspective of social constructionism, but very few take a Foucaultian-influenced analysis to identify the prevailing discourses and their power in the socially constructed situation of care and caring. This work explores the discursive roots of the current debate and shows how the power associated with the discourses of each social arena have shaped nursing practice. The findings are drawn from a grounded theory project using situational analysis. A total of 22 one-on-one interviews were completed with 14 community-based practitioners. The analysis revealed the social construction of four distinct arenas, each containing differing constructs of a caring nurse. Each specifically constructed social arena had associated discourses, to which it aligned. It revealed the conflicts between the four social arenas, the negotiation that took place, and how these conflicts and negotiation both gave power and repressed the differing world views of a caring nurse. The paper shows how alignment to discursive positions constructed three distinct senses of care.

Aim: We aim to explore healthful leadership practices in nursing and midwifery evident within the COVID‐19 pandemic in the United Kingdom, the contextual facilitators, barriers and outcomes. Background: Globally, the health and care sectors are under pressure and despite nurses and other professionals, demonstrating resilience and resourcefulness in the COVID‐19 pandemic; this has negatively impacted on their health and wellbeing and on patient care. Evaluation: Two searches were conducted in July 2021 and December 2021. Inclusion/exclusion criteria were identified to refine the search, including papers written since the beginning of the pandemic in 2020. A total of 38 papers were included principally from the United States and United Kingdom. Ten were research papers; the others were commentaries, opinion pieces and editorials. MS Teams literature repository was created. A unique critical appraisal tool was devised to capture contexts, mechanisms and outcomes whilst reflecting more standardized tools, that is, the Critical Appraisal Skills Programme and the Authority, Accuracy, Coverage, Objectivity and Date tool for reviewing grey literature to refine the search further. Key issues: Six tentative theories of healthful leadership emerged from the literature around leadership strategies, which are relational, being visible and present; being open and engaging; caring for self and others; embodying values; being prepared and preparing others; and using available information and support. Contextual factors that enable healthful leadership practices are in the main, created by leaders' values, attributes and style. The literature suggests that leaders who embody values of compassion, empathy, courage and authenticity create conditions for positive and healthful relations between leaders and others. Nurse and midwives' voices are however absent from the literature in this review. Conclusion: Current available literature would suggest healthful leadership practices are not prioritized by nurse leaders. Perspectives of nurses' and midwives' about the impact of such practices on their wellbeing is also missing. Tentative theories are offered as a means of identifying healthful leadership strategies, the context that enable these and potential outcomes for nurses and midwives. These will be explored in phase two of this study. Implications for Nursing Management: Nurse leaders must be adequately prepared to create working environments that support nurses' and midwives' wellbeing, so that they may be able to provide high‐quality care. Ensuring a supportive organizational culture, which embodies the values of healthfulness, may help to mitigate the impact of the COVID‐19 pandemic on nurses' and midwives' wellbeing in the immediate aftermath and going forward. [ABSTRACT FROM AUTHOR]

Aims: This is the second of two papers conceptualizing emotional labour in the emergency department (ED). This paper aims to understand the environmental 'moderators' of ED nurses' emotional labour. Design: Ethnography, through an interpretivist philosophy, enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nurses. Methods: Observation and semi‐structured interviews over a 6‐month period. Two hospital sites (one district general and one major trauma centre based in the United Kingdom. Results: Over 200 h of observation plus 18 formal/semi‐structured interviews were completed. Environmental, institutional and organizational dynamics of the emergency department instrumented the emotional labour undertaken by the nursing team. Time and space were found to be 'moderators' of ED nurses' emotional labour. This paper focusses on the relevance of space and in particular, 'excessive visibility' with little respite for the nurses from their intense emotional performance. Conclusion: Emotional labour is critical to staff well‐being and the way in which healthcare spaces are designed has an impact on emotional labour. Understanding how emotional labour is moderated in different clinical settings can inform organizational, environmental and workforce‐related decision‐making. [ABSTRACT FROM AUTHOR]

International studies have shown poor uptake of public health initiatives by people with learning disabilities. In addition, studies have shown that people with learning disabilities experience poor access to public health services. The contribution of community learning disability nurses in meeting the public health needs of people with learning disabilities has evolved differently across the UK resulting in conflicting understanding of this role. This paper reports on a study that explored and explained the contribution of community learning disability nurses in the implementation of public health policies for people with learning disabilities. The study demonstrates that community learning disability nurses are involved in health surveillance, health promotion, health facilitation, health prevention and protection, health education, and healthcare delivery.

The article reports that the Royal College of Nursing has called for a recognition of the central role of primary care nurses in delivering the Government's new White Paper on improving community health and care services in Great Britain, as of February 10, 2006. The Government's own research shows that 40% of people want a nurse as the first point of contact in primary care. The White Paper aims to provide local, integrated health and social care services. INSET: NEW MEASURES INCLUDE.

The study aimed to investigate the process of reflection in professional nurse education and the part it played in a teaching and learning context. The research focused on the social construction of reflection within a post-registration, palliative care programme, accessed by nurses, in the United Kingdom (UK). Through an interpretive ethnographic approach, the organisational, contextual and cultural issues impacting upon teaching and learning interactions, and the use of reflection therein were explored with student and nurse educator participants. Data were collected from observations of teaching and learning, interviews, and extracts from programme documentation and reflective learning contracts (RLCs). Findings contribute new empirical knowledge regarding the process of teaching and learning about reflection, including educator and clinical supervisor facilitation, the emotional work involved in reflection and methods of "mapping" and "modelling" to support reflection. The influence of both higher education and practice partner organisations on the use of reflection is also evident and indicates that professional reflective education requires institutional support from both education and practice. Specific findings in this paper are pertinent and transferable to other disciplines, where reflective education is used to develop being critical in order to learn through experience. This research offers valuable insights into the realities of reflective education and has currency for educators committed to developing skills for reflection and learning through experience for students, through the generation of a reflective culture.

Patient education (PE) has a crucial role in the function of a healthcare organisation. For the care process of a patient, it is essential to get the right information at the right moment and in the right form. This paper analyses PE as the primary mode of interaction between a patient and a healthcare organisation. The approach is illustrated with a study among nurses based on their conceptions about PE. Practical implications and the potential of ICT in PE in particular are discussed.

The school nurse has a crucial role in the United States and the United Kingdom and has their own expertise dedicated to school assistance for children, families, school staff, and the community. This study aims to identify the role and skills of the school nurse and understand the effects of COVID-19 on nursing skills in the following countries: The United States, the United Kingdom, and Italy. A Scoping Review was conducted following the JBI methodology for scoping reviews, following the PRISMA-ScR guidelines. Three databases were consulted: PubMed, Cinahl, and Scopus. In all, 58 studies met the eligibility criteria and were included. 93.1% of the studies were carried out in the United States, 5.2% in the United Kingdom, and 1.7% in Italy. 34.5% of the articles were published in 2020, 15.5% in 2021, 31% in 2022, and 19% in 2023. 22.4% of the studies included in the review concerned health promotion and education. Regarding the methodology of the studies, 41.5% of the studies were commentary papers, 15.5% were observational studies, and 12% were cross-sectional studies. Considering the effects of the school nurse in the United States and the United Kingdom, it is possible to reflect on how the systematic presence of a nurse could also have benefits in Italy. [ABSTRACT FROM AUTHOR]

This paper reports findings from a study into how nurse educators view the notion of an inclusive curriculum within their discipline. UK nurse education is professionally accredited, with substantial levels of work-based learning. Therefore, this analysis should be useful to practitioners on other professional courses. The study was based on a phenomenographic analysis of data collected from interviews with 15 nurse educators in one university. Analysis exposed wide variation in respondents' perceptions and experiences of developing and delivering an inclusive curriculum. Much discussion focused on teaching students with disabilities and tutors expressed concern over implications regarding fitness for practice and public safety. However, there was recognition that diversity was a feature of the contemporary educational environment and that nursing courses had much to gain from inclusive practices. Key differences identified related to the extent to which change was required to current processes and practices. The findings indicated a concern over support for educators to manage these issues and suggested that in the absence of more robust direction, the student experience is shaped by the attitudes of individual tutors. In light of this, the author suggests that a coordinated and consistent response from the higher education establishment, professional bodies, practitioners and policy-makers is necessary to fully establish the notion of inclusive curricula in any professionally accredited course. (Contains 1 figure.)

Aim: The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice. Background: Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future. Design: A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analyses Scoping Review extension (PRISMA‐ScR) guidelines. Results: One hundred fifty‐five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation. Conclusion: There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work‐ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work‐ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence‐based. [ABSTRACT FROM AUTHOR]

Background: Institutional racism within the United Kingdom's (UK) Higher Education (HE) sector, particularly nurse and midwifery education, has lacked empirical research, critical scrutiny, and serious discussion. This paper focuses on the racialised experiences of nurses and midwives during their education in UK universities, including their practice placements. It explores the emotional, physical, and psychological impacts of these experiences., Methods: This paper draws on qualitative in-depth interviews with participants from the Nursing Narratives: Racism and the Pandemic project. Of the 45 healthcare workers who participated in the project, 28 participants obtained their primary nursing and midwifery education in UK universities. Interviews with these 28 participants were selected for the analysis reported in this paper. We aimed to employ concepts from Critical Race Theory (CRT) to analyse the interview data in order to deepen our understanding of the racialised experiences of Black and Brown nurses and midwives during their education., Findings: The interviews revealed that the healthcare workers' experiences coalesced around three themes: 1) Racism is an ordinary, everyday experience; 2) Racism is operationalised through power structures; and 3) Racism is maintained through denial and silencing. Experiences often touch on a series of issues, but we have highlighted stories within specific themes to elucidate each theme effectively. The findings underscore the importance of understanding racism as a pandemic that we must challenge in response to a post-pandemic society., Conclusion: The study concludes that the endemic culture of racism in nurse and midwifery education is a fundamental factor that must be recognised and called out. The study argues that universities and health care trusts need to be accountable for preparing all students to challenge racism and provide equitable learning opportunities that cover the objectives to meet the Nursing and Midwifery Council (NMC) requirements to avoid significant experiences of exclusion and intimidation., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

The transfer of knowledge, policy and practice between nations increasingly involves knowledge of the theory and practice of evaluation. This article examines issues arising from the transcultural evaluation of a drug and alcohol misuse knowledge and skills transfer programme for nurses, nurse teachers and medical staff in the narcology service in St Petersburg, Russia that ran between 1995 and 2004. The programme is contextualized and described prior to an account of the evaluation activities. Issues arising from the evaluation process are discussed, including ethnocentricity, cultural biases and the local generation of meaning, and the use of interpreters in interviewing and transcription. The article suggests that undertaking transcultural evaluations enables more sensitive and effective domestic evaluations and that the approaches to evaluation favoured by Western funding agencies encourage ethnocentricism. The paper concludes with a recommendation for enhancing transcultural evaluations by setting them within a conceptual framework that facilitates the analysis of policy and practice "borrowing" and transfer. (Contains 4 figures.)

Purpose: Aims to provide a brief discussion of discourses of HRD, then a brief review of HRD within the NHS, including stakeholders in HRD, and particularly management development. To explore some of the different discourses used by different managers, particularly those with a nursing background and those without, and the possible reasons for the use of these different discourses. Design/methodology/approach: A qualitative case study approach was adopted, including semi-structured interviews. Primary research data were collected from tape-recorded interviews with seven Directorate General Managers from two Welsh NHS Trusts. Discourse analysis was used to explore connections between the participants, the discursive resources they employed and their professional identities. Findings: Provides evidence of some of the tensions associated with management development in the NHS, between professional and managerial development, between central and local HR activities, and between competition and cooperation. A particularly interesting dimension is the transition from "being" a nurse to "becoming" a manager and the ways in which different individuals cope, as articulated in their language use. Highlights some of the discursive struggles to maintain one's professional (nursing) identity when promoted to managerial positions. It provides examples of some nurses who have adopted the new managerial discourse without such apparent difficulty of changed identity. It also presents material from NHS managers who have no nursing background to enable further comparative analysis of the relationships between identity and discourse. Research limitations/implications: The findings are limited by small sample size, although feedback suggests the findings can be generalised to other NHS Trusts across the United Kingdom, and possibly globally. Not one senior manager used the term HRD--it was always "training and development" or "professional development" or "managerial and organisational development" and sometimes "learning." Nor was there much use of the government's preferred term "workforce development." This has implications for HRD research within this context, suggesting the need for shared understanding amongst researchers and participants. Practical implications: Various and varying discourses and associated discursive resources are identified, illustrating the diversity of talk about HRD within the NHS. As one DGM commented, "I think we're using the same words but it means something completely different." This has practical implications, suggesting the need for shared understanding amongst HRD stakeholders to ensure a coherent and integrated approach to HRD within this complex multi-disciplinary context. Originality/value: How HRD is talked about and accomplished through talk has been relatively neglected in the health care context. This paper contributes to our understanding of how the complex range of learning and development activities are perceived and articulated, from the perspective of senior managers responsible for HRD. (Contains 1 table.)

Aim: To investigate the mental well‐being of early career nurses working in the United Kingdom during the COVID‐19 pandemic, with a particular emphasis on symptoms related to post‐traumatic stress disorder. Design: A longitudinal survey study. Methods: Data were acquired at three timepoints during the COVID‐19 pandemic (between May 2020 and March 2021) to determine whether symptoms of post‐traumatic stress disorder persisted over time. Quantitative measures of well‐being were supplemented with survey data on the nurses' experiences of working during the pandemic. Results: Twenty‐seven per cent of participants suffered from persistent symptoms of post‐traumatic stress while working as nurses during the pandemic. The nurses' baseline resilience, as well as their perception of the quality of their work environment, were significant negative predictors of symptoms of post‐traumatic stress. Participants identified a range of strategies that would have helped them during the crisis, including visible, consistent and empathetic leadership, adequate training and a supportive work environment. Conclusion: The context of the pandemic has highlighted the vulnerability of the psychological well‐being of early career nurses in the workforce. Immediate implementation of some of the more simple interventions suggested in this paper would provide early career nurses with rapid support. More complex support mechanisms should be given immediate consideration, with a view to implementation in the longer term. Implications for the Profession: This study contributes new knowledge about the psychological well‐being of early career nurses working during the pandemic and suggests support mechanisms that will be crucial for the retention of these nurses in the profession. A measurement of resilience may be useful for determining the appropriate level of support to provide to early career nurses. Impact: Early career nurses are vulnerable to attrition from the profession. This could be exacerbated if the psychological well‐being of these nurses is not being supported.Around 25% of early career nurses suffered from persistent symptoms of post‐traumatic stress disorder while working as nurses during the height of the pandemic, which is a novel finding compared to other longitudinal studies.Understanding the psychological well‐being of early career nurses working during a crisis period (such as a pandemic) equips nurse managers with appropriate strategies to improve nurses' emotional health and to enhance their retention within the workforce.The current findings may be of interest to clinical practitioners who have responsibility for the retention of nursing staff. No patient or public contribution. One of the authors is a statistician. [ABSTRACT FROM AUTHOR]

Seclusion is one of the extreme measures of managing violence and aggression. Despite the evidence base for the effectiveness and therapeutic value of seclusion being limited, there arguably remains a compelling case for its use. This qualitative study aimed to explore forensic nurse's experiences and perspective on the use of seclusion in clinical practice and establish: •What are the factors that influence and inhibit the use of seclusion? •What skills are required when caring for patients in seclusion? A purposive sample of 12 registered and non-registered nurses from a UK high-security hospital consented to engage in a focus group. Thematic analysis was used to interrogate the data. The results included two emerging themes: 'Keeping everyone safe' and 'The challenges', including the identification of binary oppositions. A rationale for the use of seclusion; it's a last resort. Evidence of challenges to the therapeutic relationship and communication barriers. Findings illustrate the need to critically examine the practise of seclusion, accuracy of risk assessment, also to balance safety and security proportionately and ensure therapeutic value. The use of a daily dynamic risk assessment and staff relational training is recommended to improve communication and reduce excessive and prolonged use of seclusion What is known on the subject Over the last decade, significant headway has been made across the globe in relation to reducing restrictive practices such as seclusion. Early intervention and staff confidence in managing violence and aggression have been identified as factors that influence the occurrence of seclusion. What the paper adds to the existing knowledge Findings support the necessity to utilise objective assessment routinely. The binary oppositions described within the presenting results are as relevant today as they were almost two decades ago when published by Mason (2002) This paper provides new knowledge on forensic nurses' perception use of seclusion and draws attention specifically to the impact of the therapeutic relationship and communication challenges during a seclusion event. What are the implications for practice The provision of a daily dynamic risk assessment within nursing practice will effectively identify patients who are imminently at risk of engaging in violence and aggression and reducing excessive and/or prolonged use of seclusion. Staff development and development that includes relational skills training in how to manage complex relationships to improve positive communication and reduce the need for seclusion being required. The findings suggest the need for future research and senior managers and health-care professional leaders to gain a better understanding of the factors that influence the clinicians' decisions in the use seclusion, in order to achieve long-term reductions in its use. [ABSTRACT FROM AUTHOR]

Jim Blair is the only consultant nurse working with people with learning disabilities in the country. His job helps make people better and saves money. This article shares a conversation with Jim Blair. In the conversation, Blair says he is unhappy Valuing People programme did not do as much as it could have done. Jim is worried all the changes, happening at the moment, will make things worse for people with learning disabilities. He wants a new group set up that has the power to make changes happen.

Background: Research prioritisation exercises are used to determine which areas of research are important. In major trauma care, nurses and allied health professionals are central to the delivery of evidence-based care but their opinions on research priorities are under-represented in the literature. We aimed to identify the research priorities of major trauma nurses and allied health professionals in the UK., Methods: A three-round electronic Delphi study was conducted in the UK between November 2019 and May 2021. Round one aimed to generate research questions with rounds two and three questions in order of priority. In stages two and three responses were analysed using descriptive statistics to compute frequencies and proportions for the ranking of each question., Results: Survey rounds were completed by 180, 100 and 91 respondents respectively. The first round generated 285 statements that were condensed into 71 research questions. Analysis of rankings in subsequent rounds prioritised 54 research questions across themes of adult / children's acute care, psychological care and workforce, training and education., Discussion: Nurses and AHPs are well-positioned to determine research priorities in major trauma care. Focusing on these priorities will guide future research and help to build an evidence-base in trauma care., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: A significant proportion of the United Kingdom's (UK's) healthcare workforce comprises people from Black and Minority Ethnic (BME) backgrounds. Evidence shows that this population is under-represented at senior management levels. A collaborative leadership development initiative for BME nurses and midwives, by involving their line managers and mentors, was designed and implemented in a Scottish Health Board., Aim: This paper affirms the importance of a collaborative initiative that is targeted to support BME nurses and midwives for leadership development and career progression, and the promotion of an inclusive organisational culture to improve team work, and service standards., Method: This initiative adopted an Action Research approach. The programme began with collectively exploring participants' understanding of BME workforce development challenges, then planning and delivering a targeted leadership development training, and then evaluating it, in a cyclical way., Findings: With support from the project facilitators, line managers and mentors, a significant number of BME participants have gone on to achieve career progression. Participating line-managers and mentors have gained an in-depth and nuance understanding of workforce diversity, individuals' potentials, unconscious biases, and the importance of an inclusive organisational culture. All participants reported that they have learned to become more reflective in their professional practice, and more able to explore, embrace, and promote inclusive workplace culture. BME participants reported feeling that they were valued members of staff, and that this had led to a positive impact on team work and better patientcare outcome., Conclusion: The project has opened a new window into the world of the BME workforce. Findings highlight the value of a diverse workforce, and of an inclusive organisational culture being crucial for effective team work, and of overall benefit to workforce management. Finally, a collaborative initiative like this can successfully improve team work to deliver better patient care., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)