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4. The lived reality and meaning of Lean Thinking for nurses and nursing at an NHS Hospitals Trust

Author

Field-Richards, Sarah Elizabeth

Subjects
610.73, WY Nursing
Abstract

Lean Thinking (Lean) is a management philosophy originating from the Toyota automobile manufacturing company in Japan. Lean has been widely adopted in the United Kingdom (UK) National Health Service (NHS) as a panacea for addressing challenges that threaten its sustainability. Attempts to evaluate the outcomes of Lean implementation, in order to assess its claims to improve efficiency, quality and safety, have proved challenging owing to ambiguity surrounding the definition of Lean, differences in approaches to, and the poor quality of literature reporting, implementation. Lean continues to be adopted in healthcare regardless however, and a body of literature considering the consequences of Lean more broadly, is suggestive of implementation holding other, far-reaching implications. In attempting to transform healthcare culture and the way in which work is physically and socially structured, managed, organised and delivered, Lean can be understood as a socio-cultural intervention, holding the potential to transform the socio-cultural milieu of healthcare practice. There is, however, a dearth of research considering the nature of this transformation, the interaction between Lean and the socio-cultural context of practice, healthcare professionals’ experiences, understandings and interpretations of implementation, and the implications that it holds for them. This is especially true in the context of Lean applied to nursing. Theoretically, owing to its managerialist associations, Lean presents challenges to essential facets of nursing as a profession, its socio-cultural foundations and identity. Other ‘empowering’ characteristics of Lean philosophy however, are congruent with increasing autonomy and control over practice, associated with nursing’s professional agenda. Lean implementation can therefore be conceived of as representing both a challenge to, and as proffering opportunities for, the nursing profession. Underpinned by feminist philosophy and employing an ethnographic methodology, the thesis explores the lived reality of Lean implementation for nurses working in three settings at an NHS Hospitals Trust, and its meaning for nursing’s professional project, identity and mandate. The lived reality of Lean is conceptualised as a game played between the Trust and nurses, for power and control over nursing practice. The organisational rationale for, and mechanisms of, exercising power under the guise of Lean are explored, together with the nursing response, incorporating strategies to preserve the socio-cultural status quo and protect nursing knowledge, autonomy and practice. The notions of ‘power’ and ‘holistic, person-centred theory’ are employed as conceptual vehicles, through which the lived reality of Lean and its meaning for nursing, are critically explored and understood. The traditional ‘powerless’ depiction and ‘project’ of nursing, are challenged in light of empirical findings. The positioning of Lean as a contemporary scapegoat for a theory-practice nexus, and the role of antagonising factors intrinsic to nursing itself, are considered. The utility and feasibility of the nursing project and identity, predicated on a holistic, person-centred model, is also questioned. In this context, the notion of ‘organisational collaboration work’ is introduced, and advanced as a recommendation of the thesis, as a potential means of extending nursing’s mandate, to better meet the needs of organisations, patients and nurses in contemporary healthcare.

Published
2017

7. A technical solution to a professional problem: The risk management functions of prognosticators in the context of prognostication post-cardiac arrest

Author

Field-Richards, Sarah Elizabeth and Timmons, Stephen

Subjects
General Social Sciences
Abstract

Cardiac arrest (CA) is a major cause of mortality and morbidity globally. Two-thirds of deaths among patients admitted to intensive care units following out-of-hospital CA are due to neurological injury, with most as a consequence of withdrawing life-sustaining treatment, following prognostication of unfavorable neurological outcome. Given the ramifications of prognosis for patient outcome, post-cardiac arrest (P-CA) guidelines stress the importance of minimizing the risk of falsely pessimistic predictions. Although prognosticator use is advocated to this end, 100% accurate prognosticators remain elusive, therefore prognostication P-CA remains pervaded by uncertainty and risk. Bioethical discourse notwithstanding, when located within a wider socio-cultural context, prognostication can be seen to present risk and uncertainty challenges of a professional nature. Such challenges do not, however, subvert the medical profession's moral and ethical prognostication obligation. We interpret prognosticator use as an attempt to manage professional risk presented by prognostication P-CA and demonstrate how through performing “risk work,” prognosticators serve professional functions, mediating tension between the professional duty to prognosticate, and risk presented. We draw on sociological analyses of risk and uncertainty, and the professions to explicate these (hitherto less enunciated) professional risk management functions of prognosticators. Accordingly, the use of prognosticators is conceived of as a professional response – a technical/scientific solution to the problem of professional risk, inherent within the P-CA prognostication process.

Published
2021

9. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Subjects
Organisational Behaviour, Beliefs, Experiences, Attitudes, Compassion, Nurse Education, Nursing, Care, Discourse
Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education.Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices.Design: A corpus‐informed discourse analysis.Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion.Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively.Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and communicating should also be addressed by established practitioners in order to maintain compassionate interactions between professionals as well as nurse‐patient relationships. Future research should focus on how compassionate practice is defined by both health professionals and patients.Relevance to clinical practice: In order to maintain nursing as an attractive profession to join, it is important that nurses are viewed as compassionate. This holds implications for professional morale, associated with the continued retention and recruitment of the future workforce. Existing ideologies within the practice placement, the prior care experience environment, as well as the educational and organisational design are crucial factors to consider, in terms of their influences on the expression of compassion in practice.

Published
2018

10. The Motivations and Experiences of Day-Hospice Volunteers: a qualitative study

Author

Field-Richards, Sarah and Field-Richards, Sarah

Abstract

Aim: To explore the motivations and experiences of hospice volunteer workers in a UK day-hospice. Background: National health policy has long stressed the importance of involving and using volunteers as resources for enhancing the quality of health and social services. Traditionally, hospices rely on volunteer contributions for the delivery of care to individuals nearing the end of life. If nurses are to ensure the recruitment, retention and support of volunteers, their motivations, experiences and subsequent needs must be understood. Method: Underpinned by an interpretive approach, 12 day-hospice volunteers participated in semi-structured interviews which were recorded, transcribed and thematically analysed. Themes identified were considered to represent the motivations and experiences of the sample. Similarly, sub-themes identified represented variations in the meaning of themes for volunteers. Findings: Volunteers’ motivations related to ‘the need for meaningful activity’, ‘giving something and giving something back’ and the desire for ‘re-integration, participation and mutuality’. The experience of being an established day-hospice volunteer was characterised by ‘personal development’, ‘escapism and normalisation’ for patients, the influence of ‘wider societal culture’, methods of ‘coping’ and issues associated with ‘organisational context’. Examination of sub-themes revealed that variations in the meaning of themes were due to the volunteers’ unique personal context. Conclusion: Uniquely, this study provided insight into day-hospice volunteers’ motivations and experiences and suggests they are numerous, interrelated and meanings ascribed to them are informed by each volunteers’ personal context. When supporting volunteers, hospice nurses should appreciate their diversity and modesty and strive to reflect this in recruitment efforts. Future research is needed to assess the transferability of findings to other day-hospices and could consider the impact of voluntee

11. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, Spiby, Helen, Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively. Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and commu

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12. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, Spiby, Helen, Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively. Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and commu

Full Text
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13. The Motivations and Experiences of Day-Hospice Volunteers: a qualitative study

Author

Field-Richards, Sarah and Field-Richards, Sarah

Abstract

Aim: To explore the motivations and experiences of hospice volunteer workers in a UK day-hospice. Background: National health policy has long stressed the importance of involving and using volunteers as resources for enhancing the quality of health and social services. Traditionally, hospices rely on volunteer contributions for the delivery of care to individuals nearing the end of life. If nurses are to ensure the recruitment, retention and support of volunteers, their motivations, experiences and subsequent needs must be understood. Method: Underpinned by an interpretive approach, 12 day-hospice volunteers participated in semi-structured interviews which were recorded, transcribed and thematically analysed. Themes identified were considered to represent the motivations and experiences of the sample. Similarly, sub-themes identified represented variations in the meaning of themes for volunteers. Findings: Volunteers’ motivations related to ‘the need for meaningful activity’, ‘giving something and giving something back’ and the desire for ‘re-integration, participation and mutuality’. The experience of being an established day-hospice volunteer was characterised by ‘personal development’, ‘escapism and normalisation’ for patients, the influence of ‘wider societal culture’, methods of ‘coping’ and issues associated with ‘organisational context’. Examination of sub-themes revealed that variations in the meaning of themes were due to the volunteers’ unique personal context. Conclusion: Uniquely, this study provided insight into day-hospice volunteers’ motivations and experiences and suggests they are numerous, interrelated and meanings ascribed to them are informed by each volunteers’ personal context. When supporting volunteers, hospice nurses should appreciate their diversity and modesty and strive to reflect this in recruitment efforts. Future research is needed to assess the transferability of findings to other day-hospices and could consider the impact of voluntee

14. The lived reality and meaning of Lean Thinking for nurses and nursing at an NHS Hospitals Trust

Author

Field-Richards, Sarah Elizabeth and Field-Richards, Sarah Elizabeth

Abstract

Lean Thinking (Lean) is a management philosophy originating from the Toyota automobile manufacturing company in Japan. Lean has been widely adopted in the United Kingdom (UK) National Health Service (NHS) as a panacea for addressing challenges that threaten its sustainability. Attempts to evaluate the outcomes of Lean implementation, in order to assess its claims to improve efficiency, quality and safety, have proved challenging owing to ambiguity surrounding the definition of Lean, differences in approaches to, and the poor quality of literature reporting, implementation. Lean continues to be adopted in healthcare regardless however, and a body of literature considering the consequences of Lean more broadly, is suggestive of implementation holding other, far-reaching implications. In attempting to transform healthcare culture and the way in which work is physically and socially structured, managed, organised and delivered, Lean can be understood as a socio-cultural intervention, holding the potential to transform the socio-cultural milieu of healthcare practice. There is, however, a dearth of research considering the nature of this transformation, the interaction between Lean and the socio-cultural context of practice, healthcare professionals’ experiences, understandings and interpretations of implementation, and the implications that it holds for them. This is especially true in the context of Lean applied to nursing. Theoretically, owing to its managerialist associations, Lean presents challenges to essential facets of nursing as a profession, its socio-cultural foundations and identity. Other ‘empowering’ characteristics of Lean philosophy however, are congruent with increasing autonomy and control over practice, associated with nursing’s professional agenda. Lean implementation can therefore be conceived of as representing both a challenge to, and as proffering opportunities for, the nursing profession. Underpinned by feminist philosophy and employing an ethno

15. The lived reality and meaning of Lean Thinking for nurses and nursing at an NHS Hospitals Trust

Author

Field-Richards, Sarah Elizabeth and Field-Richards, Sarah Elizabeth

Abstract

Lean Thinking (Lean) is a management philosophy originating from the Toyota automobile manufacturing company in Japan. Lean has been widely adopted in the United Kingdom (UK) National Health Service (NHS) as a panacea for addressing challenges that threaten its sustainability. Attempts to evaluate the outcomes of Lean implementation, in order to assess its claims to improve efficiency, quality and safety, have proved challenging owing to ambiguity surrounding the definition of Lean, differences in approaches to, and the poor quality of literature reporting, implementation. Lean continues to be adopted in healthcare regardless however, and a body of literature considering the consequences of Lean more broadly, is suggestive of implementation holding other, far-reaching implications. In attempting to transform healthcare culture and the way in which work is physically and socially structured, managed, organised and delivered, Lean can be understood as a socio-cultural intervention, holding the potential to transform the socio-cultural milieu of healthcare practice. There is, however, a dearth of research considering the nature of this transformation, the interaction between Lean and the socio-cultural context of practice, healthcare professionals’ experiences, understandings and interpretations of implementation, and the implications that it holds for them. This is especially true in the context of Lean applied to nursing. Theoretically, owing to its managerialist associations, Lean presents challenges to essential facets of nursing as a profession, its socio-cultural foundations and identity. Other ‘empowering’ characteristics of Lean philosophy however, are congruent with increasing autonomy and control over practice, associated with nursing’s professional agenda. Lean implementation can therefore be conceived of as representing both a challenge to, and as proffering opportunities for, the nursing profession. Underpinned by feminist philosophy and employing an ethno

16. The Motivations and Experiences of Day-Hospice Volunteers: a qualitative study

Author

Field-Richards, Sarah and Field-Richards, Sarah

Abstract

Aim: To explore the motivations and experiences of hospice volunteer workers in a UK day-hospice. Background: National health policy has long stressed the importance of involving and using volunteers as resources for enhancing the quality of health and social services. Traditionally, hospices rely on volunteer contributions for the delivery of care to individuals nearing the end of life. If nurses are to ensure the recruitment, retention and support of volunteers, their motivations, experiences and subsequent needs must be understood. Method: Underpinned by an interpretive approach, 12 day-hospice volunteers participated in semi-structured interviews which were recorded, transcribed and thematically analysed. Themes identified were considered to represent the motivations and experiences of the sample. Similarly, sub-themes identified represented variations in the meaning of themes for volunteers. Findings: Volunteers’ motivations related to ‘the need for meaningful activity’, ‘giving something and giving something back’ and the desire for ‘re-integration, participation and mutuality’. The experience of being an established day-hospice volunteer was characterised by ‘personal development’, ‘escapism and normalisation’ for patients, the influence of ‘wider societal culture’, methods of ‘coping’ and issues associated with ‘organisational context’. Examination of sub-themes revealed that variations in the meaning of themes were due to the volunteers’ unique personal context. Conclusion: Uniquely, this study provided insight into day-hospice volunteers’ motivations and experiences and suggests they are numerous, interrelated and meanings ascribed to them are informed by each volunteers’ personal context. When supporting volunteers, hospice nurses should appreciate their diversity and modesty and strive to reflect this in recruitment efforts. Future research is needed to assess the transferability of findings to other day-hospices and could consider the impact of voluntee

17. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, Spiby, Helen, Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively. Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and commu

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18. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, Spiby, Helen, Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively. Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and commu

Full Text
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19. The concept of compassion within UK media generated discourse: a corpus informed analysis

Author

Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, Spiby, Helen, Bond, Carmel, Stacey, Gemma, Field-Richards, Sarah, Callaghan, Patrick, Keeley, Philip, Lymn, Joanne, Redsell, Sarah, and Spiby, Helen

Abstract

Aims and objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. Design: A corpus‐informed discourse analysis. Methods: A 62626‐word corpus of data was analysed using Laurence Anthony software ‘AntCon’, a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word‐types occurred. Patterns of language were revealed and interpreted through researcher immersion. Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word‐type ‘nurse’ was used positively. Conclusion: This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and commu

Full Text
View/download PDF

20. The Motivations and Experiences of Day-Hospice Volunteers: a qualitative study

Author

Field-Richards, Sarah and Field-Richards, Sarah

Abstract

Aim: To explore the motivations and experiences of hospice volunteer workers in a UK day-hospice. Background: National health policy has long stressed the importance of involving and using volunteers as resources for enhancing the quality of health and social services. Traditionally, hospices rely on volunteer contributions for the delivery of care to individuals nearing the end of life. If nurses are to ensure the recruitment, retention and support of volunteers, their motivations, experiences and subsequent needs must be understood. Method: Underpinned by an interpretive approach, 12 day-hospice volunteers participated in semi-structured interviews which were recorded, transcribed and thematically analysed. Themes identified were considered to represent the motivations and experiences of the sample. Similarly, sub-themes identified represented variations in the meaning of themes for volunteers. Findings: Volunteers’ motivations related to ‘the need for meaningful activity’, ‘giving something and giving something back’ and the desire for ‘re-integration, participation and mutuality’. The experience of being an established day-hospice volunteer was characterised by ‘personal development’, ‘escapism and normalisation’ for patients, the influence of ‘wider societal culture’, methods of ‘coping’ and issues associated with ‘organisational context’. Examination of sub-themes revealed that variations in the meaning of themes were due to the volunteers’ unique personal context. Conclusion: Uniquely, this study provided insight into day-hospice volunteers’ motivations and experiences and suggests they are numerous, interrelated and meanings ascribed to them are informed by each volunteers’ personal context. When supporting volunteers, hospice nurses should appreciate their diversity and modesty and strive to reflect this in recruitment efforts. Future research is needed to assess the transferability of findings to other day-hospices and could consider the impact of voluntee

21. The concept of compassion within UK media-generated discourse: A corpus-informed analysis.

Author

Bond C, Stacey G, Field-Richards S, Callaghan P, Keeley P, Lymn J, Redsell S, and Spiby H

Subjects
Clinical Competence, Humans, Learning, United Kingdom, Concept Formation, Empathy, Nurse's Role, Nurse-Patient Relations
Abstract

Aims and Objectives: To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education., Background: Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in health care. This is important, for any meaningful evaluation of quality, compassionate practices., Design: A corpus-informed discourse analysis., Methods: A 62,626-word corpus of data was analysed using Laurence Anthony software "AntCon", a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word-types occurred. Patterns of language were revealed and interpreted through researcher immersion., Results: Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word-type "nurse" was used positively., Conclusion: This study adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and communicating should also be addressed by established practitioners to maintain compassionate interactions between professionals as well as nurse-patient relationships. Future research should focus on how compassionate practice is defined by both health professionals and patients., Relevance to Clinical Practice: To maintain nursing as an attractive profession to join, it is important that nurses are viewed as compassionate. This holds implications for professional morale, associated with the continued retention and recruitment of the future workforce. Existing ideologies within the practice placement, the prior care experience environment, as well as the educational and organisational design, are crucial factors to consider, in terms of their influences on the expression of compassion in practice., (© 2018 John Wiley & Sons Ltd.)

Published
2018
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