bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurse–teacher behaviours in the dinicai fieid: apparent effect on nursing students' learning
Authors: Wong Shirley
Published: December 2006

One primary source of feedback on the effectiveness of their teaching, which instructors may easily overlook, comprises of students' reactions. The purpose of this study is to identify students' perceptions of teacher behaviours, which either facilitate or hinder students' learning in the clinical field, and to determine if there is a difference in the perceptions of 1st and 2nd year students. This study is exploratory and descriptive in nature.

Firstly, some research studies regarding effective clinical teaching in nursing are reviewed, followed by a discussion of the research design. The tool used for collecting data is a modified form of the critical incident technique. A description of illustrative incidents is requested within five divisions: professional competency, relationship, personal attributes, teaching methods, and evaluation of practice. A system for analysis and coding of data is then discussed. Finally, the finding of this study is presented. It would seem to the investigator that students in 1st year are particularly sensitive to how the teacher makes them feel, whereas students in the 2nd year would seem to be more concerned with the teacher's competency in teaching. The teacher behaviours reported as helpful or hindering to students' learning, as identified by the students, are outlined.
Nurse‐rating of psychotic behaviour
Authors: Downing A. R. , Brockington I. F.
Published: December 2006

The aim of this study was to review six nurse‐rating schedules to evaluate their suitability for a British psychiatric unit and current nursing practice.

They were compared for their reliability, their concordance with psychiatric ratings and their acceptability to the nursing staff. It was found that psychiatric and nursing observations corresponded over a wide area of psychopathology: anxiety, tension, depression, hostility, preoccupation with hypochondriacal, grandiose and self‐depreciatory ideas, hallucinosis, thought disorders, mannerisms, retardation, emotional withdrawal, hypomanic activity and uncooperative behaviour. These were adequately covered by two of the scales, the Brief Psychiatric Rating Scale (BPRS) and the Psychotic Inpatient Profile (PIP), which together took 71/2 minutes to complete. Another of the schedules studied, the Nursing Rating Scale (Hargreaves), also had relatively high reliability and a broad effective range.
The professional ethic in nursing*
Authors: Rule Juanita B.
Published: December 2006

The author distinguishes two significant characteristics of a profession, ‘professional service’ and ‘sense of responsibility’, and relates these to the obligations of the professional.

Ethical concepts, and the professional code of conduct, are discussed in the context of recent events and publications in the United Kingdom. They are also put into historical perspective, acknowledging the influence of over 3000 years of Greek and Christian heritage.

The author concludes that the professional ethic in nursing is a way of life.
A role for a nurse therapist In a psychiatric outpatient Clinic
Authors: Oozeer I. , Trauer T. , Watson J. P.
Published: December 2006

Sixty‐six new patients attending a psychiatric outpatient clinic were interviewed by nurses, psychiatrists, psychologists, or medical students. Immediately after being interviewed, each patient recorded their opinions of the interviewer by giving ratings on 30 semantic differential scales. Factor analysis of the ratings suggested that patients perceived nurses as favourably as they perceived the other interviewers. Patients did, however, differentiate between interviewers in terms of their perceived age, seniority and experience. The study indicates that nurses can ‘clerk’ psychiatric outpatients effectively and that this is acceptable to the patients.
A study to determine the effectiveness of a learning activity package for the adult with diabetes mellitus
Authors: Brock Anna M.
Published: December 2006

In spite of the recognized significance of the diabetic's knowledge and understanding of all phases of his health problems, studies have demonstrated a considerable lack of knowledge on the part of the diabetic patient. To investigate the effectiveness of the learning activity package (LAP) as a method for patient education, a pilot study was conducted with diabetics admitted to a general, acute care hospital facility. The pre‐ and post‐test scores of an experimental group of four patients, newly‐diagnosed as diabetic and who were taught about their disease utilizing a LAP, were compared with those of a control group which consisted of four patients who had been diagnosed as diabetic for a year or longer. Even though the significant findings of this study is limited because of lack of randomization and the small sample size, several advantages of the LAP, as a method of patient education, were demonstrated.
Nurse–physician interaction: status and social structure within two hospital wards
Authors: Devine Barbara A.
Published: December 2006

The purpose of this one year's research on two hospital wards was to explore the perceptions of nurses concerning their jobs. Specifically, the focus of this paper is on how nurses' perceptions were influenced by their interaction with physicians, singling out both the stratification system within the hospital and the structure of the two wards as a major source of conflict. Physicians are viewed as being ‘significant others’ in the nurse's definition of self and therefore physicians, involved in daily interaction with nurses, are included in the study in order that their perceptions of the nurse's job may be seen to influence the perceptions which nurses have of themselves.

An assumption, basic to this study, is that physicians are in a dominant position within the hospital and nurses are subordinates in the organization. A ward comparison viewed the relative power position of doctors at various levels in the medical hierarchy (such as clinical clerks, interns, residents and specialists) as affecting the amount of agreement and understanding that existed between nurses' and physicians' perceptions of the nurse's job.
Discussion of a project on peer evaiuation in tiie facuity of nursing, University of Toronto, Canada
Authors: Turner Lettie
Published: December 2006

The purpose of this project was to develop guidelines and involve all faculty in the evaluation of teaching and learning. The main objective was to provide the opportunity to assist faculty to become actively involved in self and peer evaluations. Three i day workshops were held in 1975 involving all fulltime faculty and some part‐time faculty. Two i day workshops were held in 1975 involving mainly new faculty, with a focus on peer evolution in the clinical area.

Criteria were developed and are used as guidelines in evaluating self and peers. The findings indicated that evaluation posed a threat, especially in evaluating one's peers, but this threat tended to decrease through involvement in the process, which included group discussions and talking and sharing feelings both in formally devised and spontaneous informal encounters. The conferences, which brought peer partners together before and after the observation of performance, proved to be a most positive experience. Teachers identified problems in criteria selection and provided criticism. They also have expertise that they can share with each other and they can identify areas requiring improvement, but they still require some impetus to spur them on to change in behaviour.

Recommendations included that each faculty member take the responsibihty to keep self and peer evaluations in her own profile and provide this data to administration if and when desired.
Toward a unified voice: individuai and Goiiective responsibiiity of nurses*
Authors: Zimmerman Anne
Published: December 2006

In this paper the individual and collective responsibility of nurses is discussed in relation to the development of appropriate health care systems to meet the health needs of all individuals in society. The author focuses, in particular, on primary health care. The individual and collective responsibility of the professional nurse entails a commitment to constant improvement of health.

The concept of the ‘nursing collective’ is discussed and the roles of the individual nurse and national and international nursing organizations in the change process are considered.
The functions of the nurse in an integrated National Health Service*
Authors: Smith James P.
Published: December 2006

The British National Health Service was reorganized in 1974 when the hospital services and the community health services, previously administered separately, were brought together into one organization: the Area Health Authority. The reorganization was a culmination of developments triggered off as long ago as 1589 when the first Poor Law Act was passed, but more particularly, the reorganization was the natural outcome of a number of important government and professional nursing reports published during the past 30 years.

From 1974 the community and hospital nursing services have, therefore, been amalgamated under the direction of one head of the nursing services: a district (or area) nursing officer, who, together with medical, administrative and financial colleagues, manages the health services on a day‐to‐day basis in a team managing by consensus. The nurse's role in the management teams is both executive and professional: the nurse's unique contribution is that he/she brings a nursing perspective to management.

The new nursing service organization has provided new opportunities for reorientating middle nurse managers to a clinical role. It has also provided opportunities for innovating integrated teams of community and hospital nurses and for developing specialist nursing roles.

Nurses are also now able to make other additional contributions to health care by their involvement in health care planning team activities and by their membership of the statutory area and regional nursing and midwifery advisory committees.

But, on the whole, changes and influence on health care have been brought about chiefly by changes in the managerial structure of British nursing, which is a perspective of the British nursing profession that seems to have been all pervasive since Florence Nightingale's reforms and which is perpetuated by the powerfully socializing agent of British nurse training.

As health care and nursing service organizations should be means towards the end of good patient care, it may be timely to focus on the suggestion of autonomous nurse practitioners supported by a separately organized administrative structure.
Genetic knowledge possessed by American nurses and nursing students
Authors: Cohen Felissa L.
Published: December 2006

As diseases of genetic origin have increased their impact on society's health, nursing's role has also increased. Nurses may not be referring those needing it for genetic counselling or prenatal diagnosis and may be inadvertently giving patients erroneous information based on lack of knowledge.

A questionnaire was used to examine the overall adequacy and specific knowledge in the more commonly encountered genetic disorders such as sickle cell disease, Rh disease and Down's syndrome. It also included interpretation of risk and basic knowledge. The sample consisted of 366 senior nursing students and 114 practising nurses. Student programme type was consistently related to score. Age was also important in the degree of knowledge manifested.

Only 19 (4.2%) of the respondents demonstrated over‐all adequate knowledge. These results indicate a need to raise the consciousness and knowledge of nurses about human genetic disorders before serious repercussions result from inappropriate and inadequate counselling, health teaching and referrals.
Staff nurse turnover in neonatal intensive care units
Authors: Duxbury Mitzi L. , Thiessen Victor
Published: December 2006

The turnover rate and patterns in Neonatal Intensive Care Units (NICUs) were assessed and compared with adult Intensive Care Units (ICUs) and General Infant Care Units at the same hospitals for the year 1976.

Thirty‐five hospitals with NICUs participated in the study. The findings of this study disagree with the previous literature in three major ways:

The turnover rate of staff nurses was less than half that estimated by The National Commission on Nursing for 1970.

The turnover rates in ICUs and NICUs were not significantly higher than that for staff nurses in Non‐Intensive Care Units. In addition, the pattern of turnover among leavers is identical for all three major types of unit. The variability pattern for neonatal units, however, is statistically significant; this is not so with the other units studied.

There is no evidence for a stabilization of turnover following the usual ‘induction crisis period’ (the first 3 to 6 months).
Research in nursing gerontology
Authors: Hirschfeld Miriam J.
Published: December 2006

Nursing gerontology is the scientific study of the nursing care of the elderly as individuals, family members and population groups. The author identifies and discusses the ethical issues which must be considered in relation to research in nursing gerontology: respect for persons, adequate knowledge base for decision‐making, quality of life, quality of death and distribution of limited resources. Research priorities are then discussed.
Bioethics and informed consent in American health care delivery
Authors: Barkes Peter
Published: December 2006

Bioethics is a multi‐dimensional discipline. The traditional aspect being medical ethics, a branch of Western philosophy which, since the time of Hippocrates, has sought to formulate rules of proper conduct for physicians.

Ethics and informed consent are interrelated issues. Consent is the central issue on which hangs most of the ethical problems in human experimentation.

The informed consent of the human patient is the ultimate protection from the hazards of research and therapy in medicine, the basic premise of this being that every human being has the right to determine what shall be done to his own body. The patient must have full prognosis, complications, sequelae, discomforts, costs, inconveniences, risks and expectations. Medically and ethically what should the patient be told? There appears to be no obvious format, but the patient should be told enough to allow him to make a rational decision.

This paper contains an analysis of the reactions of just a few American nurses to this dilemma. The nurse who attempts to use only her scientific training to determine ethical conduct is in a quandary because seldom is there empirical evidence available to support her decision, no matter what it is.
Measurement in nursing education*
Authors: Sheahan John
Published: December 2006

The objectives for this paper are fourfold. Evaluation is put into perspective, including measurement and assessment, in relation to the curriculum as a whole. The elements included in the evaluation of educational programmes are outlined. The process of evaluation is related to learning abilities in the cognitive, affective, psychomotor and experiential domains. Finally, some conclusions are made about the process of evaluation.
A sociological approach to the analysis of nursing work
Authors: Melia Kath M.
Published: December 2006

This paper describes, from a sociological perspective, the work of hospital ward nurses. An analogy is drawn between the work organization of miners at the coal‐face and that of nurses in hospital wards. Work roles are considered in order to provide a framework for the analysis of the work of nurses. Multi‐skilled and single skilled work roles are described and the concept of a hierarchy of nursing tasks is considered. Problems of observing and analyzing the work of nurses are highlighted with particular reference to the type of environment in which hospital nursing takes place.
Professionalism in nursing master's graduates
Authors: Hungler Bernadette P. , Joyce Amy , Krawczyk Rosemary , Polit Denise
Published: December 2006

The past 10 years have seen a shift in the master's level preparation of nurses. The majority of nurses currently seeking advanced preparation choose clinical specialization as the functional area rather than teaching. Such a shift in focus reflects the ever increasing specialization of services associated with an ever‐growing complex society. Although the shift in focus of preparation and the concomitant change in curriculum design have been documented, few scientific investigations have been conducted on the graduates from master's programmes.

Of those studies that have been conducted, the majority have focused on the differential personal characteristics of graduate nursing students in different types of programmes. The purpose of the present study was to investigate the relationship between a nurse's area of functional preparation in a master's degree programme and the individual's level of professionalism. The independent variable of the study was functional area of preparation in a master's programme. The dependent variables became enrolment in a formal programme of study, subscription to professional journals, attendance at non‐formal educational programmes, number of authored publications, membership in professional organizations and employment in prepared area, as these seemed to reflect the criteria of professionalism explicated by Flexner (1915).

The data for the study were gleaned from questionnaires sent to the 637 individuals who had graduated from the programme. Of the 395 questionnaires that were returned, only 272 were usable. This number represented 43% of the graduate population.

The chi‐square test was used to analyse the data. Each of the chi‐square values for association between professionalism and graduate specialty was found to be significant. Postgraduates prepared as teachers met Flexner's criteria more often than did postgraduates prepared as clinical specialists.
Who cares? Nursing and sociology: the development of a symbiotic relationship*
Authors: Cox Caroline A.
Published: December 2006

The paper has three aims: to illustrate ways in which sociology may help nurses to achieve their primary objective: good patient care; to show how nursing can contribute to sociology; and to indicate some conditions for a healthy relationship between the two activities.

After a brief discussion of the nature of sociology, intended for non‐sociologists, four examples of ways in which sociology may be relevant to nursing are discussed: (i) Imphcations for nursing of changing patterns of disease, dependency and death; (ii) Social and cultural variations in perceptions of, and responses to, pain and disease; (iii) Organizational analyses, with particular reference to the importance of nurse‐patient communication; (iv) Sociological studies of inter‐personal relationships, illustrated by a study of student nurse training.

Nursing is described as the major caring profession; as such it has inherent interest for sociologists interested in health care. However, its sociological interest is enhanced by the fact that it is permeated by paradoxes. Reference is also made to current debate on the most appropriate model for health care: the traditional medical model places relatively greater emphasis on cure than does nursing, with its relatively greater involvement with care. It is suggested that current patterns of disease and dependency increase the importance of the care model, and that nursing could play a crucial role in such a shift of emphasis.

Having shown that sociology can make positive contributions to nursing, attention is drawn to certain dangers. Nursing should thus make sure that the sociology which it welcomes into its domain is academically sound, and not ideology in disguise. It is also suggested that nursing education should encourage more critical thinking, to enliven nurses' appreciation of what sociology has to offer, and to improve their ability to evaluate the quality of health care.
Is the nursing profession really research‐based?*
Authors: Smith James P.
Published: December 2006

Modern nursing has its origins in the pioneering research of Florence Nightingale but a research approach to nursing problems was never transmitted as part of the traditions of the Nightingale pattern of nurse training.

Although nurses in North America established nursing education programmes in centres of higher education as long ago as 1899, British nurses did not utilize these facilities until the 1950s. This militated against the proper preparation of British nurses for research and the innovation of nursing research activities was therefore drastically delayed in the United Kingdom.

Such research as there was tended to focus on nurses rather than nursing. The Royal College of Nursing of the United Kingdom, together with the Department of Health and Social Security, London, sponsored a number of nursing care research projects in the late 1960s. This was followed, in the 1970s, by an upsurge of research interest and research activity among British nurses. But it is still very difficult to demonstrate any direct benefits from nursing research interest or activity on patient care. There are also problems associated with the lack of experimental and replicated studies, the dearth of research‐minded nurses and the apparent lack of interest in implementing nursing research findings. This places a great responsibility on the teachers of nurses.

Hope is on the horizon. This is fostered by recent syllabuses and guides produced by British statutory bodies responsible for basic and postbasic nursing research.

In conclusion, the author argues that nursing research activity should not be permitted to become an end in itself. The search for a research base for nursing should be motivated primarily by a desire to achieve better nursing practice.
Psychiatric patients’ opinions of nurses ceasing to wear uniform
Authors: Trauer T. , Moss A. V.
Published: December 2006

Psychatric patients at two general hospitals were asked whether they felt that nurses on their ward should wear uniforms or mufti. In one of the hospitals the procedure was repeated immediately after the nurses changed from uniforms to mufti and again at 5 and 7 month intervals. The results showed a general preference among patients for nurses to wear uniforms and there was no clear trend over time for increased acceptance of mufti on the wards which changed. There was a clear tendency for older patients to prefer uniforms, and it was only in the patients aged 29 or less that a preference for mufti could be discerned.
Educating teachers of nursing: a survey of the opinions of students
Authors: Sheahan John
Published: December 2006

In this paper an account of an opinion survey is reported, which was carried out in order to determine how student teachers of nursing rated aspects of their course. The opinion survey included questions on pedagogical and education studies, teaching practice, research methods, statistics, related science and supporting studies. In the last section the method of course assessment is evaluated. Finally there is a discussion about the implications and limitations of the survey.
A question of honesty in nursing practice
Authors: Schröck Ruth A.
Published: December 2006

This paper examines the perception of moral issues in nursing as presented in the literature and in themes of meetings, discussions and study days devoted to the subject. It offers an account of moral issues perceived by nursing students and qualified nurses as being relevant to discussions of moral aspects in nursing. The second part of this paper presents a closer examination of the problems related to professional truth telling and deception as an illustration of an ‘everyday’ moral issue in nursing and in health care generally.
The nature of nursing and the education of the nurse*
Authors: Hall Dorothy C.
Published: December 2006

The current scrutinies and criticisms of organized health services are discussed as an introduction to the need for change. The care/cure dichotomy in the nurse's role is focused on and the dearth of community nursing developments noted, as are the pathology‐orientated hospital‐centred nursing education programmes. The author believes that nursing needs to go forward and develop in depth the body of nursing knowledge and technology. This will require radical reforms of nursing education organization in Europe. But the author is enthusiastic about the possibilities of developments resulting from the extension of nursing education courses in European universities and institutes of higher education.
Disability, home care and the care‐taking role in family life
Authors: Davis Anne J.
Published: December 2006

This exploratory study examines the dynamics of keeping a disabled adult in the home. In interviews with 30 families, major foci emerged which spanned the interaction between family members and one member, the disabled adult. These foci were: the initial weighing process in the decision to keep the disabled at home, the therapeutic process which evolved among members, the interactional system which served the social unit, and the social context and adaptation that the family made to perceived misfortune.
Nurses' perceptions of the British hospital nursing officer
Authors: Hey Bob , Shaw Monica
Published: December 2006

A major objective of the Report of die committee on senior nursing staff structure (Salmon Report) was to clarify the role of middle‐management nurses. This paper analyses the views of 170 nurses in two general, one psychiatric, and one mental subnormality hospital, about nursing officers. A nursing officer was mentioned as the person with most say or influence over them by more nurses of all grades in the two non‐general than in the two general hospitals, a difference explained in terms of the greater role of the medical model, and hence the sister consultant relationship in the latter. There were, however, also marked differences between the responses received from staff in the two general and between the two non‐general hospitals in the perceived influence of the nursing officer which could not be explained in this way. Analysis of repertory grids suggested more problems in relations with senior nurses overall in the general hospitals. Nurses' descriptions of relationships with superiors suggested that nursing officer superiors were seen more as ‘socio‐emotional’ whilst sisters and charge nurses were seen as ‘instrumental’ leaders. Asked to choose a person who had annoyed them at work, nurses chose a nursing officer more frequently than other grades of nurse, particularly in the non‐general hospitals. Reasons for annoyance with a nursing officer included unwarranted interference, destructive criticism, and lack of specialized knowledge.
Hospital ward routine‐friend or foe?*
Authors: Fretwell Joan E.
Published: December 2006

The author examines the traditional model of nursing, which is dominated by hierarchy and routine, and concludes that it is an industrial rather than a professional model. It is a model which has developed to cope with the unique problems faced by nurses, but it appears to satisfy the needs of doctors rather than the individual needs of either patients or learners. Drawing on the results of a two‐stage research study of the ward learning environment conducted in wards of two general hospitals, the author suggests that the traditional model of nursing contributes to an automatic job performance and inhibits a spirit of enquiry, particularly during routine work. Changes to a professional model, which restore the patient to the centre of the nursing process, are advocated as a means of linking nursing theory with practice and detecting individual needs which fall outside the routine.

In this paper selected findings from a two‐stage research study of the ward learning environment (Fretwell 1978) are discussed. Field work was carried out in two general hospitals and a unit in a third hospital, during 1975 and 1976. Methods and techniques were piloted with staff and learners in a large general hospital.

The first stage was a ranking study in which 87 learners completed 327 rating questionnaires in respect of 14 training wards in which they had previously worked. In the second stage, observations were carried out in three pairs of high and low ranked wards from three specialities. Learners were interviewed about 571 observed activities in order to identify teaching and learning occurring under changing circumstances. By combining observations with interviews it was possible to identify covert as well as overt teaching and to ascertain how learners perceived a variety of ward activities.

The findings can only be generalized to the wards that were studied but it may be that there is a ‘ring of truth’ in the descriptions that makes them recognizable in other places. Drawing on a search of the literature on nurse education, nursing over many decades, and on medical sociology, it is proposed to consider one or two themes in a wider context.
Care of the unconscious patient: a complementary perspective
Authors: Myco Freda , McGilloway F. A.
Published: December 2006

The literature associated with the care of the unconscious patient tends to concentrate on aspects of care relevant to the maintenance of the patient's equilibrium, within a medical or surgical context (Atkinson 1970, Roper 1973, Ayres 1974, Burrell & Burrell 1977, Rhodes 1977). The importance of maintaining such an equilibrium is beyond dispute, but die difficulty of understanding what unconsciousness is becomes a contributory factor towards inhibiting the nurse from extending the same totality of care she would offer the conscious patient, to one who is unconscious. The writers draw parallels between features of the world of‘booming, buzzing confusion’often postulated for the neonate, and those of the unconscious patient. They claim that despite perceptual and other similarities, the framework of care instituted for the unconscious patient lacks the social dimension normally expected to be available to the infant. Care of the unconscious patient suffers from fragmentation because of its emphasis on the physical.
The implementation of nursing research related to the nursing profession in Northern Ireland
Authors: Myco Freda
Published: December 2006

Adopting the holistic approach to the definition of nursing as purported by Treece & Treece (1977), this paper presents the findings of the reported efforts of five grades of nursing personnel, directly involved in hospital care in Northern Ireland, to utilize research information in their area of work during the 12 months up to Spring 1979. It draws the conclusion that these groups have not yet begun to identify to any great extent the importance of research to nursing practice, or with the need to devise a process through which research can be implemented and evaluated
A study of the nurse tutor's role
Authors: Sheahan John
Published: December 2006

The aim of the study was to determine how British nurse tutors and nurse learners perceive the role of the nurse tutor in the field of general nursing. A survey by questionnaire was the method of inquiry used. The sample was drawn from eleven schools of nursing in one Regional Health Authority in England, and comprised 317 nurse learners and 93 nurse teachers. Data from the questionnaires were analysed using the statistical technique of factor analysis. In particular the learners’data were used to derive factor scales relating to aspects of the role of the nurse tutor. Twelve such factor scales emerged from the factor analysis of the data. Agreement was found between the learners and the teachers on four of these factor scales and disagreement was found relating to the remaining eight. It is suggested that the areas of agreement might form the basis for the systematic description of the role of the nurse tutor. Conversely, the areas of disagreement could provide a basis for further research into this subject.
A silent conspiracy: coping with dying cancer patients on an acute surgical ward
Authors: Knight Mary , Field David
Published: December 2006

The problems and strategies of coping with terminal cancer patients on an acute surgical ward form the focus of this paper. The effects of ward structure, organization, and communication are examined and particular attention is given to the problems of junior nurses who are primarily responsible for the care of these dying patients.
Pain assessment: development of a tool for the nurse and the patient
Authors: BourbonnaiS Frances
Published: December 2006

The assessment of pain is a difficult and yet vital component of nursing care. Discrepancies in the nursing management of pain can result from inadequate data collection and personal biases about the pain experienced by the patient. For example, how often is the patient with chronic pain consulted about personal remedies used at home to facilitate pain relief? Do nurses have preconceived ideas of how much pain should exist with each disease entity? A tool was developed which incorporated many of the variables affecting the pain response in order to sensitize nurses to the need for careful pain assessment. The information in this tool was conveyed to both graduate and student nurses resulting in improved charting of the patient's pain and improvement in the ability to assess the patient in pain.

Description of pain by the patient is often a frustrating experience and yet necessary in helping to determine the cause of the pain and the appropriate interventions. Patients often have difficulty describing their pain to health professionals. A ruler which includes the most frequently utilized terms to describe pain was developed, revised and tested on various patients. The patients interviewed found the tool easy to use and all felt they could communicate their sensation of pain to the nurse.
‘Voices of concern’— a study of verbal communication about patients in a psychiatric day unit
Authors: Allen Hilary
Published: December 2006

In this study, the author employs observations from a psychiatric day unit in an analysis of regularly occurring forms of ‘professional talk’. Considerable staff time is scheduled for such talk, which must be considered as part of the health professional's work. Much of the talk which occurs may be analysed as having ‘technical’ significance in programming staff to behave appropriately towards different patients, so as to maximize the effectiveness of hospital treatment. Very much more time than is technically necessary, however, is devoted to talking about patients. Rather than seeing this ‘superfluity’ of talk as an indication of inefficiency within the system, the author examines its functions in maintaining the social structure of the unit and meeting the personal needs of the staff. This appears to be of particular importance against the background (common to many psychiatric settings) of staff‐patient and interdisciplinary role ambiguity, high patient chronicity, and the absence of many of the structural and symbolic ‘props’ of a conventional hospital. This ‘excess talk’ is expensive in terms of professional time, and takes time away from direct patient contact. None the less, it may be a necessary cost if staff are to continue to pursue therapeutic goals within a deliberately ‘informal’ psychiatric setting.
Classification and framing: a sociological analysis of task‐centred nursing and the nursing process
Authors: Webb Christine
Published: December 2006

Sections of the British nursing profession have recently become interested in the nursing process as a means of providing better patient care and increased job satisfaction for nurses. Bernstein's code theory is used in this article to analyse theoretically the change from a task‐oriented to a patient‐oriented mode of organization of nursing care, and to suggest hypotheses regarding the possible effects of the change. The new mode is analysed as a different and more pervasive form of social control of patients and nurses, and, although it appears to be a radical initiative, the fundamental power structure within which nursing care is given is shown to be unchanged. Whether patients will be more satisfied with their care and nurses will experience less stress in the new mode cannot be taken for granted; they are matters which call for empirical investigation.
Huntington's disease: the nursing process
Authors: Drapo Peggy J.
Published: December 2006

Huntington's disease is caused by a genetic condition which has thus far escaped being understood in spite of years of research. The importance of the disease to those in medical and educational professions is great because of its devastating effects on the family unit. It is a disease for which there is no cure and no treatment other than supportive care as the disease progresses. Because the disease does not manifest itself until the fourth or fifth decade of life, the person who develops it has probably already married and had children. Since the condition is passed from parent to child in an autosomal dominant way, fully 50% of the children stand at risk of having the disease. Neurological disorders and psychological problems are the first sign the family has and these are often mistaken for other conditions, such as alcoholism. As the disease progresses, the family spends thousands of dollars on needed care and often insurance companies or other health plans will not cover these needs.

Nurses need to be aware of the long‐term plight faced by a family with this condition whose only hope, at the present time, is prevention through education during the early years about the genetic component and counselling in the child‐bearing years.

Early diagnosis could save countless problems for families as far as future planning of the patient at risk, for family planning and for the provision of resources for the possibility of costly medical expenses. Some families have been the brunt of needless scorn because a family member was suspected of drug or alcohol abuse by an uninformed public. Misdiagnosis, because of a group of symptoms similar to those in other conditions such as schizophrenia, has led to years of useless treatment for the wrong disorder.

Since genetic disease is such a big factor in health care today, it would seem that human genetics should be added, in a basic way, to the science curriculum of school children. It should become a part, in a more advanced way, of every nursing and medical programme. Public education for those who have not been exposed to this disease and others like it can best be done through the media of print.
Development of models and theories on the concept of nursing*
Authors: Clark June
Published: December 2006

This paper shows how models can be used by practitioners of nursing as a practical tool to analyse their own practice, in particular to assess needs and to plan, implement, and evaluate care. It is argued that the impact of existing work in theory development has been relatively small, at least in the UK, because the theories arc not sufficiently specific to everyday nursing activities and the models are over elaborate and not universally applicable. A simple model of nursing, based on a systems approach is presented and applied to one particular field of nursing practice, i.e. health visiting. The model, which can be used in any field of nursing, stresses the reciprocity of the nurse–patient relationship, and the significance of the environment in determining the concepts of nurse, patient and nursing.
Good and bad patients: a review of the literature and a theoretical critique
Authors: Kelly Michael P. , May David
Published: December 2006

Nursing, sociological and psychological research into good and bad, popular and unpopular, and desirable and undesirable patients is reviewed. A number of themes which have been linked by researchers with the evaluation of good and bad patients are identified. These are patients ‘illnesses and diseases, patients’ behaviour, the social backgrounds of patients, patients’attitudes and staff attitudes. It is argued that much of the literature on good and bad patients is deficient from an empirical, a methodological, an epistemological and a theoretical point of view. An alternative theoretical framework is suggested, using as its starting point an interactionist conception of the nursing role. It is suggested that patients come to be defined as good or bad not because of anything inherent in them or in their behaviour, but as a consequence of the interaction between staff and patients.
Setting the pace: new approaches in nursing practice*
Authors: Ngugi Elizabeth N.
Published: December 2006

The author discusses the health care needs and the delivery of health care in Kenya, emphasizing in particular the role and contribution of traditional health practitioners. She also identifies the knowledge and continuous education needed by professional nurses and indicates how they should relate with the community at large. The nurse, it is argued, should be clear about her identity and maintain it without depriving the community and others of their rights and privileges.
The nursing management of patients with long‐term indwelling catheters
Authors: Kennedy Anne P. , Brocklehurst J. C.
Published: December 2006

A survey of 107 hospitalized and home‐based patients showed up considerable variations in nursing management of indwelling catheters. CSU records of hospitalized patients showed a wide range of infecting organisms. Antibiotic treatment was found to be unimportant. Three types of male Foley catheter were in general use: 100% silicone, silastic and latex with teflon‐treated coatings. Difficulties were reported in obtaining the 100% silicone catheters. Sixty‐eight per cent of the patients used leg bags and the drainage bag supporting systems in use were felt to be inadequate. Catheter bypassing was a problem for 40% of the patients. Nurses adopted many procedures to cope with bypassing. Results show that some patients were needlessly cathetedzed. The study emphasizes the need for further investigations and better policies for management of long‐term catheters.
New perspectives on nursing lower limb amputees
Authors: Crowther Helen
Published: December 2006

New perspectives on nursing lower limb amputees arise from the author's researches into amputee rehabilitation and a summary of other recent research findings. These are dealt with in the context of basic amputee treatment and the nursing process. There is new material on the psychological and neurological sequelae of amputation, the practical problems of loss of a limb and the prosthetic dimension of treatment. The patients' reactions to lower limb amputation were found to vary from intense grief to intense relief, many noting it to be of minor or moderate consequence. The model of sudden and shocking loss is largely incorrect. Attention is drawn to an unrecognized ordinariness which should become part of amputee nursing. Patients have many practical problems. These are social and economic, personal and domestic. The ward environment is unsuited to these needs but, working closely with therapists, nurses can do much to facilitate amputee rehabilitation. The modern purpose of amputation surgery is prosthetic replacement. Nurses should be working with some urgency towards uniting patient and prosthesis. Pain and discomfort are underestimated and research shows them to be a major characteristic of amputation continually and for many years after surgery. A variety of pain syndromes are involved.
Patient satisfaction with community psychiatric nursing: a prospective controlled study
Authors: Mangen S. P. , Griffith J. H.
Published: December 2006

A sample of patients allocated to receive either community psychiatric nursing or out‐patient psychiatrist follow‐up was interviewed at 6‐month intervals for a total period of 18 months. Two dimensions of patient satisfaction are discussed: a cross‐sectional analysis of the quality of the perceived therapeutic relationship and an analysis over time of attitudes to aspects of the mental health care received. The satisfaction expressed with elements of the therapeutic relationship revealed that patients find nurses more approachable and more sympathetic. The satisfaction expressed by patients receiving the nursing mode of follow‐up was superior to that expressed by out‐patient psychiatrist patients. Particularly positive were responses made by nursing patients to domiciliary visiting. The greater levels of satisfaction with nursing follow‐up increased over time.
A Delphi survey of clinical nursing research priorities
Authors: Bond Senga , Bond John
Published: December 2006

In order to establish clinical nursing priorities a three round Delphi survey was carried out on a sample of 214 nurses currently working in the Northern Region of England. Little change was evident between rounds 2 and 3 and the top 20 ranked research topics of a total of 102 are presented in relation to their value for nurses and value for patients. These expressed concerns of nurses are discussed together with the potential value of and justification for determining research priorities.
Exploratory study to evaluate staff attitudes towards geriatric psychiatry
Authors: Jones R. G. , Galliard P. G.
Published: December 2006

This work is part of a larger study carried out at the Murray Royal and Murthly Hospitals within the Tayside Health District. The survey was concerned with staff attitudes towards geriatric psychiatry patients and shows that the nurses in these peripheral hospitals hold a positive attitude towards this area of nursing. These findings appear to contradict the popular opinion held throughout the nursing service, that the geriatric psychiatry nursing area is very unpopular with trained, untrained and learner nurses. In the study by Hooper [Nursing Times (1981) 77 37–40/43–44], anxiety levels among learners towards the geriatric nursing areas were found to be very high. This appears to correlate with Kogan [Journal of Abnormal and Social Psychology (1961) 62, 616–622], which summarized is as follows: Young subjects were imputed to have a more consistently negative view of old people.' By using a series of two precoded questionnaires that the subjects completed, an overview of staff attitudes towards the geriatric psychiatry areas was obtained. The hypothesis on which the study was based was as follows: that a negative view towards geriatric psychiatry would be found among the staff of the Murray Royal and Murthly Hospitals.' However, the findings of this study did not support the hypothesis on any counts and gave a highly positive attitude scale.
Management education and training of nurses: research study
Authors: Forrest Ian
Published: December 2006

The model of more pro‐active management with a more analytical and deliberative approach has considerable implications for the roles of all managers within the National Health Service today. Nurse managers, in particular, will now be faced with developing different managerial roles than they have had in the years since the 1974 reorganization. Nurse management courses in the past were more concerned with the overt training of behavioural skills and less concerned with the quantitive and analytical aspects of management. This paper investigates in what areas nurse managers perceived their training to have been deficient and argues for a continuous process of education, as opposed to the existing intermittent ‘hurdle process’ which, in the main, is the basis of nurse management development at the present time.
The reliability of expert judgement' in the marking of state nursing examinations
Authors: Street Margaret R. , Gilmore Alison M.
Published: December 2006

A pilot study was undertaken to investigate the reliability of the ‘expert judgement’ exercised in marking state examination papers. Estimates of inter‐rater reliability had a median coefficient of 0–76. Intra‐rater reliability was marginally higher overall, with a median coefficient of 0–81. While marker reliability is only one source of variation in the assessment of extended answers, it is important the level be known. This study provides useful information and guidelines for improvements.