Benny Goodman

The health effects of climate change: What does a nurse need to know?

The scientific evidence for anthropogenic climate change has been established with increasing precision and there are widespread concerns about its potential to undermine the public health gains of the past century. There is also a growing consensus across private and public sector organisations at national and international level that carbon reduction should be a policy aim. Various international nursing organisations have made strong position statements on the issue, arguing that nurses should be actively engaged as part of their roles in both health promotion and clinical practice. We point to education for sustainability initiatives in other health professions and share resources for curriculum development in nursing. The nurses of tomorrow will make a unique and significant contribution to protecting population health in an unstable climate, if todays nursing educators can help prepare them for this role.

“What are nurse academics for?” Intellectual craftsmanship in an age of instrumentalism

I wish in this paper to deliberately engage in provocations (following Thompson and Watson, 2006 and Walker, 2009) on the subject of nursing as an academic and critical thinking discipline in the UK, but which may also resonate with colleagues elsewhere. My argument is that nursing as an academic discipline is, if not dead, then is in critical care and is so without an advanced directive. Thompson and Watson (2006) suggested that nursing professorships had ‘hit the iceberg’ (p. 125). Six years on, I suggest that various contemporary issues (see Box 1) including the quality of care on one hand and the individualised and instrumental vision of higher education on the other, call into serious question nursings ability to be anything other than reactive to events and external drivers and in doing so it mirrors its historical handmaiden role to medicine. The Titanic metaphor continues. I further suggest that intellectual craftsmanship (Wright Mills, 1959) be (re)discovered and valued not just in the academy but at all levels of clinical nursing practice and theory.

Care to be a nurse? Reflections on a radio broadcast and its ramifications for nursing today

Nursing education in the UK has lagged behind most of the developed world since inception of Project 2000 because in England, a diploma has been accepted as the basis for education, unlike other countries (including Scotland and Wales) a degree has been the accepted standard for many years. While Australias nursing education has been more protected, an anti-intellectualism is creeping in with a technical college now offering a nursing degree, and some universities lowering their admission standards for nursing courses. Changes in the UK being imposed through the influence of the global financial crisis threaten nursing even further and this is not helped by short sighted media reports of problems with nursing care in the National Health Service. This paper examines the continuing devaluing of critical thinking, something that we contend, with the strongest emphasis, should be at the core of every aspect of nursing practice, education and research., and implications for nursing in both the UK and Australia.

Recognising the challenges of collaborative, multi-site research

Background: Collaborative multi-site research is gaining recognition. In particular, across stakeholders in the health and social care professions, there has been an increase in the documentation of such approaches, with the majority acknowledging the strengths and few identifying the pitfalls. Four universities in the south west of England collaborated on the design, analysis and implementation of a project scoping the staff development needs of nursing and midwifery academics to meet the National Health Service Modernisation Agenda in the United Kingdom. Aim: This paper highlights the challenges and the lessons learned from each stage of the process of this large multi-site collaborative study. Consideration has been given to addressing the site-specific differences as well as the politics of the processes and power relations across the research team. Discussion: From an analytical reflection across the team, there were a number of lessons learned from the process of collaboration. Initially, the main challenge was the selection of the team and lead researcher and these were its greatest success. Nevertheless, managing each individuals competing roles within the organisation remained problematic. Particular challenges included gaining consensus on the research design, the chosen sample and data collection to reflect the site-specific differences and were overcome through discussion and effective leadership. Towards the end of the study, adequately representing each institution in the findings, as well as dissemination have remained the greatest challenges. Conclusions: While collaboration has been lauded as a way forward, this analysis of the process highlights some of the difficulties of working as a multi-site virtual team who are widely spread geographically and who have no previous connection. At different stages of the process there has been acknowledgement of the political dimensions affecting such an approach and a need to avoid the pitfalls of collaborative working in order to harness the potential of all team members, if success is to be achieved.

The missing two Cs – commodity and critique: Obscuring the political economy of the ‘gift’ of nursing

This discussion paper argues for understanding nursing care as a commodity within capitalist relations of production, ultimately as a product of labour, whose use value far exceeds its exchange value and price. This under-recognised commodification of care work obscures the social relationships involved in the contribution to the social reproduction of labour and to capital accumulation by nursing care work. This matters, because many care workers give of themselves and their unpaid overtime to provide care as if in a ‘gift economy’, but in doing so find themselves in subordinate subject positions as a part of the social reproduction of labour in a ‘commodity economy’. Thus they are caught in the contradiction between the ‘appearance’ and reality. A focus on the individual moral character of nurses (e.g. the UK’s 6Cs), may operate as a screen deflecting understanding of the reality of the lived experiences of thousands of care workers and supports the discourse of ‘care as a gift’. The commodification of care work also undermines social reproduction itself. Many nurses will not have tools of analysis to critique their subject positioning by power elites and have thus been largely ineffectual in creating change to the neoliberalist and managerialist contexts that characterise many healthcare and other public sector organisations. The implications of this analysis for healthcare policy and nursing practice is the need for a critical praxis (an ‘action nursing’) by nurses and nursing bodies, along with their allies, which may include patient groups, to put care in all its guises and consequences central to the political agenda.

The case of the Trump regime: The need for resistance in international nurse education

publisher: Elsevier articletitle: The case of the Trump regime: The need for resistance in international nurse education journaltitle: Nurse Education Today articlelink: http://dx.doi.org/10.1016/j.nedt.2017.02.013 content_type: simple-article copyright:

A South West regional survey to identify education staff development needs in clinical skills and practice

This paper reports tentative findings from a survey (undertaken in 2001) of education staff employed to teach nurses and midwives in four highereducation institutions in the South West of England, with specific focus on answers regarding clinical skills and practice within a wider aim of evaluating training needs. A 57 item self-administered postal questionnaire was sent out to 760 educators, 426 were returned with a response rate of 56%. The results were analysed using SPSS version 9, using descriptive statistics focusing on the responses of HE staff and lecturer practitioners on joint appointments. Findings suggest HE staff teach a limited range of (defined) clinical skills, they have varying and wide definitions of clinical skills, less confidence in teaching skills in practice, minimal experience in working in practice settings and difficulties in engagement in practice. They continue to experience role diversity and a wide variation in meeting clinical demands for clinical competence. Definitions of clinical practice and practice skill are explored in relation to the need for nurse teachers to have ‘recent and practical experience of nursing’. A range of education roles are explored.

Antonio Gramsci on intellectual thought – Challenging nursing

publisher: Elsevier articletitle: Antonio Gramsci on intellectual thought – Challenging nursing journaltitle: Nurse Education Today articlelink: http://dx.doi.org/10.1016/j.nedt.2017.02.023 content_type: simple-article copyright:

Nurse participation in legal executions: An ethics round-table discussion

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion.

Wendell Berry—health is membership

Wendell Berry is perhaps little known in the UK. A Kentucky farmer, poet, cultural critic, essayist, novelist, and environmental activist, whose corpus of work is extensive but largely passed by in nursing. However, some are beginning to link his work with ideas around, for example, ‘ecojustice education’ (Martusewicz et al., 2011) involving cultural critique and a recognition on wholeness in health and healing (Martusewicz et al., 2013). Ideas around ‘Wholeness’ or ‘Holism’ are of course nothing new in nursing. That being said, Berrys take on health is worth reflecting upon because it challenges assumed epistemologies and ontologies that underpin much of nursing, especially adult nursing. According to Berry, health is at once ‘wholeness’ and a kind of ‘unconsciousness’. Illness and disease makes us aware, conscious, of our bodies, and the separation of our body and the world into parts. This may be otherwise known as ‘dualism’ and biological reductionism. Berry develops wholeness to mean a sense of belonging to others and to our place, an unconscious awareness of community and ‘having in common’. This conception sits in antithesis to a modernism and a globalisation that for some has been called ‘liquid modernity’ (Baumann, 2000). This is a society characterised by atomisation, individualism, consumerism, and community fragmentation in which individuals struggle to feel ‘place’ and ‘community’. The current care issues faced by growing numbers of older people are exacerbated by liquid modern conditions, as many families are no longer embedded in space, place, or community and face difficulties in providing care. By Berry’s definition, individuals in liquid modern societies are not whole or healthy. It might be that liquid modern conditions make us more aware of division, individual and social disintegration, and perhaps reinforces a dualist ontology. Berry explicitly argues against ‘dualism’—the philosophical argument that separates mind from body, the physical from spiritual, the human from non-human, the organic from non-organic, the material from non-material, and the individual from community: