Carey Denholm

Intuition in emergency nursing: a phenomenological study.

The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

Expert nursing practice: a mathematical explanation of Benner’s 5th stage of practice development

TITLE Expert nursing practice: a mathematical explanation of Benners 5th stage of practice development. AIM This paper is a theoretical discussion of a mathematical explanation for Benners theory of practice development. BACKGROUND Benners practice development theory demonstrates how a nurse moves from a beginning, rule-based practice through to expert care. Her notion of expert practice as intuitive has not been well-accepted or understood in nursing. A new description of expert practice includes three types of intuitive practice (cognitive, transitional and embodied), the development of which are dependent on knowledge, experience and reflective time. DATA SOURCES This paper is based on phenomenological research conducted in 2000-2003 and Benners publications, as well as recent discussions about the relationship between mathematics and phenomenology. DISCUSSION The mathematical explanation for Benners theory of practice development relates reflective time and knowledge to the mathematical power of experience and links the unique components of intuitive practice to expert care. On reaching expert practice, the three types of intuition include previously identified themes (knowledge, experience, connection, feeling, syncretism and trust) as differentials along the reflective time axis. When graphically represented, expert practice becomes a three-dimensional figure as practice becomes more complex, rather than a two-dimensional one as seen in previous stages. CONCLUSION Having the intuitive component of expert practice further clarified from Benners first vision confirms it as a valid component of practice. It is important to recognize that experience is a powerful component of practice and that it is essential to the development of expertise. Although this discussion has been nested within nursing practice, it has wide implications for medical, psychological and educational practice.

Testing the Theoretical Fit of an Abseiling Harness: A Study of an Australian Primary and Secondary Prevention Program

A theoretical model of prevention addressing adolescents at-risk of offending was developed then utilised to assess a primary and secondary prevention program. The study of the wilderness-based practise was conducted between September 1992 and October 1994, adopting a pre-post-follow-up quasi-experimental design using waiting periods to establish treatment and control groups. Maturational changes were gauged over a 12 month period of 44 male and 18 female voluntary Australian adolescents between the ages of 15 and 25 years. Significant differences between the treatment and control groups in the psychometric areas of general self-esteem and self-actualisation were found establishing positive program effect on participants. Further, the long term effect of this program in preventing participants initial contact with court proceedings or reducing further involvement respectively, over a twelve month period was substantiated. It was shown that following this experience post program goals of employment and education for adolescents at-risk were positively influenced.

Combining measures of risk perceptions and risk activities: The development of the RAPRA and PRISC indices

The influence of risk perceptions on risk activities of teenagers is well known, but the development of indices, which combine measures of perception as well as behavioral outcomes, has proved problematical. This article discusses the ways in which this methodological problem was tackled within a five-year, multiphase, multimethod study of factors affecting adolescent risk-taking in Tasmania, Australia, which included an intergenerational comparison of adolescents and parents. The development of the Risk Activity by Personal Risk Assessment (RAPRA) Index combines measures of perceived riskiness of 26 activities identified by young people as involving varying degrees of risk, with the degree of participation by each respondent, through a rectangular model of weights. The Personal Risk Score Category (PRISC) Index summarizes and categorizes an individuals risk-taking profile relative to the groups risk values and risk hierarchy established by the RAPRA Index. The article discusses ways in which technical problems involved in combining measures of risk perceptions and risk activities were addressed during index construction, compared with examples in the literature. Some key findings from analysis of two student and parent samples are presented as exemplars of the methods used and the results produced. Findings demonstrate the widespread nature of risk-taking among teenagers, and the similarity of levels of risk-taking between teenager and parental generations. The indices allow for detailed comparison of particular risk-taking activities and reveal differences among teenagers now compared with parents when they were teenagers, and illustrate the dynamic cultural context of risk-taking perceptions and values.

Coping strategies during hospitalisation and recovery following motor vehicle trauma: A personal account

Described in this paper are the multiple injuries the author sustained as a result of a serious motor vehicle accident 5 years previously and the subsequent surgical and medical treatment. Also described are the different coping and adaptive skills he utilised during and after hospitalisation and how the nature of surgical and medical intervention and nursing practices affected their usefulness and effectiveness. Recommendations for psychologists when engaging with hospital patients facing similar treatments, are provided.

If Only You Knew What I've Just Done: Adolescent Memories from A Tasmanian Wilderness Primary Prevention Programme

Forty six subjects were invited to respond by mail to a series of written questions relating to their previous experiences while undertaking a Tasmanian wilderness primary prevention programme. Most participants recalled vivid and lasting memories, which when analysed revealed eight major themes. The authors argue that participant memories are a rich source of information and potential source of evaluative data for team leaders and managers of wilderness programmes.

Making the Implicit Explicit: Creating Performance Expectations for the Dissertation

No abstract published: This invited book review examines the structure, underlying premise and applications of a 2007 US text on doctoral education.