Caroline Dickson

Learning to deal with crisis in the home: Part 1 - developing community simulation scenarios

Contemporary health care is increasingly being located in the community. From the evident changes in demographics and general health, it can be derived that the people whom student nurses care for are likely to have multiple comorbidities and be vulnerable to clinical deterioration. These nurses are required to develop a range of transferrable skills to meet the demands of the population. The challenge for educators of preregistration student nurses is to develop educational strategies to prepare them with the skills, knowledge, and confidence necessary to recognise and manage deterioration appropriately in any context. This article is the first of two papers discussing the stimulus, design, and delivery of an educational innovation that focuses on the recognition and management of the deteriorating patient. The article explores current literature about community-focused simulation highlighting the potential learning opportunities resulting from contextualising simulation scenarios specific to the community setting.

RCN backs the district nurse specialist practice qualification

Students find the district nurse specialist practice qualification (SPQ) ‘transformational’—equipping them with knowledge and skills to be effective caseload managers and team leaders in a variety of community settings (QNI, 2015). As a result of the resolution passed at Congress in 2016 (Royal College of Nursing (RCN), 2016), the RCN committed to lobbying for all district nurse (DN) caseload holders to have the professional SPQ. The RCN will work with key stakeholders to raise the profile of DNs to ensure that they are adequately prepared to undertake their role over the coming year.

Inspiring undergraduates towards a career in community nursing

This article is based on the findings of a literature review commissioned by the Queens Nursing Institute Scotland as part of its commitment to promote an evidence-based educational policy. An analysis of the literature suggests that there is potential to expand the provision of community placements beyond traditional clinical areas and these placements should be identified and overseen in collaboration with managers, mentors and higher education institutions to ensure a consistent approach and a positive learning experience. This may inspire undergraduate nurses to pursue a career in community nursing. Currently, there is little evidence to support models. High-quality evaluation research is required to ensure that new models are developed using a sound evidence base.

P-291 Shifting sands – using emancipatory practice development to help engage with culture

Background Culture is not about individuals but about the social contexts that influence the way people behave and the social norms that are accepted and expected (Manley et al., 2011). Culture is widely understood as ‘how things are done around here’ (Drennan, 1992). Anthony (1994) argues that corporate culture reflects what is espoused, what the organisation wants to portray rather than the actual culture that is experienced. Nursing practice is significantly impacted by the constantly evolving societal, environmental and organisational context in which nurses work (Keyko, 2014; McCormack et al., 2013). The dominant NHS approach in recent years has been described as ‘pace-setter’ (King’s Fund, 2012), a command and control culture with little delegation or collaboration, which is primarily driven by top down targets (Riley, 2014). The present health care environment is paternalistic (Newton, 2000) and predominantly task orientated which can lead to fundamental care falling short (Shannon & Peelo-Kilroe, 2012; Francis, 2010). Emancipatory practice development is the product of critical social theory (Shaw, 2013; Fairbrother et al., 2015), action orientated (McCormack et al., 1999) and transformational. It relies on the development and maintenance of critical and progressive clinical practice cultures which drive change and growth in health care practice (Manley et al., 2013; Fairbrother et al., 2015). Aims Understand the perception of culture Engage staff with their beliefs of self and culture. Methods Using creative emancipatory practice development methodologies to explore questions about culture in a less confrontational way. Conclusion Practice development and person-centred care aim to establish workplace cultures that enable everyone to flourish (Manley et al., 2014). Working collaboratively and enabling staff to contribute to the future success of the organisation provides them with a voice and creating shared governance contributes to an atmosphere of respect for staff (Boyer, 2005).

Learning to deal with crisis in the home: Part 2 - preparing preregistration students

The global shift of health care is from acute services to community and primary care. Therefore, registrants must be prepared to work effectively within diverse settings. This article is the second in a series discussing the preparation of nurses for contemporary health-care challenges in the community. In it, we outline the design, implementation, and evaluation of simulated emergency scenarios within an honours degree-level, pre-registration nursing curriculum in Scotland. Over 3 years, 99 final-year students participated in interactive sessions focusing on recognition and management of the deteriorating patient and emergency care. Clinical scenarios were designed and delivered collaboratively with community practitioners. Debriefing challenged the students to reflect on learning and transferability of skills of clinical reasoning and care management to the community context. Students considered the scenarios to be realistic and perceived that their confidence had increased. Development of such simulation exercises is worthy of further debate in education and practice.