Christine Webb

Clinical supervision skills: a Delphi and critical incident technique study

Like many other health care professions, recent curriculum reform in radiographer education has resulted in the development of an undergraduate programme, which aims to produce an independent, ‘reflective’ practitioner. It was therefore considered that the role of supervising radiographers would be even more critical than previously, and their activities in the clinical setting which would support the aims of the curriculum were examined. The study methodology was separated into two stages. First, the Delphi technique consulted expert radiographers in order to define clearly the role of clinical supervisors. The statement derived by the experts using the Delphi method was used to assist students in making their judgements. The second stage used the Critical incident technique, in which students described activities by radiographers which assisted or hindered their learning. As well as clarifying the current activities of practitioners when supervising student radiographers, the findings indicated that the...

The power of socialjudgement: struggle and negotiation in the nursing process

In this paper we discuss an alternative view of the nursing process as it is experienced by both patients and nurses. The current conception of the nursing process is that it is a benevolent activity which aims to render care more individualized or person-centred. Its rhetoric usually includes notions of mutuality in goal setting, openness and collaboration between patients and nurses. We will suggest that such a view is idealized and has little basis in empirical reality as it is experienced by both nurses and patients. Rather, nurse-patient relations are beset by conflict and struggle, frequently resulting in the acquiescence of patients to the nursing and the medical goals of care. On the basis of an ethnography of a hospital medical ward, we will describe a process of social judgement and set it into a discussion of the social context where an unequal balance of power is integral to provider-recipient relations. Our account will focus upon four categories through which judgemental labelling may be analysed. These are assessing, negotiation, struggling and acquiescing. Of special interest to us are strategies which nurses used to maintain excellent care in the context of negative social judgements, and the place social judgement may play in moral decision-making. We emphasize the strengths which rich qualitative data have in relation to previous survey approaches of this phenomenon, whilst recognising the limitations of so focused a study.

Self-concept, social support and hysterectomy

This paper reports on part of a larger study financed by the DHSS and concerned with describing recovery from hysterectomy and evaluating an experimental counselling session aimed at helping women to plan and manage their own recovery. The effect of the operation on the womans self-concept and the possible role of social support in the recovery process are the principal foci. Contrary to findings in much previous research, women in this study showed no evidence of adverse changes in self-concept, depression levels were reduced after operation, and the majority of women were glad to have had a hysterectomy. Low levels of support from partner, family and friends were associated with poorer outcome on some of the indicators used, and possible explanations for this are considered.

Changing Nursing and Nursing Change: a dialectical analysis of an action research project

Abstract This paper focuses on an action research project, which aimed to develop the roles of nurses working in a specialist out‐patient department. There is a dearth of literature in this field of nursing. Complex issues (historical, cultural, personal and political) surrounding the process and outcome of change are discussed. Current analyses often highlight specific aspects of the complexities of the process of change (see, for example, Titchen & Binnie, 1992). In this paper, the present debate is expanded by developing practical and theoretical arguments which draw on the work of hermeneutic philosophers and critical theorists, including Gadamer (1975) and Winter (1989). Accordingly, non‐correspondences or contradictions within the research setting are identified, and 13 key factors which hindered/helped change are discussed. Drawing on a general body of literature, the analysis is widened to take into account change in other areas of nursing and education. It is argued that as nurses and researchers...

Nursing models in the curriculum: the nursing degree course at Bristol Polytechnic

This article discusses the use of nursing models as a basis for curriculum planning in a Nursing degree course. Each module in the course is based on a Nursing model, as are assessment of theoretical aspects and of nursing competencies. Rationales for the structure of the course and choice of models are given, and the article concludes by emphasising the need for continuing evaluation of this way of planning and implementing the curriculum.