David Hall

The blocked bed: Definition of a problem

The blocked bed is a term familiar to doctors and hospital administrators, but has no conventional definition. Estimates of the prevalence of bed blockage vary and are largely subjective. A survey of Area and Regional Health Authorities in the U.K. was used to collect information on the nature and extent of bed blockage. The definitions offered focus on the match between patient characteristics and services provided, and refer in the main to elderly patients in acute hospital beds. It is argued that the emergence of blockage as a problem is related to a dominant model of acute care in hospitals, which does not accurately reflect the situation of elderly patients or their needs for treatment.

Social and psychological care before and during hospitalisation

Hospitalisation is a stressful experience, especially for children. While maternal separation has been as a major cause of distress among younger children, a broader perspective is required to understand the links between the individual, familial, professional, institutional and structural levels of hospital care affecting children. This can be seen in the changing attitudes in hospitals to parents as visitors, and the gradual introduction of open visiting. A model of discontinuity is proposed to analyse the experiences of children, parents, and professional staff in the ward. A variety of ameliorative techniques are discussed, in terms of their implications for change to hospitalised children or to hospital organisation. Studies in the development of childrens concepts of illness show the need for providing information relevant to their developmental level. It is suggested that more should be done to involve parents in the care of their children in hospital, and to offer them support during this time. The effects on nursing and other staff are considered. The introduction of play schemes has benefits for children, but may lead to organisational complications if the priorities between therapy and welfare are not reassessed. More attention should be given to the psychological risks of treatment in assessing effects of medical intervention. A move towards more child centred care should in particular involve a change in the role assigned to the family within the medical sphere, and a reduction in the insularity of hospitals and fragmentation of treatment derived from existing medical and nursing practices.

The research imperative and bureaucratic control: The case of clinical research

This paper examines the development of Research Ethics Committees and explores some of the conflicts of value and role which surround the practice of medical research. The case of medical research on children is discussed as one which raises in an acute form concerns about consent and risk/benefit analysis. The paper draws on a survey of Research Ethics Committees to illustrate their variety of structure and functioning, and to relate current practice to a model of bureaucratic control. Bureaucracy is considered both in its common-sense understanding of officious rule-making and delay, and in its theoretical formulation in terms of specialisation, standardisation, formalization and centralisation of procedures. It is argued that the concept of bureaucracy can aid an understanding of the problems of control over research, as well as providing a model for more informed, consistent and open decision making.

The Role of Volunteering in Transitions from Higher Education to Work

Why should we be interested in the place of volunteering in transitions from higher education to work? As Ulrich Teichler commented in a report compiled for the International Labour Office, in the 1990s and beyond ‘transition from higher education to employment has become more complex and protracted’ (1999, p. 5). There is a widespread perception of under-employment, over-qualification yet inadequacy in basic skills required by business, leading to a mismatch between graduates’ skills and employment opportunities. Recent research from the European CHEERS1 study has suggested that in fact such transitions are smoother than they are often perceived to be (Teichler, 2007, p. 21), with rates of graduate unemployment continuing to be lower than those of non-graduates. In fact, this research suggests that many graduates view their career prospects more negatively than a research-informed perspective would suggest. Despite this evidence, anxieties about graduates’ transition into work, we will suggest, have become an important driver of volunteering within the curriculum and after graduation. This is not, however, to discount the importance of volunteering or service learning within higher education as a form of experiential education, as a means of developing university-community partnerships for knowledge transfer and social action, or indeed as an enjoyable activity in its own right (Strand et al., 2003; Hall and Hall, 2007).

Issues in Methodology

Practical social research involves negotiation with a client organisation about the purpose of the research project, its intended outcome and also the research methods to be used. On this last point the supervisor and you the student are the ‘experts’ who will have to decide how to carry out the research. You can discuss with the client organisation various strategies for obtaining the results, but ultimately you and your supervisor have responsibility for choosing what is appropriate and feasible.

Analysing Ethnographic Data

This chapter deals mainly with how to handle material generated by semi-structured, in-depth interviews focused on the particular topics required by the client. The analysis of qualitative data from interviews, case studies, oral and life histories will be considered, as well as how it can be presented in a report and still retain the richness or depth which is its main value.

Social climate and ward atmosphere

Abstract The question of the relationship between the individual and the environment has been studied under the headings of social climate or atmosphere. It is argued that current usage of these terms conceals three different sorts of approach, each of which has its own strengths and weakness. In the first place, people commonly distinguish between organizational settings in terms of evaluative criteria, though often not explicit and this “feeling tone” may be more closely related to individual behaviour than organizational indices. The problem of different evaluations of the same social setting by different actors has largely been ignored in the more quantitative studies of organizational environments (the second and third approaches we identify) which rely on either a check list of variables or a large scale questionnaire response. Many of these studies are designed to differentiate between organizations and their success in this respect necessitates a lesser emphasis being given to within-organization differences. We argue that the effective evaluation of such studies must rest on a greater understanding than has been shown at present in the processes of attitude formation within and across organizations. We are looking for an approach to the individuals perceptions of his environment which will give due weight to differences of perception and link these to structural features of the individuals social position. At present the outlook is pessimistic for a rapprochement between the subjective and the so called objective analysis of environmental interaction. Our concern started from perceptions of differences in ward atmospheres and the article is illustrated with research pursued mainly in a medical setting.

Negotiating an Agreement

This chapter deals with a key stage in developing a research project. It is essential that the project is properly set up from the beginning, so that you and the organisation you are working with are clear about what is expected. The aim is to negotiate an agreement which is acceptable to all parties, including the academic supervisor. The agreement will outline the project to be undertaken and define the contributions of yourself and the client organisation respectively.

Introduction and Acknowledgements

This book is written as a guide to students wanting to become involved in practical social research in the local community. In particular it is addressed to undergraduate students participating in small-scale research projects as part of their assessed work, though we hope that the book will also be useful for anyone who wants a general understanding of social research.

Case-studies of Small-Scale Evaluation

The two case studies in this chapter are reports of student projects with non-profit organizations. They supplement the argument of the previous chapters by giving an idea of the kind of projects that have been conducted using the model of small-scale evaluation, and of how the research has been used.