Elizabeth Rosser

Exploring the development of a cultural care framework for European caring science

The aim of this paper is to discuss the development of a cultural care framework that seeks to inform and embrace the philosophical ideals of caring science. Following a review of the literature that identified a lack of evidence of an explicit relationship between caring science and cultural care, a number of well-established transcultural care frameworks were reviewed. Our purpose was to select one that would resonate with underpinning philosophical values of caring science and that drew on criteria generated by the European Academy of Caring Science members. A modified framework based on the work of Giger and Davidhizar was developed as it embraced many of the values such as humanism that are core to caring science practice. The proposed caring science framework integrates determinants of cultural lifeworld-led care and seeks to provide clear directions for humanizing the care of individuals. The framework is offered to open up debate and act as a platform for further academic enquiry.

Generalist or specialist in nurse education

© 2 01 5 M A H ea lth ca re L td Nurse education has been the subject of numerous reviews and recommendations certainly since the Athlone report (The Athlone Committee, 1939) recommending student status. Many reviews (Briggs, 1972; Royal College of Nursing, 2007) have focused on the ‘employment’ status of the nursing student and the development of graduate status of the nursing workforce. Equally contentious has been the move of UK nursing from one generalist point at registration, into four ‘fields’ of nursing so that at point of registration, nurses are specialist in either adult, mental health, learning disability or children and young people’s nursing. While the rest of Europe continues to prepare nurses as generalists, it is only the UK adult nurse who complies with EU directives and is permitted to seek employment across Europe. Lord Willis, who published his review of nurse education following the first Francis Report in 2012 (Willis Commission, 2012), has been charged with a comprehensive review of the standards of education and training of the qualified nurse and care assistant workforce in his Shape of Caring review, due to report in February 2015. Speaking at the recent Chief Nursing Officer conference, he suggested that without change, nurse education would no longer be fit for purpose over the next 10–15 years (Lintern, 2014). Although the report will not be published until February, his current thinking is that nurse education should require students to spend the first 2 years of their programme learning a foundation of general nursing, beginning their specialism of mental health, learning disability or children’s nursing in their third year and continue into a 1-year preceptorship programme following registration. He suggests the 1-year preceptorship programme should be a continued and active contribution to the education process (Lintern, 2014). In this column, I recently discussed the implications of the Shape of Caring review and the move to an integrated care model of care delivery, with a focus on the education and training of the healthcare assistant workforce, and the need for a whole systems approach to bring together health and social care services Elizabeth Rosser

Strong leadership: the case for global connections

AIMS AND OBJECTIVES To identify how nurse leaders view and experience the opportunities offered by one of the largest global nursing organisations Sigma Theta Tau International. BACKGROUND Worldwide, nursing leadership is challenged with addressing the complex issues impacting on care delivery. International nursing organisations are a means to bring together individuals to promote leadership and scholarship for nursing practice to promote patient safety and quality care. The newly established all-England chapter of Sigma Theta Tau International is a recent addition to the society in terms of nurse leadership in Europe, as such faces challenges as it establishes its identity and seeks to interpret the organisational vision: to advance world health through nursing leadership and scholarship. Moving forward, members views were sought on the goals of the chapter and how they may be enacted. DESIGN In July 2013, all chapter members at that time had been nominated on the basis of achievement in nurse leadership; all were invited to participate in an online survey. The online questionnaire contained a series of closed and open questions. RESULTS Most respondents joined because they believed in the vision and networking opportunities Sigma Theta Tau International provides. Three themes were extracted from the data: the value of networking and communication, leadership and the development of culturally sensitive organisations and the need for shared scholarship for nursing practice. CONCLUSION Findings indicate the growth of effective leadership at all levels of nursing could be harnessed through successful collaboration and keen support for robust connections between practice and education to promote quality care. RELEVANCE TO CLINICAL PRACTICE Whilst challenging, globalisation presents an opportunity for a nursing society such as Sigma Theta Tau International to work collaboratively to address healthcare issues. A nursing society that explores and resolves its own complex issues by actively promoting leadership and collaborative scholarship reveals a potential to empower the profession to share our collective solutions towards enhancing clinical practice.

Challenges for future caring science research: a response to Hallberg (2006)

In a direct and somewhat provocative editorial in IJNS (43) pp. 923–927, Hallberg (2006) raises several challenges for nursing research if it is to provide useful evidence for health-care practice in both the short and the long term. We wish to offer a response to Hallberg’s challenges and to add support to her general call. In particular we wish to consider the challenges she poses in the wider context of caring science rather than the more limited perspective of nursing science. In the spirit of constructive debate we counter some of the claims made and indicate some areas for future direction which embrace a more epistemologically sound view of knowledge generation, which is methodologically sensitive to different research questions. This direction we believe is at the heart of what caring and nursing science is about.

Why education matters: reflections on the last 50 years

Elizabeth Rosser, Professor of Nursing and acting Executive Dean of Faculty, Bournemouth University, reflects on her own nursing journey and the importance of nurse education.

Professorial leadership in nursing

I read with some alarm the editorial published in the Journal of Advanced Nursing by Watson et al. (2016). My overriding concern is their motivation to ‘name and shame’ what they refer to as the ‘zero to hero’ of the UK nursing professoriate. My concern is around the notion of nursing leadership. Watson et al. (2016) acknowledge that there are many ways to demonstrate leadership but the impact individuals have made on their organisation, the profession, both nationally and internationally, and the current and future workforce is not even mentioned. Neither has any consideration been given to the nature of the infrastructure of any one organisation to support nursing professors in their leadership to facilitate a publication profile. It has been my observation that these nursing professors who lead from the front, altruistically galvanising their faculty, the university and their profession are significantly less likely to be able to apply for large research grants. Therefore, they are less likely to generate research income or lead large research teams and achieve multiple publications with co-authorship. The organisation of Russell group universities, for example, tends to rotate the senior faculty leadership teams offering a research assistant to support a continuation of their research activity. Often, following their leadership rotation, they are awarded a period of sabbatical to allow them to make up for the lack of intensive research activity during that time. However, in post-92 universities, professors often become trail blazers for the profession to create and develop a research culture that will support staff to develop their rounded portfolio. Some universities, such as Bournemouth University, believe in the fusion of education, research and professional practice to ensure greater impact of higher education institutes on society. Such fusion helps the developing professional and will, in the longer term, influence and support the development of a research culture in both education and practice and the promotion of clinical academic careers. I undertook a study myself about 10 years ago (Girot 2010) to understand the role of the professoriate, from those most involved as research leaders in SW England, and two key expectations were identified: (1) that they should be leaders of research and (2) that they should be inextricably involved in the business of the faculty as strategic leaders. I wonder whether these two expectations are mutually exclusive? I challenge Watson et al.’s blinkered view as to who really does have the greatest impact? Whilst I am totally committed to all professors researching and publishing and try to achieve the same, I observe that the ‘system’ favours those in editorial positions who have greatest access to getting published as well as those who remain in the luxurious positions of securing time and space away from the business of the university to indulge in the pleasures of publishing. Certainly, those with the largest number of publications leave their legacy in published papers, but surely, the strong leaders are those who are building and shaping the research culture in the profession and who leave a legacy that will be measured by others such as Alschul, Martha Rogers, Virginia Henderson as Rolfe (2016) acknowledges. Ultimately, good researchers who make an impact on either clinical practice or education are not necessarily the professors who lead from the front and who galvanise students and staff at all levels to the benefit of their profession, their organisation and most importantly the service users. The way forward So, what do we want most from our nursing professors? In my opinion, there was a sense in the original editorial, that Watson et al. (2016) felt a sense of ‘I’m alright Jack’. . .. However, those universities which recognise the leadership qualities of their nursing professoriate employ them in positions of responsibility and executive roles. In

What role can education play in developing leadership

© 2 01 4 M A H ea lth ca re L td T here is only one profession other than nursing that constantly seems to be in the glare of public scrutiny over the quality of their practice and that is social work. Indeed, in spite of the untold success stories of millions of people benefitting from our health and social care services, social workers and nurses seem to be in competition when it comes to the media portrayal of public criticism. There appears to be a burning desire to identify someone to point the finger at in an attempt to seek public recrimination for the regrettable, exceptional cases of poorquality service. Nevertheless, some individuals are blameworthy, so what is it in our ‘systems’ that places a professional caregiver in a position where they act contrary to their own fundamental beliefs and values, and what place does education have in shaping the decisionmaking in such circumstances? Reflecting back on the host of high-profile reports of scandalous failures of care in recent years, epitomised in the Mid Staffordshire NHS Foundation Trust inquiry, Robert Francis (2013) highlights the lasting physical and emotional damage we, as professionals, can cause when things go wrong. For me, the most striking aspect of the report was the presence of an “unhealthy and dangerous culture” (Francis 2013: 1360) and its link with leadership. Francis (2013: 1348) remarks “it is a truism that organisational culture is informed by the nature of its leadership”, observing that there was a significant lack of quality leadership at Mid Staffordshire. So, understanding the role of leadership in an organisational culture that allowed hundreds of patients to die unnecessarily seems key to accepting what needs changing and how education can play a role in supporting such change. If leadership holds such a key role in the culture of an organisation, it suggests that the development of leadership skills should hold an important place at an early stage in the developing professional’s preparation. Of course, this begs the question of whether leadership skills can actually be taught. The NHS seems to have invested heavily in leadership education and training, mainly at the post-qualifying level, Elizabeth Rosser

Nursing Now: nurses at the heart of the challenge to improve global health

Elizabeth Rosser, Acting Executive Dean, Bournemouth University, discusses two initiatives to promote nursing around the world and make improvements in global health.

Encouraging political participation among the next generation

Elizabeth Rosser, acting Executive Dean, Deputy Dean for Education and Professional Practice, and Professor of Nursing at Bournemouth University, discusses how nurses can be encouraged to be politically engaged.

Consultation on the new roles of supervisor and assessor

Elizabeth Rosser, Deputy Dean (Education and Professional Practice) and Professor of Nursing at Bournemouth University, outlines three new practice and education roles proposed by the Nursing and Midwifery Council.