Fintan Sheerin

Lesbian, gay, bisexual and transgender older people in Ireland: Mental health issues

International policy initiatives have highlighted the need to include older lesbian, gay, bisexual and transgender (LGBT) issues in the provision of appropriate health and social care. However, empirical studies in the area remain sparse. The aim of this study was to investigate the experiences and needs of LGBT people over the age of 55 years living in Ireland and this article reports on specific mental health issues. Mixed methods were used involving 144 surveys and 36 semi-structured in-depth interviews. The findings revealed that a significant number of the survey respondents had experienced a mental health problem at some point in their lives with interview participants providing further details of their concerns. It is recommended that policy makers address the mental health needs of older LGBT people in future strategic directives and develop standards of care that support the principles of equality, inclusion and respect for diversity.

Frontline Care in Irish Intellectual Disability Services: The Contribution of Nurses and Non-Nurse Care Staff.

The ongoing development of generic intellectual disability services in Ireland, driven by a policy of inclusion and normalization, has posed significant challenges to the interdisciplinary team, with the creation of new frontline carer roles not linked to any particular profession. It is within this context that attention has been focused on the appropriateness of nursing to frontline caring in intellectual disability service provision. The separation of caring and nursing posts that is now evident within many residential services suggests that decisions have already been made regarding the appropriateness of nursing within particular settings. These decisions have, however, been made in the absence of any real attempt to delineate the contribution of nursing to frontline caring in Ireland. This study is the first of its type in Ireland and seeks to set out the unique interventional contribution of nursing and non-nurse caring within frontline intellectual disability services.

Models of initial training and pathways to registration: a selective review of policy in professional regulation.

AIM To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. BACKGROUND Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. EVALUATION Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. KEY ISSUES Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. CONCLUSIONS Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. IMPLICATIONS FOR NURSING MANAGEMENT The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models.

Identifying the Foci of Interest to Nurses in Irish Intellectual Disability Services

The role of nursing in intellectual disability services has not been constructively debated in the Republic of Ireland. The single report on such nursing in recent years retained a biomedical bias and was prepared within the context of staffing shortages. Intellectual disability nursing in Ireland is at a crucial juncture, with various forces seeking to relegate it to a postgraduate specialist subject. The specific input of intellectual disability nursing to the broader profession may be lost, and may be subsumed within an illness model unrepresentative of the reality of care. The purpose of this study was to explore this specific input and to identify foci for nursing intervention within residential intellectual disability care. This was achieved through a Delphi study; three focus groups held among Irish intellectual disability nurses working in three service settings; and personal interviews held with residential service/nurse managers.

Diagnoses and Interventions Pertinent to Intellectual Disability Nursing

PURPOSE The field of intellectual disability care in Ireland has been undergoing significant change, and this has called into question the role of specialist intellectual disability nursing. This review aims to identify the diagnoses and interventions that are employed by intellectual disability nurses. DATA SOURCES Exploration of the relevant professional literature, drawing on a broad scope of sources, was completed. DATA SYNTHESIS Examination and discussion within the taxonomic structure of the Nursing Interventions Classification. CONCLUSIONS Initial data set of diagnoses and interventions identified as a basis and justification for further systematic examination of specialist intellectual disability nursing practice. IMPLICATIONS FOR NURSING PRACTICE Explication and elaboration of the contribution of specialist nursing within intellectual disability care settings.

An evaluation of a community living initiative in Ireland

One of the central principles underpinning Irish intellectual disability policy is that of decongregation. Allied to this is the belief that life in community settings offers greater opportunities and richer experiences than does life in institutional settings. This study explores the experiences of a group of adults with intellectual disabilities who moved from residential settings to living units in the community. Using a qualitative descriptive approach, it considers the significance of that move for them and seeks to understand the extent to which their lives have changed. Whereas it emerges that this was a positive period in their lives, it is clear that a number of issues remain to be addressed and these provide useful information for similar developments in the future.

The impact of four family support programmes for people with a disability in Ireland.

Background: This article reports on an evaluation of four family support programmes in Ireland for families of people with a physical or an intellectual disability or autism. The focus of the evaluation, which took place within a year of the programmes’ completion, was on establishing whether the programmes had an impact on families’ capacity to effectively support their family member. Method: A mixed-method design was used, which included a survey (n = 38) and interviews (n = 19) with participating family members. Ethical approval for the study was given by the relevant university ethics committee. Results: Findings suggest that participation in the programmes enhanced knowledge, attitudes, and competencies of families and also impacted their ability to advocate for their family member and to connect with the community. Discussion and conclusions: Whilst outcomes were overwhelmingly positive, further follow-up would be required to ascertain if sustained capacity building took place.

The Cloaked Self: Professional Decloaking and its Implications for Human Engagement in Nursing: Professional Decloaking and its Implications for Human Engagement in Nursing

PURPOSE Much of our practice as nurses is predicated on the development of a trusting relationship between patient and nurse. Through this, the nurse and patient can identify the issues which are challenging health, the desired outcomes of care and the interventions that will be enacted, by both parties, in order to achieve these outcomes. Often, though, both nurses and patients find it difficult to put aside the relative roles that they play in health care and the level of engagement that is possible may not be achieved. METHODS In this theoretical paper, I will explore the importance of human engagement to nursing practice, drawing, in a reflective and personal manner, on experiences gained throughout my 30 years of providing nursing service. CONCLUSIONS Human engagement is central to the practice of nursing, but if engagement is to be valid, it must involve a dialogic transaction between the nurse and patient such that both parties are changed and there is a commitment to journey together, as humans, in the hope of finding positive outcomes for both. PRACTICE IMPLICATIONS In a time of increasing tendency to build boundaries between people and communities, it is imperative that nursing does not lose its most essential quality: the coming together of human beings in dialogic engagement.

Just Give the Money to the Women: Overly Simplified Advice that Works in International Education, Health, and Development Initiatives

Abstract Since 2008, the Global North universities and the rural district of Chilanga, Kasungu in Malawi, have endeavored to create a dialogic, inclusive, and reciprocal knowledge-transfer project. Numerous years of consultation with community members resulted in the creation of Transformative Praxis: Malawi, a project dedicated to bettering human conditions in one of the most impoverished areas of the world. Through participatory action research (PAR), the Malawian community strongly indicated the need to foster critical thinking, creativity, and social entrepreneurship in the areas of Education, Health, and Development. Although local women were prominent in all stakeholder meetings, a growing suspicion emerged that the inclusive intent of our research-based work was actually supporting existing male-oriented power structures, which exist despite ongoing assurances of the active participation of women in decision-making, and the purported matrilineal societal nature of Malawi. Through a progressive series of critical incidents connected to literature on PAR and women in impoverished communities, this chapter chronicles the manner in which local Chilanga women unexpectedly and unconventionally solidified their participation and authentic leadership in a Global North and South initiative based in Malawi.

Case Studies Introduction: Transformational Research

Chapter 14 reports on nursing informatics in relation to change management. It introduces the proceeding chapters which are presented as case studies on the various perspectives and differing approaches from authors working in the sphere of nursing informatics. The cross cutting theme evident in the case studies is that health care systems and nursing informatics are in various stages of transition. Authors report within the case studies how ICT is shaping nursing while highlighting the importance of implementing in parallel effective change management strategies to maximize effectiveness. Chapter 14 offers a summary overview of change management principles and how they can be applied in practice. It also includes a summary report on the ACENDIO Conference on eHealth and Nursing Innovations for the Future.