Gerard Kenny

Skills or Skilled? Children's Nursing in the Context of the Current Debate Around Nursing Skills

This article seeks to demonstrate how the current debate around nursing skills is derived from an economic model of care and competency that has been based on the needs of the adult population. The professional perspective of childrens nursing has been unheard in policy and decision-making circles concerning the skills agenda debate within educational and clinical practice. As a consequence, the need of childrens nurses has been assumed to be the same as those of general/adult nursing. This article argues that childrens nursing has followed a different historical and professional pathway on its progression to maturity. These differences call for alternative educational and clinical solutions for childrens nurses in the issue of skills acquisition. In the childrens nursing context, this is the difference between having a skill and being skilled. Recognition of this could ensure that childrens nursing has a valuable contribution to make to the debate from its unique perspective.

Attention Deficit Hyperactivity Disorder: the current debate and neglected dimensions

The aim of this article is to identify and highlight the issues facing children, young people and families experiencing Attention Deficit Hyperactivity Disorder (ADHD) in an United Kingdom context. In presenting these issues it is hoped that wider discussion and awareness of the challenges of this condition may have an effect on the planning and delivery of services within the UK. We seek to highlight that an overreliance on a medical perspective has the effect of neglecting the wider context of the rights of the child and the needs of the family. We advocate for an approach that recognizes the importance of the contributions of other professionals and the implementation of locally-agreed guidelines that incorporate the perspectives of families and the rights of the child.

The healers journey: A literature review

While much important research has gone into identifying the efficacy and importance that healing interventions can make to healthcare this paper seeks to synthesise some of the core themes of the processes that healers go through in their journey to becoming a healer. Through the process of a literature review of seminal texts and current literature the paper identifies the key themes of, healer as facilitator, connecting to sources of healing, an appreciation of the healee, an expanded sense of spirituality, an acknowledgement of the wider archetypal significance of the healer, the importance of the wound and the role that these can play in the process of personal transformation and also acceptance. In doing so it hopes to offer that the journey of the healer plays a crucial role in guiding the quality of the healing that healers share in a healing encounter.

Children’s student nurses’ knowledge of spirituality and its implications for educational practice

Children’s nurse educators have to rely predominantly on adult-based literature to guide their educational practice concerning spirituality in the nursing curriculum. The aim of this study was to get a children’s nursing perspective. A questionnaire was designed around the main themes emerging from the adult literature on spirituality. This was distributed to children’s nurses on the undergraduate curriculum at a UK university. The results showed that some of the challenges of delivering spirituality are common to both adult and children’s nursing. However, there were also significant differences revolving around the impact that children and families had in informing students’ understanding of spirituality, and the problems of seeking a unified theory of spirituality in a children’s nursing context. It concludes that children’s nursing has important lessons to learn from the adult literature; however, it must strive to construct its own insights and use this understanding to inform educational approaches to the topic.

Family presence during resuscitation: Validation of the risk–benefit and self-confidence scales for student nurses

Background. There is increasing debate about the advantages and disadvantages of family-witnessed resuscitation. Research about the views of healthcare providers depends upon reliable tools to measure their perceptions. Two tools have been developed for use with nurses (26-item cost-benefit tool, 17-item self-confidence tool). Objectives. Firstly, to validate these tools for use with student nurses in the UK. Secondly, to report on the perceived risks and benefits reported by student nurses, and their self-confidence in dealing with this situation. Methods. A sample of 79 student nurses were invited to complete the tools. Item-total correlations and Cronbach’s α were used to determine internal consistency. Factor analysis was computed to assess construct validity. The correlation between the two scales was explored. Results. 69 students completed a questionnaire. Very few had experience of family-witnessed resuscitation. Mean total scores were 3.16 (standard deviation 0.37; range 2.04–4.12) on the risk-benefit scale and 3.14 (standard deviation 0.66; range 1.94–4.82) on the self-confidence scale. Four of the original items were removed from the risk-benefit scale (Cronbachs α 0.86; 95% confidence interval ≥0.82). None were removed from the self-confidence scale (Cronbachs α 0.93; 95% confidence interval ≥0.91). There was a significant correlation between the two scales (r = 0.37, p = 0.002). Conclusions. There is growing evidence that these tools are valid and reliable for measuring student nurses’ perceptions about family-witnessed resuscitation.

Compassion for simulation

This topic for debate explores how simulation based education has become an area where Higher Education providers look to deliver on an agenda of recruiting, educating and assessing for compassion. This paper offers that rather than SBE being a forum for developing and promoting compassion it may actually be achieving the opposite both for those we educate and those they in turn care for. It does this through introducing two ideas, near enemies and Jungs shadow and uses these ideas to explore our understanding and expression of compassion through simulation.

Improving and validating children’s nurses communication skills with standardized patients in end of life care

Children’s nurse education is experiencing increases in recruitment targets at the same time that clinical placements are decreasing. With regard to end-of-life care, it is has become a challenge to ensure that all students come into contact with a satisfactory range of experience as part of the requirement for competency at the point of registration. The aim of our study was to find out if students at the end of their course were able to use communication skills acquired in their three years of training and adapt and transfer them to a specific palliative care context even if they had never worked in that area of care. Focus groups were conducted after the simulations which explored the students’ experiences of being involved in the scenarios. Four themes emerged that students identified either inhibited or enabled their communication skills, which included anxiety and fear, the need for professional props, the experience of it being real and feeling empowered.

Educator as shaman and the sublated space

This paper seeks to identify and explore some of the tensions that nurse educators face when engaging in the competing internal and external demands that are made on their delivery of curricula. It offers that one of the ways to explore these tensions constructively is to see them dialectically. It seeks to identify three archetypal dialectical themes that can be present in our teaching and offers that the educators role can be understood to be one of a shaman as they seek to resolve these dialectical tensions skillfully.

Reflections on love’s spirals

This article seeks to explore how the experience of love and its expression might inform and guide reflection and inquiry into love. Despite the importance of love in our personal and professional lives, it remains a topic that has further scope for inquiry within nursing circles. The article takes as its catalyst an encounter that emerged out of a piece of research that was exploring individuals’ experiences of becoming healers and the journey they undertook. One participant spoke deeply and profoundly of his experience of love, which generated for me a personal, experiential, and intellectual process of inquiry. The article seeks to try and create a synthesis between rational inquiry and subjective experience. It explores W. B. Yeats’s notion of a gyre, a spiral, as an image and metaphor for integrating different conceptions and understandings of love. It seeks to illustrate how a more integrated understanding of love may open up spaces of inquiry that are more flexible, creative, and spontaneous.

Family-witnessed resuscitation: focus group inquiry into UK student nurse experiences of simulated resuscitation scenarios

Aims To describe the impact of family members’ presence on student nurse performance in a witnessed resuscitation scenario. To explore student nurses’ attitudes to simulated family-witnessed resuscitation and their views about its place in clinical practice. Background Family-witnessed resuscitation remains controversial worldwide. Hospital implementation remains inconsistent despite professional organisation support. Systematic reviews of international literature indicate family members wish to be involved and consulted; healthcare professionals express concerns about being observed while resuscitating. Student nurse perspectives have not been addressed. Design Qualitative, focus groups. Methods Participants: UK university second-year student nurses (n=48) who participated in simulated resuscitation scenarios (family member absent, family member present but quiet or family member present but distressed). Data generation 2014: focus group interview schedule—five open-ended questions and probing techniques. Audio recordings transcribed, analysed thematically. Research ethics approval via University Research Ethics committee. Findings Overarching theme=students’ sense making—making sense of situation (practically/professionally), of themselves (their skills/values) and of others (patients/family members). Students identify as important team leader allocating tasks, continuity of carer and number of nurses needed. Three orientations to practice are identified and explored—includes rule following, guidance from personal/proto-professional values and paternalistic protectionism. Discussion We explore issues of students’ fluency of response and skills repertoire to support family-witnessed resuscitation; explanatory potential to account for the inconsistent uptake of family-witnessed resuscitation. Possible future lines of inquiry include family members’ gaze as a motivational trigger, and management of guilt.