Helen Chapman

Student Voice in Curriculum Making.

Undergraduate student nurses (n = 117) were asked to reflect critically on their psychiatric clinical learning experience and identify strengths and weaknesses not only in the actions and behaviors of others, but also in their own. A questionnaire was specifically constructed to encourage the voicing of issues, concerns, actions, and behaviors that centered around the concept of quality in relation to four predetermined categories: clinical practice, clinical nursing staff, clinical facilitators, and students. Themes, inductively derived from the collected information within each category, were organized into clusters and then into frequency distributions to facilitate interpretation. The study generated information that should be useful in planning and supervising effective and mutually satisfying clinical practicums in any psychiatric context. Moreover, the responses gave voice to matters that otherwise may have gone unrecognized in the curriculum. The study confirms that student voice must become an integral part of the alternatives from which curriculum-making choice is made.

Resident-staff interactions: a challenge for quality residential aged care

Objectives: This paper describes one facet of a study to develop and implement a “best practice model” of residential care for older people. The purpose of this facet of the larger study was to describe the current interactional context of a residential aged care facility.

Discharge Planning in the Emergency Department: A Comprehensive Approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Changing to learner-centred education: Challenges experienced by nurse educators in Taiwan

This paper reports the challenges experienced by nurse educators in changing a teacher-centred, content-driven approach to teaching and learning to a learner-centred, process-driven approach within a School of Nursing in Taiwan. While a general movement towards a learner-centred approach was achieved, the curriculum transformation process was complex and inevitably slow with many challenges. First the study is outlined, with the key challenges experienced by the participating nurse educators explicated and illuminated with excerpts drawn from the research data. This is followed by a discussion of possible reasons for the challenges and how they were overcome and the transition process from teacher-centred to learner-centred education facilitated.

Contemplating, Caring, Coping, Conversing

This article is based on the premise that mental wellness for older adults can be promoted through communication and presents a model drawing on the constructs of contemplating, caring, coping, and conversing. The importance of interpersonal communication processes in the care of older adults and some barriers to communication and mental wellness are briefly reviewed. This article challenges nurses to develop awareness of their own caregiving styles and communication processes, and to assist others (e.g., family caregivers, care receivers) to communicate and interact more effectively to advance mental wellness for older adults.

Overcoming challenges to collaboration: nurse educators' experiences in curriculum change.

This article describes challenges to effective collaboration encountered by nurse educators as they transformed a unit within a school of nursing in Taiwan. This study introduced collaborative action research as a vehicle for curriculum change. Although the team achieved positive outcomes in transforming a unit, the collaborative process was complex with four major challenges: meaning, time, work culture, and conflicting views. This article provides an overview of the study, and the major challenges posed by working together are expounded and illustrated with excerpts drawn from the study data. Possible reasons for the challenges, how these challenges were overcome, and facilitation of the collaborative process are discussed.

Communicating in family aged care dyads Part 1: The influence of stereotypical role expectations

This paper contends that dysfunctional patterns of communication can develop in family aged care dyads in response to stereotypical role expectations in the caregiving-carereceiving relationship, thus giving rise to a role predicament of caring. If this argument holds it follows that more productive and effective forms of communication and relationship are dependent upon both members of the aged care dyad understanding the expectations of their role and if necessary reconstructing them. Part 1 of this two part conceptual paper develops the Communication Predicament of Ageing Model to include role expectations. The conceptions are grounded in important conclusions drawn from data contained in a large comprehensive study of older people and their family caregivers. Part 2 of the paper (to be published in the next issue of Quality in Ageing) introduces the health promoting communication model which was developed as a framework for guiding both prevention and intervention strategies to prevent or transform a role predicament of caring.

Caregiver—carereceiver communication Part 2: Overcoming the influence of stereotypical role expectations

Part 1 of this paper explored the premise that a role predicament of caring exists within family caregiving relationships. It was argued that dysfunctional patterns of communication develop in family caregiving relationships not only in response to stereotypical expectations about older people but also in response to stereotypical expectations of both caregiver and carereceiver concerning their role in the caregiving relationship. The argument was grounded in data contained within a large comprehensive study of older people and their family caregivers. This paper builds on the earlier contention and holds that more productive and effective forms of communication and caregiving relationships can be promoted through modification of role expectations and behaviours. The Health Promoting Communication Model is introduced and proposed as an appropriate framework for guiding both prevention and intervention strategies for health promoting communication in family caregiving.