Jane Hunt

A specialist nurse: an identified professional role or a personal agenda?

A specialist nurse: an identified professional role or a personal agenda? Specialist nurses have existed for many years. Initially denoting a nurse with extensive clinical experience, implicit within nursing’s professional agenda for attaining ‘specialist’ status since the 1960s has been the requirement to achieve a high degree of ‘specialist’ knowledge through post-basic education. Despite the professional agenda, much confusion surrounding definitions of specialist nurses prevails. In recent years this confusion has been compounded in the United Kingdom by the introduction of advanced nurse practitioners alongside existing clinical nurse specialists. This paper suggests that health care professionals’ perceptions of a ‘specialist’ are subjective, grounded in their own experiences. Drawing on a study which examined relationships between paediatric oncology outreach nurse specialists and other health care professionals, two types of personal agenda from which perceived ‘specialist’ status evolves are described: (1) ‘needs-driven agendas’, and (2) ‘peer-driven agendas’. When ‘specialist’ status is accorded to paediatric oncology outreach nurse specialists, ‘specialist’ knowledge is derived from: formal qualifications, hands-on technical skills, previous ‘specialist’ work experience, in-depth medical knowledge and/or insight into families’ dynamics. The relative contribution each of these makes towards constructing a ‘specialist’ depends on the experiences of individual health care professionals and the varying work locations and professional backgrounds of paediatric oncology outreach nurse specialists.

Draw, Write and Tell: A Literature Review and Methodological Development on the "Draw and Write" Research Method.

The creative research method ‘draw and write’ has been used in health, social care and education research for several decades. A literature search of studies utilising this method was conducted during the planning stages of a study exploring primary school children’s perceptions of infant feeding. A review of this literature noted a range of benefits of ‘draw and write’ in enabling child participation. However, it also identified that the method has been used inconsistently and found that there are issues for researchers in relation to interpretation of creative work and analysis of data. As a result of this, an improvement on this method, entitled ‘draw, write and tell’, was developed in an attempt to provide a more child-orientated and consistent approach to data collection, interpretation and analysis. This article identifies the issues relating to ‘draw and write’ and describes the development and application of ‘draw, write and tell’ as a case study, noting its limitations and benefits.

Empowering health care professionals: a relationship between primary health care teams and paediatric oncology outreach nurse specialists

The concept of ‘empowerment’ has become an ‘in-phrase’ of the 1990s, underpinning both government and nursing ideology. However,‘empowerment’ lacks clear definition and has hitherto been attributed to relationships between health care professionals and their client/patient groups.This paper suggests that empowerment amongst health care professionals arises when patients with rare disorders have specialist needs, which some groups of health care professionals lack the specialist knowledge to provide. Drawing on data from a large, two-stage study in which both quantitative and qualitative data were collected to examine the work of paediatric oncology outreach nurse specialists (POONSs) and the relationships they develop with other health care professionals, this paper discusses how POONSs empower primary health care teams to care for children with malignant disease. Empirical data were collected in 1993 from 43 POONSs throughout the UK and the Republic of Ireland by semi-structured interview, either by telephone or in person. In addition, between October 1994 and April 1995,65 focused individual and group interviews were conducted with a range of other health care professionals from three locations including 45 health visitors, district nurses and general practitioners.

An assessment of lead R&D nursing roles in acute trusts and an evaluation of their status within the NHS research agenda

For over a decade, the need to develop a robust evidence base for nursing, midwifery and health visiting through research has been part of the UK governments R&D strategy. Progress has been slow and little is known about the organisational reality of the most recent strategies. This study aimed to investigate the nature of posts with named responsibilities to lead and develop nursing and midwifery research activity, based in acute NHS hospital trusts. Data were obtained through telephone interviews with directors of nursing services, and a postal survey of relevant staff. Fifty two people responsible for nursing and midwifery R&D were invited to complete the questionnaire, of whom 34 responded. The majority of trusts were able to name an individual responsible for leading nursing R&D, although the remit of the role varied considerably. The effectiveness of implementing any national research strategy is likely to be constrained by the lack of consistency regarding nursing research roles, a factor that may also be implicated in the lack of progress in securing a meaningful contribution to NHS research from nursing R&D.

Factors that affect adolescents' adherence to diabetes treatment.

There is strong evidence suggesting young people with type 1 diabetes experience difficulties adhering to their treatment regimens. The purpose of this literature review is to identify reasons for a lack of compliance in adolescents to allow nurses to develop knowledge to help improve treatment adherence. A literature search was undertaken by searching databases using key terms and inclusion criteria identified. The three themes are: parental influence, peer influence and depression. Findings indicate parental influence may be the main contributing factor towards non-compliance; however, associations between themes imply non-compliance is a result of a combination of factors. Limitations have been highlighted from the articles reviewed and provide opportunity for future research.

A nursing student’s reflective account of decision-making in a school nursing setting

Reflection is integral to professional revalidation and enhancing nursing practice; it is an art and a science to be learned. Learning the art of reflection begins as a student in clinical placement settings. Drawing on a reflective model, this article presents an account of one second-year childrens nursing students experiences in a community-based placement with a school nursing team. A school nurse appointment was reflected on where advice was offered to a 13-year-old student with sleep difficulties, low affect and lethargy, which included avoiding caffeinated drinks, reducing use of a laptop and mobile phone before going to sleep, and establishing a regular bedtime routine. Providing nursing care to this young person enabled the nursing student to improve their decision-making skills, become more self-aware, increase their confidence when communicating with a patient and reinforce the importance of applying theory to practice.

Acute burns management: placement reflections of a children’s nursing student

Reflection can help nurses make sense of their clinical surroundings and understand risks, challenges and opportunities. Learning the art required for reflective practice begins as a student when critical reflection is particularly important during practice placements. A suitable reflective framework is provided by Rolfe et al ( 2011 ). Adopting this framework, this article draws on the placement experiences of a second-year undergraduate childrens nursing student in an acute setting, caring for a toddler with 13% partial and full-thickness burns. The decisions made about assessing and monitoring homeostasis, overall fluid and pain management, infection prevention and potential safeguarding concerns are explored. Reflecting on clinical experience provides students with invaluable transferable skills.

Practical Research with Children Prior Jess Van Herwegen Jo and Practical Research with Children 309pp £31.99 Routledge 9781138937895 1138937894

This book, edited by two UK-based psychologists but with contributions by education and psychology experts, has three distinct methodological sections: qualitative, quantitative and mixed methods research approaches.

Employers need to join the 21st century.

I WILL never forget a young patient I looked after when I began my job as a staff nurse on the children’s intensive care unit (CICU). The child suffered a spontaneous bleed on the brain and was left with extensive neurological defects. The extent of the damage was uncertain at that point but the prognosis was that the child’s future would be bleak. When I heard about this story, my immediate thoughts were about the child’s parents and the devastation the situation had brought on their family. It must have been shocking for them because the child had been healthy but was so ill now. Their whole lives changed in an instant and they had no control over this. I remember feeling unsure about what to say to the family and how to interact with them. I wondered how I or anyone could possibly help to ease the pain and sorrow they now felt. This child’s case had a significant effect on me because it made me doubt my decision to work as a nurse in CICU. I even rang my mother and told her that I was going to leave my job and return to Ireland. I realised how emotionally challenging it was going to be for me to nurse children with complex medical conditions in such a highly pressured clinical environment. That day I doubted my abilities to cope and carry out the necessary nursing duties to the best of my ability. This was because I have never taken care of patients in the most critical phase of their illness before. Thankfully, I am still in a supernumerary period and I do not yet have the responsibility of caring for patients at an independent level. This has given me time to reflect on my experiences, learn from them and transform any negative thoughts or feelings about my new job into positive ones. I know I will have experiences in future that will make me doubt my abilities as a nurse. That is only natural. However, I am grateful for the opportunity to be starting out my career in the CICU. I intend to make sure that it will be a positive and fulfilling experience at all times.

Anatomy of Research for Nurses Hedges Christine and Williams Barbara Anatomy of Research for Nurses £28.09 Sigma Theta Tau International 9781938835117 1938835115

AMONG THE increasing number of research methodology and methods texts for nurses, the title and cover of this book stand out and draw in attention. And, while its content is similar to that of other research handbooks, on closer inspection, it offers fresh perspectives.