Joan Cameron

Why students leave in the UK: an integrative review of the international research literature

AIMS AND OBJECTIVES The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. BACKGROUND Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community. DESIGN   Integrative review of the literature. METHOD Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. RESULTS Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. CONCLUSIONS Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. RELEVANCE TO CLINICAL PRACTICE The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society.

Woman centred maternity care and professional positioning : A response to Dornan

In his editorial on childbirth in the UK, Dornan (2008) expresses his opinions on the structure of the medical and midwifery professions and the organisation of childbirth in the UK. While I would not wish to deny him the right to express these opinions, I feel that it is essential that the factual inaccuracies and the assumptions based on these inaccuracies are challenged. There was no UK Midwives Act in 1902 as Dornan asserts (Dornan, 2008). The 1902 Act related only to midwifery practice in England and Wales. Midwifery legislation for Scotland followed in 1917 and in Ireland in 1918 (Donnison, 1988). The various Midwives Acts enacted throughout the UK almost certainly protected the role of the midwife and ensured that midwifery practice continued, unlike the situation in many parts of the world notably North America, where midwifery practice has almost disappeared. The Central Midwives Board did have members of the medical profession but it was not comprised solely of doctors as Dornan states. Dornan (2008) declares that Changing Childbirth reflected the policy of the UK Department of Health. This is incorrect. Although the National Health Service exists in each of the 4 countries in the UK, there is no UK wide National Health Service. Each country devises its own health policy. Thus ‘Changing Childbirth’ was a policy devised by the Department of Health (DoH) in England for the NHS in England (DoH, 1993). Wales, Scotland and Northern Ireland all had and still have their own maternity policy strategies and documents.

Holy Innocents – Grieving for the death of a baby

This book has been written for parents who have experienced the loss of a baby and the professionals who care for them. The text is written in a conversational style that makes it easy to read. It covers the development of the baby in utero, the loss of a baby, and the way in which different religions approach birth and death. The author draws on her own extensive clinical experience to llustrate her arguments and these make powerful reading. In particular, the accounts of parental responses to the loss of a baby are poignant. Many parents would recognize their own reactions to the loss of their baby in her descriptions. Reading and reflecting on her stories, health professionals might arrive at a better understanding of the impact of their behaviours on parents whose baby has died.