Kathleen Duffy

Developing nursing students' decision making skills: Are early warning scoring systems helpful?

This paper is presented to contribute to the emerging debate on Early Warning Scoring Systems. The Early Warning Scoring System was introduced, and has been implemented internationally, to aid in the identification of the patient whose condition is deteriorating. Early identification of patient deterioration is of vital importance for patient safety. Therefore how we teach this skill to students and how they become competent and confident in its utilisation, interpretation and subsequent clinical decision-making is crucial. The paper initially explores the competence of student nurses in this area. The discussion then focuses on three models of clinical decision making to illustrate why the introduction of Early Warning Scoring Systems has hindered student nurses in the development of the decision-making skills required to identify and manage the patient whose condition is deteriorating.

Newly qualified staff's perceptions of senior charge nurse roles.

Nursing roles have been recognised as pivotal to the delivery of good quality, patient-centred care. At the centre of this debate are the leadership roles of the senior charge nurse (SCN), which in recent years have come under great scrutiny. However, research suggests that these roles have become decreasingly popular as a career pathway. The aim of this study was to develop a clearer understanding of leadership as experienced by newly qualified staff nurses in the acute hospital setting by exploring their perceptions and beliefs of SCN roles. The study supports the view that SCNs remain central to setting standards of care, but suggests that the SCN leadership role appears unattractive to newly qualified staff, who cite responsibility, lack of trust and negative feedback as the most offputting factors.

Are theoretical perspectives useful to explain nurses' tolerance of suboptimal care?

AIM This paper explores two theoretical perspectives that may help nurse managers understand why staff tolerate suboptimal standards of care. BACKGROUND Standards of care have been questioned in relation to adverse events and errors for some years in health care across the western world. More recently, the focus has shifted to inadequate nursing standards with regard to care and compassion, and a culture of tolerance by staff to these inadequate standards. EVALUATION The theories of conformity and cognitive dissonance are analysed to investigate their potential for helping nurse managers to understand why staff tolerate suboptimal standards of care. KEY ISSUES The literature suggests that nurses appear to adopt behaviours consistent with the theory of conformity and that they may accept suboptimal care to reduce their cognitive dissonance. CONCLUSION Nurses may conform to be accepted by the team. This may be confounded by nurses rationalising their care to reduce the cognitive dissonance they feel. IMPLICATIONS FOR NURSING MANAGEMENT The investigation into the Mid Staffordshire National Health Service called for a change in culture towards transparency, candidness and openness. Providing insights as to why some nursing staff tolerate suboptimal care may provide a springboard to allow nurse managers to consider the complexities surrounding this required transformation.

Person-centred reflective practice.

Person-centred health and person-centred care have gained prominence across the UK following the publication of reports on public inquiries exploring failings in care. Self-awareness and participation in reflective practice are recognised as vital to supporting the person-centred agenda. This article presents an education framework for reflective practice, developed and used in one NHS board in Scotland, and based on the tenets of the clinical pastoral education movement. Providing an insight into the usefulness of a spiritual component in the reflective process, the framework provides an opportunity for nurses and other healthcare professionals to examine the spiritual dimensions of patient encounters, their own values and beliefs, and the effect these may have on their practice.

Supervision and assessment: the new Nursing and Midwifery Council standards

In the UK, mentors of pre-registration nurses must achieve the stage 2 outcomes of the Nursing and Midwifery Council (NMC) ( 2008 ) standards to support learning and assessment in practice. Approval for new standards for student supervision and assessment was granted at the NMC meeting in March 2018 ( NMC 2018a ). The introduction of the new standards will see the dissolution of mentorship and the emergence of new roles to support students in academic and practice environments. This article gives an overview of these standards and, drawing on the recommendations from a collaborative event hosted by NHS Education for Scotland and some of the findings from a rapid literature review undertaken for that event, provides nurse managers with information to help inform their discussions as they work in partnership with approved education institution colleagues to realise, support and sustain the roles outlined in the new standards. The article concludes with some questions to consider during these collaborative discussions.

Mentorship practice and revalidation.

Nurses and midwives who are registered with the Nursing and Midwifery Council (NMC) are required to renew their registration with the NMC. In April 2016, the NMC introduced revalidation, which replaces the requirements for renewal of registration set out in the post-registration education and practice standards. Every registrant should be aware of the revalidation process and requirements. Revalidation is linked to the professional standards for nurses and midwives set out by the NMC and known as The Code. Mentorship is an essential component of The Code; therefore, mentorship practice will assist registrants in meeting some or all of their revalidation requirements. As registered nurses, mentors will be required to reflect on their practice and update their preparation for mentorship. This article provides guidance on how mentorship preparation and practice can contribute to meeting revalidation requirements.

Making Sense of Research in Nursing, Health & Social Care Moule Pam Making Sense of Research in Nursing, Health & Social Care 200pp £21.99 Sage 9781473907539 1473907535

IF YOU found the previous versions of this text useful then this, the fifth edition, will not disappoint. Like the earlier editions it covers key topics in the research process, but also includes more up-to-date reference material, resources and practice examples.