Mary P. Finlayson

Alcohol, violence, and a fast growing male population: exploring a risky-mix in "boomtown" Darwin

Boomtowns are places where populations grow rapidly, mostly as a result of large-scale natural resource developments. Increases in alcohol consumption and alcohol-fuelled violence are often linked to influxes of (predominantly male) workers associated with such developments. This article provides an integrated review of literature concerning alcohol and violence in boomtowns. The authors aim to understand the links between these issues and explore how negative impacts have been addressed. New learning from the review is considered in the context of Darwin, a newly booming city in Australias Northern Territory. The authors find that although alcohol-related violence is likely to increase, there is limited literature concerning the prevention or mitigation of negative impacts in boomtown contexts. The need for research, planning, and policy making involving all stakeholders is highlighted.

Insiders or outsiders? Mental health service users' journeys towards full citizenship

The present study explores the journeys towards full citizenship for those using mental health services as they lobbied to be included as full citizens with the same rights and responsibilities as others in society. Qualitative data were collected through semistructured interviews with 17 service users, five government representatives, and seven registered mental health nurses. A conceptual framework of citizenship containing four domains - the extent, content, depth and acts of citizenship - was used to analyse the data. This paper reports the findings from the service users data in the first domain, the extent of citizenship, defined as the rules and norms of inclusion and exclusion. The degree to which the service user participants were accepted as full citizens with the same civil, political, and social rights as others was contingent on their ability to adopt their societys rules and norms and appear as normal citizens. Participants often experienced being othered and excluded from the many rights and responsibilities of citizenship due to societys perception that service users lack certain attributes of normal, productive citizens. Participants reported that being labelled with a mental illness led to them being marginalized and ostracized, thus placing conditions and barriers on their citizenship status. Findings show that in response to experiencing conditional citizenship, participants shaped their behaviour to assimilate with other citizens. As well, they engaged in practices of inclusion to challenge and broaden the social rules and norms in order to be accepted without disavowing their differences.

Open for Business but at What Cost? Housing issues in ‘boomtown’ Darwin

ABSTRACT The Greater Darwin area has long experienced high housing costs and high rates of homelessness. Into this already stressed housing context have come large-scale, natural resource development projects, which are predicted to bring thousands of new workers to town, and exciting property investor interest. While many view these developments as positive, there is concern about the impacts upon the most vulnerable members of the population. This paper presents the findings of a qualitative research project exploring current housing issues in the Greater Darwin area. Interviews with housing support service providers and real estate agents reveal that the current population and investment growth have exacerbated longstanding housing issues. Increased housing stress in Darwin, and a myopic focus on rapid economic growth, may disenfranchise current residents and undermine service and support industries. We argue that while there may be some economic benefits from a ‘booming’ Darwin, greater planning and partnership between government, community organisations and corporates is required to ensure the benefits are spread across the population. Unfortunately, the Northern Territory governments dilatory approach to both housing issues and the social costs of the resources boom makes it highly unlikely innovative partnerships will occur.

The rights and responsibilities of citizenship for service users: some terms and conditions apply

ACCESSIBLE SUMMARYnWhat is known about the subject? Citizenship is an important yet largely overlooked concept within psychiatric and mental health nursing practice Many service users are subject to legally mandated restrictions that place conditions on their rights and responsibilities as citizens. What this paper adds to existing knowledge? Even though service users have legal status as citizens, they continue to experience many conditions on their rights and responsibilities. Concerns about services users trustworthiness and doubts about their levels of insight impact on their status as full citizens. What are the implications for practice? Nurses understandings of the conditions placed on the citizenship rights and responsibilities of service users will ensure inclusive and less restrictive care and treatment Integration of the principles of therapeutic reciprocity and procedural justice within practice will help nurses balance both the rights of services users and legal restrictions on their liberty and autonomynnnABSTRACTnnnnINTRODUCTIONnService users have long been lobbying for equal participation as citizens, yet citizenship is an important and largely overlooked concept within nursing education and practice.nnnAIMSnThe study explored service users understandings of their rights and responsibilities of citizenship and the conditions placed on these.nnnMETHODSnA total of 17 service users participated in semi-structured interviews. Isins theory of the content of citizenship was used to analyze the data using a framework approach.nnnRESULTSnService users experience conditional citizenship that includes barriers to their participation and their rights and responsibilities that others in society enjoy.nnnDISCUSSIONnWhen the world of the service user is constructed through the language of the biomedical model, nurses may unwittingly reinforce psychiatric labels and thus perpetuate the stereotype that service users lack the competence to fully enact their rights and responsibilities.nnnIMPLICATIONS FOR PRACTICEnWhen providing care, nurses should incorporate the notion of therapeutic jurisprudence and the principles of reciprocity, procedural justice and the implementation of advanced directives to reduce conditions on service users status as citizens.Accessible summary n nWhat is known about the subject? n nCitizenship is an important yet largely overlooked concept within psychiatric and mental health nursing practice nMany service users are subject to legally mandated restrictions that place conditions on their rights and responsibilities as citizens. n n n n nWhat this paper adds to existing knowledge? n nEven though service users have legal status as citizens, they continue to experience many conditions on their rights and responsibilities. nConcerns about services users trustworthiness and doubts about their levels of insight impact on their status as full citizens. n n n n nWhat are the implications for practice? n nNurses understandings of the conditions placed on the citizenship rights and responsibilities of service users will ensure inclusive and less restrictive care and treatment nIntegration of the principles of therapeutic reciprocity and procedural justice within practice will help nurses balance both the rights of services users and legal restrictions on their liberty and autonomy n n n n nAbstract nIntroduction n nService users have long been lobbying for equal participation as citizens, yet citizenship is an important and largely overlooked concept within nursing education and practice. n n n nAims n nThe study explored service users understandings of their rights and responsibilities of citizenship and the conditions placed on these. n n n nMethods n nA total of 17 service users participated in semi-structured interviews. Isins theory of the content of citizenship was used to analyze the data using a framework approach. n n n nResults n nService users experience conditional citizenship that includes barriers to their participation and their rights and responsibilities that others in society enjoy. n n n nDiscussion n nWhen the world of the service user is constructed through the language of the biomedical model, nurses may unwittingly reinforce psychiatric labels and thus perpetuate the stereotype that service users lack the competence to fully enact their rights and responsibilities. n n n nImplications for practice n nWhen providing care, nurses should incorporate the notion of therapeutic jurisprudence and the principles of reciprocity, procedural justice and the implementation of advanced directives to reduce conditions on service users status as citizens.

A Boom for Whom? Exploring the Impacts of a Rapid Increase in the Male Population Upon Women’s Services in Darwin, Northern Territory

A rapidly expanding natural-resource extraction industry and a growing military presence mean an increasingly male-skewed population for the city of Darwin, Australia. This has sparked concerns about the potential for increased violence against women. In this article, we present qualitative research detailing the views of 13 participants from 10 women’s support services in the Darwin area. We argue that women’s support services bear witness to and are tasked with responding to the impacts of population change on women, yet their work is undermined by uncertainties that stem from neoliberal funding rationales and limited demands on companies to address social issues.

Variation in the Adoption of Patient Safety Practices among New Zealand District Health Boards

OBJECTIVEnTo investigate the adoption and impact of quality improvement measures in New Zealand hospitals.nnnMETHODnStructured interviews with quality and safety managers of District Health Boards (DHBs). Correlation of use of measures with adjusted 30-day mortality data.nnnRESULTSnEighteen of New Zealands 21 DHBs participated in the survey. Structural or policy measures to improve patient safety, such as credentialing and event reporting procedures, had been introduced into all DHBs, whereas changes to general clinical processes such as medicine reconciliation, falls prevention interventions and disease-specific management guidelines were less consistently used. There was no meaningful correlation between risk-adjusted mortality rates for three common medical conditions and related quality measures.nnnCONCLUSIONnWidespread variation exists among New Zealand DHBs in their adoption of quality and safety practices, especially in relation to clinical processes of care.

Identifying the nontechnical skills required of nurses in general surgical wards

AIMS AND OBJECTIVESnTo identify the nontechnical skills (NTS) required of nurses in general surgical wards for safe and effective care.nnnBACKGROUNDnAs the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms; however, these skills have not been identified for nurses in general surgical wards.nnnDESIGNnA nonparticipant observational descriptive design was used.nnnMETHODnA purposive sample of 15 registered nurses was recruited from four surgical wards and observed for a full shift on a morning, afternoon or night shift. Nonparticipant observations were conducted using field notes to collect data. A coding frame was developed, and an inductive process was used to analyse the data.nnnRESULTSnA taxonomy comprising seven NTS required of nurses in their roles in surgical ward teams emerged from the data analysis. They are communication, leadership and management, planning, decision-making, situation awareness, teamwork and patient advocacy.nnnCONCLUSIONnPatient care provided by general surgical nurses involved the seven identified key NTS. These particular NTS are an important component of safe nursing practice as they underpin the provision of safe and effective care for general surgical patients. Nurses block the trajectory of error by using NTS to address the vulnerabilities in the system that can lead to adverse patient events.nnnRELEVANCE TO CLINICAL PRACTICEnIdentifying general surgical nurses NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety.

'They're Not Really Doing "Normal" Psychiatry': The Socio-Legal Shaping of Psychiatric Expertise in Insanity Trials

The use of psychiatric expertise in criminal trials has generally been construed as problematic despite the fact that there remains little in-depth research in this area. Qualitative research on other forensic experts has indicated the existing literature on psychiatric expert testimony may be simplifying the dynamics that occur in practice between psychiatry and law. This article draws on data generated from 31 qualitative interviews and medico-legal documentation to explore the socio-legal shaping of forensic psychiatrists expertise during insanity trials in New Zealand. It describes how the hybrid features of the insanity defence shape forensic psychiatrists practices in this context to the point that their performances as expert witnesses cannot be adequately described as doing ‘normal psychiatry’. Rather, adding to the existing body of social studies of forensic expertise, the article exemplifies how the forensic psychiatrists practices are inextricably linked to the legal context in which they are operating. It concludes by demonstrating that the ‘art’ of forensic psychiatry involves managing the hybrid nature of the expertise they provide in cases of insanity.