Michelle Howarth

The role of the lecturer practitioner: An exploration of the stakeholders and practitioners perspective

Joint appointment roles are pivotal in forging links between service and education and whilst current government and professional strategies recognise the contribution of such roles [DOH, 2001. Working Together - Learning Together: A Framework for Lifelong Learning for the NHS, Department of Health, London], there is still concern about the ambiguity of these roles, specifically the role of the lecturer practitioner [Fairbrother, P., Ford, S. 1998. Lecturer practitioners: a literature review. Journal of Advanced Nursing 27, 274-279]. This paper provides insight in to the experience of being a lecturer practitioner from the perspectives of two lecturer practitioners and from the perspectives of stakeholders from education and practice who had a vested interest in the employment of this role within their organisation. Each lecturer practitioner kept a diary and met on a monthly basis for one hour over a six month period to critically reflect on the experience of being a lecturer practitioner. The significant areas identified in the diaries were then used to develop the schedule for a series of semi-structured interviews with seven stakeholders drawn from clinical practice and higher education environments. The data collected were analysed using [Bernard, P., 1991. A method of analysing interview transcripts in qualitative research. Nurse Education Today 11, 461-466] framework. In total, five themes emerged. Whilst findings highlighted great job satisfaction, they also illustrated the lack of collaboration between organisations especially in terms of the initial development of the role. It is suggested that the initial lack of clarity is a contributory factor causing continuing role ambiguity. A series of recommendations based on the findings have been discussed, some of which are currently being implemented.

“Let's stick together” – A grounded theory exploration of interprofessional working used to provide person centered chronic back pain services

Chronic back pain is a global phenomenon and a common reason why patients seek help from health professionals. Person-centered interprofessional working is acknowledged as the main strategy for chronic back pain management; however, the complexity of chronic pain can present significant challenges for teams. Although methods used by interprofessional teams to collaborate have been previously explored, how they work together to deliver person-centered chronic back pain care has received limited attention. The aim of this study was to explore person-centered care from the perspectives of people with chronic back pain and the interprofessional teams who cared for them. A grounded theory methodology was used to capture the interprofessional teams perspectives of person-centered working. A purposive sample of four chronic back pain management teams participated in semi-structured face-to-face interviews and focus groups. Data were thematically analyzed using a constant comparative method. Three categories emerged, collective efficacy, negotiated space and team maturity, which illustrated the attributes of interprofessional teams that influenced person-centered working. The findings suggest that collective efficacy matures over time within a negotiated coalesced space and re-enforces the need for teams to stick together to ensure effective person-centered care.

Being an effective nurse consultant in the English National Health Service: what does it take? A study of consultants specializing in safeguarding

AIMS This study established key attributes and perceived strengths, weaknesses, opportunities and threats (SWOT) of nurse consultants specializing in safeguarding children. BACKGROUND The nurse consultant role in England spans four domains--clinical, leadership, education and research--and was intended to enable senior nurses to remain in clinical practice. METHOD ata identifying the time spent by the nurse consultants in the four domains was collated and a thematic content analysis of the SWOT of the role was ascertained from semi-structured interviews with nurse consultants (n = 4) and stakeholders (n = 6). RESULTS Strengths and opportunities in clinical (consultancy), leadership and educational functions were identified but some weaknesses and threats in terms of nurse consultants contributions to research were also identified. The role was neither wholly strategic nor clinical. Role ambiguity meant that they were not always valued by managers, making the role potentially expendable. CONCLUSIONS Nurse consultants are pivotal within health-care organizations because they span clinical practice and leadership enabling them to support managers in strategic planning, commissioning and implementation of policy. IMPLICATIONS FOR NURSING MANAGEMENT Nurse consultants can support strategic practice development and influence quality and effectiveness service-wide. To succeed they must be understood, supported and nurtured by managers.

The influence of therapeutic horticulture on social integration

Purpose The purpose of this paper is to qualitatively evaluate the impact of therapeutic horticulture (TH) on social integration for people who have mental health problems. Design/methodology/approach A qualitative grounded theory approach captured the perceptions about TH from people with mental health problems. Data were collected using semi-structured focus group and interviews from a purposive sample (n=7) and were analysed using a constant comparative approach. Findings Four key themes emerged from the analysis: “a space to grow”, “seeing the person”, “learning about each other through nature” and “connecting to nature and others”. The findings suggest that TH enabled participants to integrate socially, engage with nature and develop confidence. Research limitations/implications TH is a potential approach that can help combat social isolation. The findings from this research have implications for people working towards supporting people who are socially excluded. However, this was a pilot study with a small sample size of seven people with mental health problems, whilst four key themes emerged, the saturation of concepts rather than the sample size were saturated to provide an emic perspective of the phenomena. Practical implications TH provides a person centred approach that enables people with mental health problems to re-engage and connect with their fellow human beings. Using TH could help improve the public health and well-being of local communities through re-connecting people to the environment and reduce social isolation. Social implications TH embody the principles of empowerment, person centeredness and can support people with mental health problems to integrate socially. Originality/value There is limited evidence about the influence that TH have on mental health and social integration. The use of TH is an area that is gathering evidence and this small study highlights the perceived potential benefits of this approach.

Reporting of ethical considerations in clinical trials in Chinese nursing journals

Background: It is acknowledged that publishers now require all primary research papers to demonstrate that they have obtained ethical approval for their research. Objectives: To assess the rate of reporting of ethical approval in clinical trials in core nursing journals in mainland China. Research design: A retrospective observational study. Participants: All clinical trials published in all of the 12 core nursing periodicals from 2016 edition China Science and Technology Journal Citation Report (core version) between 2013 and 2016 were retrieved by hand to explicate rate of reporting ethical approval and informed consent. Ethical considerations: The study did not require approval from the research ethics committee as it did not involve human subjects or records. Results: In total, 40,278 papers were published in 12 nursing periodicals between 2013 and 2016. Out of these, 9488 (23.6%) focused on clinical trials. Informed consent obtained from patients or the legally authorized representative was reported in 51.8% of clinical trials. Notably, only 27.4% of clinical trials reported that they had obtained written consent. Furthermore, 25.9% of clinical trials described ethical approval; however, the rate of reporting informed consent and ethical approval in these 12 nursing journals in China during 4 years from 2013 to 2016 improved markedly, with 38.1%, 44.0%, 59.0% and 66.6%, respectively (p < 0.001), and 17.6%, 21.9%, 28.6% and 35.8%, respectively (p < 0.001). In addition, both reporting informed consent and reporting written informed consent had a positive significant correlation with the reporting ethical approval (p < 0.05 or < 0.01). Conclusion: Chinese scientific nursing journals have improved the rate of reporting informed consent and ethical approval in clinical trials during the last 4 years. However, it should be noted that nearly half of clinical trials still did not report either ethical approval or whether informed consent was obtained. Efforts from editors, researchers, sponsors and authors are needed to ensure the transparency of ethical scrutiny and adherence to ethical guidelines in publishing clinical trials in Chinese nursing journals.