Owen Doody

An exploratory study of role transition from student to registered nurse (general, mental health and intellectual disability) in Ireland

Ireland has seen much change in nurse education resulting in four year degree programmes since 2002. A unique aspect of these programmes was the incorporation of rostered internship. This study explored role transition for a cohort of students at pre and post-registration. The sample consisted of fourth year students registered on BSc nursing programmes (general, mental health and intellectual disability) within an Irish university. The samples were surveyed to compare their perceptions and expectations of role transition pre and post-registration. Data were analysed using SPSS (version 16). Respondents had high levels of confidence in clinical abilities both at pre-registration and post-registration. They also perceived themselves to be competent across a range of domains: managing workload, prioritising care delivery, interpersonal skills, time management and multidisciplinary team working. However, this research highlights pre-registration stress, the need for ongoing feedback and support and differences between expected and actual levels of direct patient care involvement. It is argued that the rostered internship provided students with a valuable opportunity for adjustment and preparation for their role as registered nurse. Recommendations include stress management, a supportive environment and post-registration preceptorship programmes to enhance professional development and gain confidence during the internship.

Increasing student involvement and learning through using debate as an assessment

Assessment has long been recognised as the single most influential factor in shaping what and how students in higher education choose to learn and the quality of learning outcomes depends on the quality of assessment. Within intellectual disability nursing the student are prepared within a biopsychosocial educational model and curriculum address these challenges. Structured student debates have great potential for promoting competence and in-depth knowledge of substantive topics relevant to practice. Like other interactive assignments designed to more closely resemble real-world activities, issue-oriented debates actively engage students in course content. Allowing students to develop and exercise skills that translate to practice activities. Most importantly debates help to stimulate critical thinking by shaking students free from established opinions and helping them to appreciate the complexities involved in practice. This article identifies the use of a debate as an assessment method within an intellectual disability nursing programme and a students reflective comment on the process, and their experience of a debate as their assessment method.

Exploring fathers’ perceptions of parenting a child with Asperger syndrome

This study explores Irish fathers’ perceptions of parenting a child with Asperger syndrome (AS). Ethical approval was granted by the service provider, and Husserlian phenomenological approach facilitated the exploration. Data were collected through semi-structured interviews of nine fathers in the West region of Ireland. Data were transcribed and analysed using Colaizzi’s (1978) method. The study highlighted that parenting a child with AS is an arduous task, but while there are difficulties, many positive aspects to their parenting experience were reported. Overall, the study highlights the importance of listening to parents and their initial concerns regarding their child’s development.

Intellectual disability nursing in Ireland: identifying its development and future.

As a profession, intellectual disability nursing has often come under scrutiny and been called into question. Since its inception as an individual nursing profession in 1959 in Ireland, both education and service provision philosophies have changed over time. These changes have been in response to national and international reports and changing attitudes. The changes have led to the current position where intellectual disability nurse education in Ireland is a four-year undergraduate course. As the discipline of intellectual disability nursing is unique to Ireland and the United Kingdom, there is a responsibility on intellectual disability nurses to identify their unique identity and their responses to the demands of changing services. This article traces the development of intellectual disability nursing in Ireland and identifies implications for the future.

Raising a child with disability and dealing with life events: a mother's journey.

Intellectual disability services recognise people with intellectual disability as a family member and aim to provide effective support that facilitates family cohesion. However, the needs of families and individuals within the family should be addressed in a holistic manner to ensure a seamless service. This article outlines a mother’s reflections on her experience of raising a child with autism spectrum disorder and its impact on her life. The article focuses on one mother’s feelings, coping or lack of coping and growth during a time of sadness. This article written by a mother, nurse and academic through their shared interest in supporting families of children with a disability all came together to tell this story. It is hoped that this article will assist professionals understand a mother’s perspective when raising a child with intellectual disability and support professionals to recognise the importance of listening, coordinated support and working in partnership.

Using a simulated environment to support students learning clinical skills.

Within intellectual disability nursing students are prepared within a biopsychosocialeducational model and curriculum address these challenges. Using a simulated learning environment has great potential for promoting competence and in-depth knowledge of substantive topics relevant to practice. This article presents an assignment designed to more closely resemble real-world activities to allow students develop and exercise skills that translate to practice activities and incorporates a students reflective comments on the process. The assignment was designed to foster intellectual disability student nurses ability to facilitate family/client education. The aim of the assignment was fulfilled through the students designing a clinical skill teaching session that could be used with families/clients. The sessions were recorded and the student reviewed their recording to reflect on their performance and to self assess. To facilitate student learning the modules academic lecturer also reviewed the recording and both lecturer and student meet to discuss the reflection and self assessment.

The development of clinical nurse specialists (CNSs) in intellectual disability nursing in Ireland

Since the commencement of intellectual disability nurse training in 1959, both education and service provision philosophies have changed over time in Ireland. These changes have occurred in response to national and international reports and attitudes. Coinciding with the changes in education and philosophy have been the development and advancement of the intellectual disability nursing profession. Currently undergraduate intellectual disability nurse education is unique to Ireland and the United Kingdom and, similar to the developments across other disciplines of nursing, advance practice has become a focus of development. This article traces the development of intellectual disability clinical nurse specialists (CNSs) in Ireland and identifies possible challenges and implications for future practice.

Pain and pain assessment in people with intellectual disability: Issues and challenges in practice

Accessible summary Pain is difficult to identify when people cannot communicate. If pain is not identified, it cannot be managed and causes stress. Pain assessment is essential in order to identify pain. Pain assessment requires a combination of knowledge, health assessments and observations. AbstractBackground Individuals with intellectual disability experience the same chronic diseases and conditions as the general population, but are more likely to have physical and psychological co-morbidities, resulting in a higher risk of experiencing pain and having more frequent or severe pain. Method This position paper aims to highlight the importance of pain assessment for people with intellectual disability. Results As people with intellectual disability live within the community and/or remain in the family home, they are accessing a wide range of healthcare services. This necessitates that nurses across all care settings are knowledgeable regarding appropriate/alternative pain assessment methods for people with intellectual disability. While many pain assessment tools are available for use with the intellectual disability population, they are often not well established or infrequently used to establish their validity. Conclusion Although self-report is the gold standard in pain assessment, pain assessment for people with intellectual disability is often challenging as they may be unable to self-report their pain due to their levels of communication or cognitive ability. Assessment requires a combination of approaches amalgamating: pain assessment, health assessment and observation of behaviours.

Families’ experiences of involvement in care planning in mental health services: an integrative literature review

Accessible summary What is known on the subject?Current policy advocates for the participation of family carers in care planning.Caring for a person with a mental illness requires a significant commitment from families to support their relatives recovery. &NA; What this paper adds to existing knowledge?The evidence of family involvement in care planning is generally fraught with conflicting experiences related to different requirements between mental health professionals, families and service users.Confidentiality remains contentious at a practice level in terms of information sharing and decision‐making.There is a requirement and need for a shared understanding around care planning between families and mental health professionals. &NA; What are the implications for practice?The provision of written information pertaining to families regarding confidentiality is required at service level.Educational workshops concerning care planning and treatment options should be provided for service users, families and mental health professionals.Further research into effective service‐wide strategies that explore with families how their engagement can be positively fostered in mental health services is warranted. Introduction: Mental health service policy stipulates that family carers be involved in care planning. Aim: To identify families’ experiences of care planning involvement in adult mental health services. Method: An integrative review where electronic databases and grey literature were searched for papers published between 01 January 2005 and 10 February 2016. Results: Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1) families’ experience of collaboration, (2) families’ perceptions of professionals and (3) families’ impressions of the care planning process. Collaborative decision‐making is not regularly experienced by families with an ‘us’ and ‘them’ divide, perpetuated by a lack of communication, confidentiality constraints and a claim of ‘insider knowledge’ of service users. When involved, families perceive care planning to be uncoordinated and that their lived experiences are not always appreciated. Discussion: Families need to be valued, empowered and engaged in care planning and the partnership distance be addressed. Accommodating the views of family, service user and professionals is preferable but not always possible. Our findings suggest that the key element for professionals is to value all ‘insider knowledge’ where possible. Implications for Practice: Services should develop written information on confidentiality for families and facilitate open communication concerning their involvement in care planning.

Professional carers’ experiences of caring for individuals with intellectual disability and dementia: A review of the literature

The number of people with intellectual disability living into old age and developing dementia continues to increase. Dementia presents a wide range of challenges for staff due to progressive deterioration. This article presents the findings from a narrative literature review of professional caregivers’ experiences of caring for individuals with intellectual disability and dementia. Seven electronic databases were searched using Boolean operators and truncation to identify relevant literature. Search results were combined and narrowed to articles relevant to staff working with individuals with intellectual disability and dementia, and 14 articles met the criteria for review. Themes outlined in the review include staff knowledge of dementia, staff training in dementia, caregiving, challenging behaviour, pain management, mealtime support and coping strategies. Overall carers must review and adjust their care delivery and support to people with intellectual disability and dementia, not only in terms of identifying and responding to their health needs but also through collaborative team working within and across services.