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Michael Traynor
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Research concludes that professional socialisation in nursing is deeply problematic because new recruits start out identifying with the profession's ideals but lose this idealism as they enter and continue to work in the profession.... more
Research concludes that professional socialisation in nursing is deeply problematic because new recruits start out identifying with the profession's ideals but lose this idealism as they enter and continue to work in the profession. This study set out to examine the topic focussing on the development of professional identity. Six focus groups were held with a total of 49 2nd and 3rd year BSc nursing students studying at a university in London, UK and their transcripts were subject to discourse analysis. Participants' talk was strongly dualistic and inflected with anxiety. Participants identified with caring as an innate characteristic. They described some qualified nurses as either not possessing this characteristic or as having lost it. They explained strategies for not becoming corrupted in professional practice. Their talk enacted distancing from 'bad' qualified nurses and solidarity with other students. Their talk also featured cynicism. Neophyte nurses' talk...
Why do nurses in training continue to draw on the ideal of compassion when responding to their experiences of nursing work in the UK National Health Service (NHS), despite the difficulties that they face in developing compassionate,... more
Why do nurses in training continue to draw on the ideal of compassion when responding to their experiences of nursing work in the UK National Health Service (NHS), despite the difficulties that they face in developing compassionate, long-term relationships with patients in practice? To answer this question, we draw from a psychosocial analysis of focus group data from 49 trainee nurses in the NHS. First, we show how this ideal leads them to blame qualified nurses for failures in patient care. We suggest this is an unconscious defence against the anxiety evoked both by the vulnerability of their position as those who need to gain access to the profession, and of being unable to conduct compassionate nursing work. Second, we emphasize that less powerful occupational groups, such as trainee nurses, may adopt defences that underpin dominant organizational policy, such as idealization, despite further disadvantaging their group and benefitting those in power. We conclude by questioning t...
This discussion paper considers recent nursing failures. Drawing on a selection of key literature and ongoing research, it argues that nursing failures are a possibly inevitable consequence of work in healthcare systems with their... more
This discussion paper considers recent nursing failures. Drawing on a selection of key literature and ongoing research, it argues that nursing failures are a possibly inevitable consequence of work in healthcare systems with their combination of cognitive, bureaucratic, professional and work-related pressures. It also argues that nursing has a residual tendency to be viewed as primarily character-based moral work and that this can encourage understandings of causes of failures and their solutions in similar terms, i.e. as moral failures of caring requiring recruitment of those with the appropriate characters. Drawing on ongoing research with those training for the profession at an English university, it suggests that while the profession focuses on the recruitment of those with a ‘caring’ orientation it has not developed an adequate explanation to support new recruits in understanding the causes of inadequate practice. This leaves those entering the profession without a strong model...
First, a suggested definition of discourse: at its most general, discourse can be understood as any system of signs, whether spoken, written, or otherwise. I say 'otherwise',... more
First, a suggested definition of discourse: at its most general, discourse can be understood as any system of signs, whether spoken, written, or otherwise. I say 'otherwise', because it is possible to 'read' town planning or architecture, for example, as systems that reflect and enact political values and practices. Some use the term a little more specifically; so, for example a phrase such as 'medical discourse' implies an organised and more or less self-conscious system of concepts and language practice which reflects and is supported by an institutional base. Some while ago, Ian Parker set out certain characteristics of discourse and, importantly, questioned any notion of a simple distinction between discourse and 'reality' - something that can be comprehended outside of discourse.
In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th... more
In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usual...
This article examines reliability and validity as ways to demonstrate the rigour and trustworthiness of quantitative and qualitative research. The authors discuss the basic principles of reliability and validity for readers who are new to... more
This article examines reliability and validity as ways to demonstrate the rigour and trustworthiness of quantitative and qualitative research. The authors discuss the basic principles of reliability and validity for readers who are new to research.
... Vari Drennan Claire Goodman Charlotte Humphrey Rachel Locke ... E-mail: v.drennan@pcps.ucl. ac.uk Professor Claire Goodman, BSc, MSc, PhD, RN, DN Professor of Health Care Research, Centre for Research in Primary and Community Care,... more
... Vari Drennan Claire Goodman Charlotte Humphrey Rachel Locke ... E-mail: v.drennan@pcps.ucl. ac.uk Professor Claire Goodman, BSc, MSc, PhD, RN, DN Professor of Health Care Research, Centre for Research in Primary and Community Care, University of Hertfordshire ...
This paper uses the findings of a recent bibliometric analysis of published UK nursing research to ask whether the field is characterized by a fundamental split between two underlying areas of research interest. These can be termed... more
This paper uses the findings of a recent bibliometric analysis of published UK nursing research to ask whether the field is characterized by a fundamental split between two underlying areas of research interest. These can be termed 'endogenous' and 'exogenous'. The former term describes research which tends to be concerned with problems and issues to do with nursing as a profession; the latter is concerned with problems and issues centring around the nursing of patients. Papers in the Wellcome Trust's Research Outputs Database (ROD), a database of UK biomedical research, were analysed. Nursing papers published between 1988 and 1995 numbered 1,845, just less than 1% of the total papers in the ROD. Analysis of the subfield identified that nursing research was atypical of biomedical research as a whole in a number of ways. One difference was that usually in biomedical research there is a general correlation between numbers of funders acknowledged on a paper, numbers of authors, and esteem of the journal in which a paper appears. In nursing there was, if anything, a tendency for highly esteemed papers to have fewer authors and be less likely to have acknowledged funding. However, the apparently endogenous and exogenous papers have quite different characteristics. This paper explores this apparent difference and possible reasons for this difference and will briefly compare nursing research with some other newly emerging social and academic groups. Thinking of nursing research outputs in this way can provide insight into the existence of different reward systems influencing nurse researchers. However, it is impossible to draw too confident a differentiation without reading each individual paper and making judgements about whether they are 'endogenous' or 'exogenous', a practice generally beyond the scope of bibliometric practice.
Resilience is one of the attributes nurses need if they are to deliver quality care successfully in an ever more demanding environment. But how does resilience enhance a healthcare setting and the wellbeing of patients, and is it a... more
Resilience is one of the attributes nurses need if they are to deliver quality care successfully in an ever more demanding environment. But how does resilience enhance a healthcare setting and the wellbeing of patients, and is it a personal trait or something that can be taught?
ABSTRACT this is an interview with les Gelling, editor of Nurse Researcher about research interests, impact, views about the strengths and weaknesses of research in nursing.
A day spent watching a fitness for practice panel reinforced what Michael Traynor found in the literature about referrals to the nurse regulator.
Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. To critically... more
Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control, and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Twenty-seven studies were included, 9 of 27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all 11 therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), four types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular ES implant). The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations, and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters, and conduct more rigorous trials.
It is well established, following Menzies' work, that... more
It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of 'surplus'. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients.
Introduction Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and ‘modernizing’ project... more
Introduction Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and ‘modernizing’ project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups. Methods Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions. Results The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses. Conclusion Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and ‘sold’ to the nursing profession as e...
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In 1991, the United Kingdom (UK) government introduced reforms of the National Health Service (NHS), the most recent in a series of successive rationalisations aimed at increasing accountability and containing the service's costs.... more
In 1991, the United Kingdom (UK) government introduced reforms of the National Health Service (NHS), the most recent in a series of successive rationalisations aimed at increasing accountability and containing the service's costs. These rationalisations ...
For many events in professional life we are given guidelines, for example how to structure your job application or how to write a report about a patient.

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