Showing papers by "Mike Nolan published in 1993"
TL;DR: The trend apparent in nursing and other practice disciplines towards more participative and collaborative methods of enquiry as exemplified by action research is described and a mechanism to facilitate and make explicit the values underpinning care in any given environment is suggested.
Abstract: This paper describes the trend apparent in nursing and other practice disciplines towards more participative and collaborative methods of enquiry as exemplified by action research. In so doing it notes the conceptual similarities between action research, change theory and quality initiatives. Particular attention is focused on the need to establish the basic values which provide the impetus and direction for subsequent activity. The difficulties this may pose are illustrated by reference to the application in two continuing care hospital wards for elderly patients of a checklist operationalizing a typology of care. A mechanism to facilitate and make explicit the values underpinning care in any given environment is suggested.
74 citations
TL;DR: It is argued that the application of models of nursing do not represent the best solution and that there is a need for a fundamental re-appraisal of sources of job satisfaction for nurses working with frail elderly patients in continuing-care environments.
Abstract: This paper considers the issue of the quality of nursing care for frail elderly patients in continuing-care environments. The continued failure to raise the standards of such care is explored and potential explanations sought. It is argued that the application of models of nursing do not represent the best solution and that there is a need for a fundamental re-appraisal of sources of job satisfaction for nurses working with such patients. Using the results of an evaluation of a respite care service two concepts, 'rust out' and 'therapeutic reciprocity', are identified as offering the basis for future research, education and practice developments in this field.
21 citations
TL;DR: There are major tensions inherent in much of the current thinking about audit, and the potential effects of ignoring such tensions are illustrated by reference to the development of day hospital care for older people in the United Kingdom.
Abstract: There can be very few nurses, at the moment, whose daily activity is not in some way influenced by the notion of audit and related concepts. Yet despite an impressive growth in the literature relating to audit, conceptual clarity on a number of key issues remains elusive. This paper suggests that there are major tensions inherent in much of the current thinking about audit. In outlining the arguments supporting our position, we term these tensions primary and secondary. The potential effects of ignoring such tensions are illustrated by reference to the development of day hospital care for older people in the United Kingdom. This is used to highlight a number of paradoxical expectations and deleterious consequences for day hospital services which have arisen from a failure adequately to address a number of fundamental questions. The lessons to be drawn are then applied to audit in general, with particular reference to services for individuals with on-going health care needs.
19 citations
TL;DR: The central tenets of a pluralistic model are presented and the benefits of such an approach are illustrated by reference to a recent evaluation of a respite care scheme for elderly people and their carers.
Abstract: This paper draws attention to issues raised by the present emphasis on service evaluation. It highlights in particular the limitation of many current models and argues the need to adopt a broad approach which takes account of the potentially disparate views of differing interest groups. The central tenets of a pluralistic model are presented and the benefits of such an approach are illustrated by reference to a recent evaluation of a respite care scheme for elderly people and their carers.
19 citations
TL;DR: Evidence suggests that nurses who consider that their educational needs are being fully met have higher morale and work more efficiently than those who do not.
Abstract: Debate on the costs and benefits of continuing professional education for nurses has intensified following the PREPP proposals. Evidence suggests that nurses who consider that their educational needs are being fully met have higher morale and work more efficiently than those who do not.
17 citations
TL;DR: The benefits of research are demonstrated by examining nurses' knowledge of the factors that are important in taking an accurate blood pressure reading and demonstrating the importance of studies to inform nursing practice.
Abstract: It is over 20 years since the Briggs (1971) report extolled the virtues of nursing becoming a research-based profession. However, despite progress having been made towards achieving a research base, studies all too rarely inform nursing practice. This article offers a number of explanations for this failure and demonstrates the benefits of research by examining nurses' knowledge of the factors that are important in taking an accurate blood pressure reading.
15 citations
TL;DR: The extent to which nurses feel that their contribution is recognized and that they are involved in important decisions varies according to grade and location.
Abstract: The extent to which nurses feel that their contribution is recognized and that they are involved in important decisions varies according to grade and location. Clinical nurses generally feel that they exert little influence over doctors, general management or their own nurse managers.
14 citations
TL;DR: The major contributory factors and the role of community nurses in accident prevention assessment of older people are discussed.
Abstract: The high incidence of falls among older people and the subsequent high rates of potentially preventable morbidity and mortality highlight the need for early identification of risk factors. This article discusses the major contributory factors and the role of community nurses in accident prevention assessment of older people.
6 citations
TL;DR: Standards of physical care on continuing care wards have improved but psychosocial care remains generally poor and nurses must take greater responsibility for its provision.
Abstract: Standards of physical care on continuing care wards have improved but psychosocial care remains generally poor. Purposeful activity is central to the quality of care of patients on respite and continuing care wards and nurses must take greater responsibility for its provision.
4 citations
TL;DR: Some of the conceptual and practical problems surrounding the topic of elder abuse are highlighted in order to raise awareness and provide some indication of the nurse's role.
Abstract: Despite a growing literature, many professionals have a limited knowledge of elder abuse. This article highlights some of the conceptual and practical problems surrounding the topic in order to raise awareness and provide some indication of the nurse's role. Language: en
1 citations