Nursing students' attitudes towards sustainability and health care.

Aim To evaluate attitudes towards embedding sustainability and climate change in nursing curricula among nursing students, some of whom had participated in a sustainability and health skills session, and determine whether the session could improve knowledge of sustainability. Methods Three months after the sustainability session, students who had participated along with a sample of students who had not, completed a Sustainability Attitudes in Nursing Survey questionnaire. This investigated attitudes towards climate change and sustainability in nursing curricula and the costs of clinical and domestic waste disposal. Results Nursing students were positive about sustainability and climate change and its inclusion in the curriculum, irrespective of their participation in the sustainability scenario session. Participants in the sustainability session were more likely to identify correctly the cost of clinical waste disposal in the NHS. Conclusion The sustainability and health skills session has the potential to improve nursing students' knowledge of the cost of clinical waste disposal.

The use of evidence-informed sustainability scenarios in the nursing curriculum: development and evaluation of teaching methods.

BACKGROUND: Climate change and resource scarcity pose challenges for healthcare in the future, yet there is little to raise awareness about these issues in the nursing curriculum and nurses are poorly equipped to practice in a changing climate. The aims of this paper are to describe how an evidence-informed 'sustainability and health' scenario based on two sustainability issues (resource depletion and waste management) was introduced into a nursing clinical skills session, and to report the evaluation of the session. METHODS: Based on evidence from our own research on waste management, sustainable procurement and resource scarcity, a practical hands-on skill session was delivered to 30 second year student nurses as part of a scheduled clinical skills day. The session was observed by one of the facilitators and interactions recorded and this was followed by a brief questionnaire completed by participants. FINDINGS: Observations of the group sessions and discussion found that students demonstrated limited knowledge about natural resources (such as oil) used in the production of items used in healthcare; they engaged in discussions following the use of Internet resources, and were able to segregate waste appropriately. Thirty (100%) students completed the evaluation questionnaire, found the resources used in the skill session helpful, and thought that the scenarios were realistic. Nineteen reported being more aware of peak oil; 30 were more aware of risks to patient experience and service delivery if resources become unavailable; 30 reported greater awareness of the management of waste in healthcare. Comments on the questionnaire indicated a high level of engagement and interest in the subject. CONCLUSION: The problem of climate change and resource scarcity can too easily be seen as a distant or intractable problem. However one way to make this topic real for students is through the use of clinically relevant scenarios in skill sessions.

How the observed create ethical dilemmas for the observers: experiences from studies conducted in clinical settings in the UK and Australia.

Observational research has a history of controversy, particularly when the research is conducted in a clinical setting. Existing ethical approval processes focus on protecting participants and the researcher's responsibilities, in particular where vulnerable populations are concerned. In this study, the authors explored the less overt and often understated ethical challenges that can arise when conducting observational research in a clinical setting. Reflecting on two recent studies conducted in different clinical settings, the authors described the challenges of blurring role boundaries, the risk of collecting redundant data, and the impact of reverse power relationships between researchers, clinicians, and managers. From their experiences, the authors suggested that the preparatory work undertaken with clinicians and managers onsite, which typically focuses on how the researchers will maintain the ethical robustness of the research and protect the rights of participants and the vulnerable, should also highlight the sometimes overlooked ethical issues associated with participatory research. This can help ensure that participants and managers understand the scope and limitations of the research, and consider the ways in which the observed can influence the researcher and the findings.

Exploring nurses' experiences of providing high dependency care in children's wards.

The care of critically ill children has received much attention in the past decade, and many of the recommendations from reports relating to the provision of paediatric intensive care have been addressed. In comparison, high dependency care has received less attention. This level of care is often provided on 'general' children's wards, yet its impact on nursing staff and care delivery have received little attention. This article presents a study which explores nurses' experiences of providing high dependency care on children's wards using focus groups. Following analysis, six categories emerged: definitions and perceptions of high dependency care; having a high dependency unit; problems in district general hospitals; the skills needed for high dependency care; team working; and staffing for high dependency care. These findings have implications for current clinical, managerial and educational practice and for future developments in the field of high dependency care for children.