Isolation and Marginalization: Exploring Attrition of Men in Preregistration Nursing Programs.

BACKGROUND: In Scotland, similar to other countries, male nursing students have a high attrition rate. This study examined the reasons for and ways to decrease the attrition rate. METHOD: This four-phase collaborative study included four Scottish universities. Phase 1 involved three telephone interviews with men who had left a nursing program. Phases 2 through 4 used focus groups and interviews with 18 nursing students (13 men and 5 women) and 12 nurse lecturers. Thematic analysis followed a four-stage process. RESULTS: Male nursing students in this study felt isolated and marginalized, were stereotyped regarding their masculinity and physical attributes, had difficulty communicating, and were reluctant to seek help. Financial pressures and access to learning opportunities also disproportionately affected male students. Resilience and maturity are required to cope with these challenges. CONCLUSION: Proactive measures and visible role models in academic and clinical environments are needed to support male students in completing their nursing education. [J Nurs Educ. 2022;61(4):179-186.].

An exploration of the influences on under-representation of male pre-registration nursing students.

BACKGROUND: Worldwide, men are under-represented in the nursing profession. In Scotland less than 10% of pre-registration nursing students are male. Reasons for this imbalance need to be understood. OBJECTIVES: To explore the views of male pre-registration nursing students, nursing lecturers and school teachers about this imbalance. DESIGN: Mixed methods study using focus groups and online survey. SETTINGS: Focus groups in four locations across Scotland. Online survey sent to teachers across Scotland. PARTICIPANTS AND METHODS: Eight focus groups with 33 male nursing students; four focus groups with 21 university and college nursing lecturers; 46 school teachers returned the online survey. RESULTS: Although nursing was considered a worthwhile career with job stability and many opportunities, it was also viewed as not being a career for men. Assumptions about the profession and femininity were challenging for men and use of the term 'male nurse' was felt to be anomalous. In some circumstances the provision of intimate care to particular patient groups caused difficulty. Positive encouragement from others, a positive role model or knowledge of nursing from significant others could be helpful. However concerns about low earning potential and negative media publicity about the NHS could be a disincentive. Being mature and having resilience were important to cope with being a male nursing student in a mainly female workplace. Some more 'technical' specialties were felt to be more attractive to men. CONCLUSIONS: Nursing is viewed as a worthwhile career choice for men, but the gendered assumptions about the feminine nature of nursing can be a deterrent.

Enriching the care of patients with dementia in acute settings? The Dementia Champions Programme in Scotland.

Admission to hospital has been found to have a negative impact on people with dementia. The Scottish Dementia Champions programme was developed to prepare health and social service Dementia Champions working in acute settings as Change Agents. The programme was initially delivered to a cohort of 100 health professionals via blended learning, and comprised five study days, a half day spent in a local community setting, and e-learning. In order to complete the programme and graduate, participants were required to complete and submit reports relating to three work-based activities. The evaluation of the project adopted a two-pronged approach: Impact on programme participants was assessed by scores derived from the Approaches to Dementia Questionnaire (ADQ) (Lintern, 1996) completed at Study Days 1 and 5, and analysis of qualitative data derived from the three written assignments. Participants were asked to evaluate course materials and input for each of the five study days, as well as satisfaction with delivery. Analysis of data derived from the ADQ and 100 reflective reports of the community experience indicate that participants' perceptions of people with dementia shifted significantly during the Programme. Participants identified a range of issues which should be addressed with a view to improving the experiences of people with dementia in acute settings, and put in place actions to bring about change. The format of the programme provided a cost effective means to prepare NHS and Social Service Dementia Champions as Change Agents for practice within a relatively short period of time, and would be transferrable to other staff groups as well as different organisational structures in other countries.

No decision about me without me: concordance operationalised.

AIMS AND OBJECTIVES: To demonstrate that concordance can be operationalised to the benefit of patients. Concordance can be understood as a composite of knowledge, health beliefs and collaboration. BACKGROUND: In discussing any clinical decision, it would be ideal if different views could be incorporated to reach the most coherent decision. This is a definition of concordance, a widely agreed ideal in nursing. There are limits, however, that make the practice of concordance problematic. Sometimes there is little time or willingness to discuss issues in depth. Some views of the world are considered more worthy than others. As a consequence, clinical guidelines currently prioritise easier to measure outcomes of negotiation, such as adherence. DESIGN: This discursive article argues that prioritising adherence is a fundamental error, incoherent with current strategic rhetoric such as the Department of Health's 'no decision about me without me'. METHODS: The impact of prioritising concordance is contrasted with adherence-based interventions. RESULTS: Where adherence is a goal of treatment, non-adherence is considered problematic. This value judgment is not useful and does not occur in a consultation that prioritises concordance. However, concordance is difficult to translate into clinical practice. This article shows that concordance can be operationalised by considering it a composite of health beliefs, knowledge and collaboration. CONCLUSION: The main thesis is that different behaviours can always be incorporated into a concordance framework. This negates the necessity for adherence as an endpoint in itself. RELEVANCE TO CLINICAL PRACTICE: Fifty per cent of people do not take medicines as prescribed. Interventions focused towards improving adherence are only ever partially successful. This is because it presupposes the clinician is right. Concordance by contrast is more coherent with person centred care and thus more likely to generate clinically meaningful outcomes for patients.

Improving the care of people with dementia in hospital.

The Dementia Champions Programme was set up in NHS Dumfries and Galloway, Scotland, to equip nurses with the skills and knowledge to improve the care of people with dementia in hospital. Nurses who complete the programme are known as dementia champions. This article describes the multi-faceted, educational approach to improving the care of adults with dementia.

Reflexivity: promoting rigour in qualitative research.

This article illustrates how the concept of reflexivity has matured in conjunction with developments in qualitative research, and makes the case for inclusion of a reflexive account to increase the rigour of the research process. A qualitative study (Jootun and McGhee 2006) is used to show how the reflexive process improved data reliability. Reflexivity is an invaluable tool to promote understanding of the phenomenon under study and the researcher's role. The relationship between, and influence of, the researcher and participants should be made explicit.

Grounded theory research: literature reviewing and reflexivity.

AIM: This paper is a report of a discussion of the arguments surrounding the role of the initial literature review in grounded theory. BACKGROUND: Researchers new to grounded theory may find themselves confused about the literature review, something we ourselves experienced, pointing to the need for clarity about use of the literature in grounded theory to help guide others about to embark on similar research journeys. DISCUSSION: The arguments for and against the use of a substantial topic-related initial literature review in a grounded theory study are discussed, giving examples from our own studies. The use of theoretically sampled literature and the necessity for reflexivity are also discussed. Reflexivity is viewed as the explicit quest to limit researcher effects on the data by awareness of self, something seen as integral both to the process of data collection and the constant comparison method essential to grounded theory. CONCLUSION: A researcher who is close to the field may already be theoretically sensitized and familiar with the literature on the study topic. Use of literature or any other preknowledge should not prevent a grounded theory arising from the inductive-deductive interplay which is at the heart of this method. Reflexivity is needed to prevent prior knowledge distorting the researcher's perceptions of the data.

Enabling students to develop confidence in basic clinical skills.

An increase in the number of nursing students is making it difficult to guarantee those on the common foundation programme the opportunity to practise basic nursing skills. In order to address this problem a nursing college developed a skills week that enabled students to practise their skills and develop confidence. Simulated clinical situations gave students the opportunity to relate these skills to practice while learning about teamwork and holistic patient care.

Research supervision.

BACKGROUND: Nurses are expected to base their practice on research, and to carry out research themselves. Whereas research supervision is useful to the experienced researcher, it is vital to the novice. It is surprising, therefore, that there is little published work on research supervision. Practical advice based on first-hand experience is the focus for most work and, ironically, very little of that available is research based. This literature review is categorised into three main sections: the supervision relationship, good practice in supervision, and the context of supervision. A review is necessary to address what information is known, to provide guidance both to supervisors and supervisees, and to highlight the need for further work. CONCLUSION: The little research evidence that is available suggests a way forward based on practical experience of both supervising and being supervised. The implications of this are briefly outlined.

What all nurses need to know about Stickler syndrome.

Stickler syndrome is one of the most common clinical syndromes in Europe although it is also one of the least known and consequently most misidentified. Because Stickler syndrome affects connective tissue, many different symptoms present, from vision to mobility difficulties. This article examines the main symptoms of the syndrome and includes an insightful personal account showing how it affects the whole family.