Being a newly qualified diagnostic radiographer: Learning to fly in the face of reality.

INTRODUCTION: The phenomenon of role transition has been investigated by a range of differing professions over a range of time and utilising a range of different methodologies. It is acknowledged by all studies that the period of transition from student to practitioner is a challenging and at times a stressful experience, often culminating in the newly qualified practitioners experiencing the reality shock of practice. This paper explores one of the key subthemes 'reality hits' which was identified during a wider PhD study Being and Becoming a Diagnostic Radiographer. METHODS: A longitudinal study was utilised employing an interpretive phenomenological methodology, collating data from nine participants during their first year as a newly qualified diagnostic radiographer. Each participant was interviewed at three months, six months and twelve months. RESULTS: Six main themes were identified. This paper explores the subtheme 'reality hits' which strongly featured in the three and six month interviews. CONCLUSION: Eight of the nine participants found the first three to six months a stressful and emotional time. The experience of the graduates during this time raises issues which need to be used to inform future curriculum development, practice placement models and support strategies.

Factors influencing the patient with rheumatoid arthritis in their decision to seek podiatry.

INTRODUCTION: Despite the level of foot involvement in rheumatoid arthritis (RA), and the literature to support early assessment of foot care needs, local referral of patients to podiatry has been occurring too late to instigate certain preventative interventions. Preliminary fieldwork has highlighted that the primary responsibility for the instigation of this lies with the patient. The present study describes the factors that influence the patient with RA in their decision to self-report foot problems. METHOD: A case study research strategy was employed. Nine patients attending the outpatient rheumatology department participated in the study and data were gathered through semi-structured interviews. This information was analysed using a framework approach. RESULTS: The key themes derived from the data suggested that there are a variety of factors influencing the patient's decision to self-report foot concerns. Some will act to encourage the action and others will act to oppose it. Other factors can influence the decision either way, depending on the individual patient (psychological state, previous experience, body image changes). In addition, age, gender, and cultural and social aspects are also significant. CONCLUSION: Due to the multitude of factors influencing the individual's decision to seek help, the patient cannot be given sole responsibility for their foot health if we wish to achieve timely and appropriate podiatry, as recommended in the literature. Responsibility should be three-way; the patient, the members of the rheumatology team and, once in the podiatry service, the podiatrist should maintain this.

Patients' experience of return to work rehabilitation following traumatic brain injury: a phenomenological study.

Many persons with traumatic brain injury (TBI) are young adults who, prior to their TBI, were in paid employment. Psychosocial outcome after TBI, for many, remains poor. This includes low rates of return to pre-injury work or education, among others. This qualitative study explored the experience of return to work (RTW) rehabilitation with 10 individuals who sustained TBI. Data were collected from semi-structured interviews. Transcripts were analysed using interpretative phenomenological analysis (IPA). Some of the main findings from this study included the following: Individuals find the RTW experience difficult and painful. They experience a distinct grief reaction in the process of exploring re-engagement in occupation following TBI. In view of these and other findings, changes to RTW rehabilitation should be considered to facilitate the optimal support for patients with TBI engaging in the RTW rehabilitation process.

Improving international nurse training: an American-Italian case study.

BACKGROUND: Institutionalized international nurse training organized by national educational institutions is a relatively new phenomenon. This, descriptive case study examines an early example of an American-Italian initiative of such training, in order to stimulate future international education of nurses. AIM: To find out what factors have to be taken into account to improve training and what its potential effects are in exchange and also in the context of nurse migration. METHOD: A questionnaire was sent to the 85 nurses who all participated in this particular international programme (response rate: 30.6%). FINDINGS: The collected data indicate that personalized and well-aimed training, preparatory language courses, pre-departure exposure of nurses to the culture of the host country and well-prepared welcomes are among the most important ways to improve this programme. IMPLICATIONS FOR PRACTICE: While the specific circumstances and cultures involved in this particular case study should not be ignored, these factors might also be applied to maximize the positive effects of nurse-migration. Two-way learning is among the positive effects of such an international training experience. Motivational and team-building effects can result in enhanced quality of care and a more efficient allocation of resources. However, the mind-opening effect seems to be the most important learning experience. Therefore, regardless of whether one system is considered better or worse than another, experiencing a different way of nursing/education is considered the most important, enriching element of an international learning experience. The effects of this experience could include avoiding cultural imposition in the increased cultural diversity of nursing in the country of origin.

New meanings: a qualitative study of change in nursing education.

This paper reports on the experiences of teachers in one college of nursing and midwifery in South East England during a period of profound and complex change. Personal perceptions and reactions are studied in the context of professional organizational influences. A phenomenological approach was used to identify and portray the personal perspectives and meanings of the respondents. Fifty semi-structured interviews with a purposeful sample of the college staff were supplemented with participant observation and documentary analysis. The data were analysed inductively, and emergent categories were confirmed and clarified through respondent validation. Findings relating to organizational, professional and personal perceptions are presented alongside the major themes of belonging, knowing and controlling. The conclusions and implications of this exploratory study are discussed, together with aspects of the researcher's role and areas for future research.