Visiting all hours: a focus group study on staff's views of open visiting in a hospice.

St Columba's Hospice, Edinburgh, is a busy specialist palliative care unit with 30 inpatient beds. A previous publication reported the first strand of a qualitative exploratory study evaluating the impact of open visiting on patients at the hospice. This paper reports on the second strand, which sought to elicit the views of the hospice staff through focus group interviews. The main themes identified were valuing the family and friends as visitors, involving the family as part of the care team, patient powerlessness over visiting, shared rooms and their impact on visitors and patients, and the staff role as advocates or gatekeepers. Several strategies for developing a flexible and 'patient-controlled' visiting policy were identified, including quiet times without visitors, restriction of visitor numbers in shared rooms, and encouraging breaks from visiting. Since the study was completed, the hospice's visiting policy has been modified to ensure that it is patient-centred and meets the needs of patients and families.

Open all hours: a qualitative exploration of open visiting in a hospice.

Over the past 20 years, visiting policies within adult care settings have progressed from strictly enforced times to more flexible arrangements. The Scottish Commission for the Regulation of Care (SCRC, 2003) advocates open visiting in hospices, which allows access at all times of day. However, little research has been carried out to investigate the assumption that an 'open visiting' policy in a hospice benefits patients and carers and improves the quality of care. This article describes the first strand of a qualitative exploratory study designed to evaluate the impact that open visiting has on patients and the multidisciplinary team in a hospice. A purposive sample of ten inpatients was interviewed. Data were analysed thematically. Patients acknowledged the benefits of contact with family and friends, such as maintaining links with the outside world and improvement in mood. However, they also reported that visitors could be intrusive and, depending on the nature of the relationship, were not always sensitive to cues that the patient was tiring or in pain. Patients indicated a need for more control of visiting arrangements, particularly related to timing, visitor numbers and restrictions on who could visit. These data will contribute to the second strand of the study which involves interviewing multidisciplinary team members.

The impact of a postgraduate critical care course on nursing practice.

The continuing emphasis on collaboration and partnership has resulted in the development of a Trust led, University accredited postgraduate certificate in critical care nursing. This paper explores the impact of the programme on clinical practice in the first cohort of students. A descriptive phenomenological study using focus groups was chosen to examine the student experience. Following a thematic analysis the transition to specialist practitioner is discussed under the headings of: opening the window, becoming more expert, having your wings clipped, changing the goal posts and slotting back in. The paper discusses the lived experiences of the group and findings are integrated with a review of the literature. The data is used to evaluate the course and while the results cannot be generalisable to the general population, the emerging themes are compared with similar studies. A number of limitations to the study are recognised and recommendations are made for future studies including wider research into the outcomes of education.