Male nurse practice in inpatient rehabilitation. Finding a safe way: a grounded theory.

BACKGROUND: Research interest in nursing's contribution to inpatient rehabilitation is growing. Nurses contribute to rehabilitation specifically by teaching patients how to care for themselves. This contribution is largely reported from a female or genderneutral perspective. Despite the work of male nurses being examined in a range of other specialities, their work within inpatient rehabilitation remains underexplored. OBJECTIVE: To report on a grounded theory study to identify and make visible male nurse practice in inpatient rehabilitation in Australia. DESIGN: Constructivist grounded theory informed by symbolic interactionism. SETTING(S): Stage 1 data were collected in locations of participants choosing throughout Australia. Stage 2 data collection centred on seven data collection sites across two specialist rehabilitation hospitals in two states of Australia. PARTICIPANTS: Twenty-three male nurses and 15 patients participated in the study. METHODS: Stage 1 (October 2013 to June 2014) consisted of semi-structured interviews with 11 male nurses. Stage 2 (February to April 2015) consisted of semi-structured interviews and 63.5 h of non-participant observation with 12 male nurses. Fifteen interviews with patients as recipients of male nurse care were also conducted. Data analysis included initial coding, focused coding, and theoretical coding using constant comparative methods, memo writing and diagramming. RESULTS: Nurse participants were aware of patient perceptions about nursing being an occupation for women and male nurses being perceived as sexual threats, which led to an everyday concern of potential for misinterpretation. To address this concern, male nurses engaged in a three-phase process known as assessing and managing risk in order to minimise risk and to keep themselves safe in practice. However, two contextual conditions, type of care and urgency of care, influenced engagement in assessing and managing risk. The core category and substantive grounded theory to explain these results is finding a safe way. CONCLUSIONS: Gender stereotypes affected the daily working lives of male nurses in inpatient rehabilitation. To counter the risk of misinterpretation male nurses used a range of strategies to address the barriers encountered daily in their working lives. However, male nurse efforts were often influenced by conditions outside of their control. In inpatient rehabilitation, male nurses practised cautiously to keep themselves safe in order to practise nursing.

Clinical learning for pre-registration nursing students: a viva voce approach during COVID-19.

The COVID-19 pandemic restricted face-to-face contact between students and educators, limiting continual assessment of student's clinical skill development. This led to rapid transformational online adaptations to nursing education. This article will present and discuss the introduction of a clinical 'viva voce' approach, which has been used at one university to formatively assess students' clinical learning and reasoning skills using virtual methods. The Virtual Clinical Competency Conversation (V3C) was developed using the 'Think aloud approach' and involved facilitated one-to-one discussion based on two questions from a bank of 17 predefined clinically focused questions. A total of 81 pre-registration students completed the formative assessment process. Overall, feedback from students and academic facilitators was positive and facilitated both learning and consolidation in a safe and nurturing way. Further local evaluation is continuing to measure the impact of the V3C approach on student learning now that some aspects of face-to-face education have resumed.

Assessment and management of a person experiencing pain from pancreatic cancer ascites: a case study.

The most common type of pancreatic cancer is pancreatic adenocarcinoma, which affects the exocrine ducts. There are many risk factors associated with pancreatic cancer, including smoking, obesity, poor diet, diabetes, inactivity and genetics. In the UK, pancreatic cancer is the 10th most common cancer with a poor prognosis, with only 24% of people surviving the first year after diagnosis and 7% surviving for 5 years. The lives of those with the condition are impacted in a number of ways. This case study of a patient with pancreatic cancer explores the nursing assessment, management and evaluation of care provided from a student nurse perspective under the supervision of a qualified nurse.

Potential for misinterpretation: An everyday problem male nurses encounter in inpatient rehabilitation.

AIMS: This study aims to report on the everyday concern of the 'potential for misinterpretation', which was the basic social problem revealed in a grounded theory study exploring male nurse practice in inpatient rehabilitation in Australia. BACKGROUND: Male nurses account for approximately 10% of nursing workforce across western countries and they practice in a range of clinical areas; however, how they practice in inpatient rehabilitation remains unexplored. METHODS: Constructivist grounded theory was used in this study and was conducted in two phases: (i) involved semi-structured interviews with 11 male nurses from October 2013 to June 2014 and (ii) observation of practice of 12 male nurses and semi-structured interviews with male nurses and 15 patients from February to April 2015. RESULTS: Nurse participants encountered the intersection of two pervasive patient ideologies about male nurses. Patients perceived nursing to be women's work and that male nurses are sexual threats. These two intersecting ideologies created a concern for male nurses working in inpatient rehabilitation and that concern was labelled 'potential for misinterpretation'. CONCLUSION: Gender stereotypes impacted on the ability of male nurses to practise nursing in inpatient rehabilitation. Male nurses were mindful on a daily basis that misinterpretation could, and did, happen in inpatient rehabilitation.

Survey of research activity among multidisciplinary health professionals.

Objective The aim of the present study was to describe the research activities being undertaken by health service employees within one Australian health service and explore their experiences with undertaking research. Methods The present mixed-methods study was conducted across one health service in Queensland, Australia, and included a cross-sectional online survey and interviews with healthcare service employees. The anonymous survey was a self-administered online questionnaire, distributed to all 6121 employees at the health service via email, asking about research activity and engagement. Willing participants were also interviewed on their perceptions and experiences with research and capacity building. Results In all, 151 participants responded to the survey and 22 participated in interviews. Three-quarters of respondents reported actively participating in research over the past 6 years and several research outputs, such as publications, conference presentations and competitive grant funding, were displayed. Four concepts emerged from interview findings, namely collaborative partnerships, skilled mentorship, embedding research and organisational support, which represented the overall theme 'opportunities for a research-infused health service'. Conclusion Employees of the health service recognised the importance of research and had a range of research skills, knowledge and experience. They also identified several opportunities for building research capacity in this service. What is known about the topic? Building research capacity among healthcare professionals is important for enabling the conduct of high-quality research in healthcare institutions. However, building research capacity is complex and influenced by the uniqueness of organisational context. In order to successfully build research capacity among employees at any health service, current research activity, skills and experience, as well as staff perceptions around building research capacity in that setting, should first be explored. What does this paper add? Healthcare services should incorporate teaching and research with clinical care to optimise outcomes for consumers. Support for research can be diminished in favour of clinical care and reduced emphasis on the importance of research can negatively influence research activity and expansion of clinician-led research. Highlighting the perceptions and experience of clinicians with enabling research and capacity building is a context-specific but necessary process to ensure that strategies, processes and resources are targeted to maintain support for research activity while overcoming barriers. What are the implications for practitioners? Participants in this study identified several ways to build research capacity in their health service, many of which may be applicable to other settings and contexts. Building research collaborations and academic partnerships are important to enable and drive research. Structural processes, such as organisational support and opportunities for skilled mentorship, may be necessary to build health service employees' research knowledge, skills and confidence. Finally, embedding research into everyday practice is important to foster a positive research culture within health services.

Education requirements for nurses working with people with complex neurological conditions: relatives' perceptions.

This paper reports on the exploration of relatives' perceptions about the need for education and training of nurses (registered nurses and healthcare assistants) who work with people who have complex neurological long-term conditions. A service evaluation was undertaken to meet the study aim and a cross-sectional, self-administered postal questionnaire was undertaken with relatives related to someone (patient/resident) with a complex neurological condition between October and November 2007 at one specialist hospital in South-West London in the UK. Results indicate that the majority of respondents (87.2%, n = 34) believe that nurses working in this setting require specific complex neurological disability education and training. The perceptions of relatives support the need for the development of specialist education and training for nurses working with this patient population. These findings are similar to other neurological and rehabilitation studies, and warrant further exploration across multiple sites.