Biomedical subjects
Publications and source records attributed to J Nolan.
In this article those factors which influence the job satisfaction and morale of nurses are considered. It is suggested that action is needed if the profession is to continue to grow and develop.
The management of chronic illnesses represents a major health challenge with interventions still being dominated by approaches that are more appropriate to acute conditions. Nurses have a key role to play in meeting the health needs of people with chronic illnesses and yet place little value on this type of care. This article reviews the Corbin and Strauss model of nursing which has proved effective in the management of a wide range of chronic illnesses.
This article, the first of two, considers the factors precipitating the widespread adoption of self-directed and student-centered learning in nurse education. It argues that these concepts have been accepted in a relatively uncritical fashion and that the theoretical rationale for their use has yet to be fully tested empirically. The results of a study of the expectations of Project 2000 students suggest that adult learners may not necessarily want the freedom afforded by self-directed approaches, but may prefer a more structural and ordered model.
Based on a study of student nurses' expectations at the start of their Project 2000 training, this article, the second of two, argues for the need to develop a new approach to self-directed learning. Termed the cooperative model, it places emphasis on tutors providing initial direction and leadership so that students can gradually develop the skills needed to become self-directed. This requires the use of pedagogical approaches which recognize the value of didactic as well as experiential teaching strategies. The characteristics of the cooperative model, which is located within the continuum of self-directed learning suggested by D'A Slevin and Lavery (1991), are outlined.
This article highlights the present renewed interest in the subject of rehabilitation and describes the nursing role as it is portrayed in the literature. It is argued that the focus of rehabilitation is too narrow, concentrating mainly on the physical aspects of care, and that the nursing contribution is under developed. The article is the first in a series which will subsequently consider rehabilitation in multiple sclerosis, arthritis, spinal injury, myocardial infarction and stroke. The series will conclude with suggestions as to how rehabilitation in general, and nursing in particular, can respond more adequately to the needs of chronically ill and disabled people and their family carers.
This article, the second in a series focusing on aspects of rehabilitation, considers the potential nursing role in relation to multiple sclerosis (MS). It begins with a brief description of the experience of MS as recounted by the individuals affected, which is then contrasted with current interventions which focus primarily on physical aspects of care. A number of areas of potential improvement are outlined, together with suggestions for a more comprehensive nursing role.
This article is the third in a series concerned with the nurse's role in rehabilitation dealing with both individuals and their family carers facing the challenges posed by a number of chronic conditions. This article focuses on arthritis. Following the format of earlier articles attention is first turned to patients' experiences of arthritis. This is then followed by consideration of a range of psychosocial interventions. It is suggested that the nurse's role in arthritis care is reasonably well established; however, further developments, particularly in the community, are briefly explored.
This, the second of two articles, presents the results of a recent survey of nurses' job satisfaction and morale undertaken at the Northern General Hospital NHS Trust, Sheffield. The survey was conducted in order to provide a benchmark against which to gauge progress towards creating a work environment in which nurses are able to exercise maximum autonomy within a supportive and enabling culture. The results mirror recent national reports which highlight the increasing tension between workload pressures and the desire to provide holistic patient care. A number of factors were identified which suggest the need for remedial action across a range of fronts. Such factors are briefly described, together with the action taken to date to address the issues raised.
Spinal cord injury is one of the most unexpected and devastating of events that typically affects young people, often males. Thus it stands in stark contrast to both multiple sclerosis and arthritis, the conditions considered in the previous two articles of this series. The differences do not end here as spinal injury is relatively stable once the initial phase has passed, whereas both multiple sclerosis and arthritis are progressive. However, despite this variation the literature suggests that rehabilitation in all three conditions raises similar concerns. This article focuses on these concerns and how nurses can respond to them.
Coronary heart disease is the major cause of death in the UK, but cardiac rehabilitation programmes have tended to develop in an ad hoc and unsystematic way. This article considers some of the deficits in current practice and suggests ways in which nurses can contribute more fully to care in this area. The need for better training and the necessity to develop skills in psychological care are highlighted. The authors also emphasize the importance of giving greater attention to a number of areas such as family involvement, sexuality and gender issues, and community follow-up.
This is the first of two articles which consider rehabilitation following a stroke. Although stroke is a major cause of morbidity and mortality in the UK there have been relatively few studies describing its long-term effects. Despite relatively good functional recovery, in many cases a number of stroke survivors still experience 'long-term misery'. This article argues for an expanded range of outcomes in stroke rehabilitation and for greater attention to be paid to the psychological needs of stroke survivors and their carers. Areas of deficit in stroke rehabilitation are described, as is the currently poorly developed nursing role.
This article, the second of two considering the nurse's role in stroke rehabilitation, focuses on potential nursing contributions in a number of areas. There is scope, particularly in the community, to develop a far greater nursing role in both the acute and the postacute phases of rehabilitation. However, nurses often have ambivalent attitudes towards rehabilitation--seeing acute care as more prestigious and important. Such attitudes are developed and reinforced in basic training which gives relatively little emphasis to chronic illness.
This article concludes this part of the rehabilitation series by looking at the nursing contribution to rehabilitation. It brings together the common elements which have emerged in the previous seven articles, identifying areas in which there is considerable scope for improvement to current practice. Indicative areas of knowledge and skill required for nurses to play a more active role are considered and a number of potential models are briefly described.
This article, based on a paper given at the International Network for Studies Concerning Older Adults conference in Brazil, considers the health of older people. It argues that greater efforts must be made both to improve preventive healthcare interventions and enhance quality of life. It is suggested that nurses have a significant but, as yet, largely unrealized role to play and that action is needed if older people are to get maximum benefit from health care.
A method has been developed for determining ivermectin in 5 mL samples of cattle blood by a 2-step process: cleanup solvent extraction followed by direct injection onto a normal phase liquid chromatography (LC) system with UV detection. Recovery was 77-80% +/- 5.5% standard deviation. Endogenous interference that may be present caused the lower limit of detection to be set at 4-5 ng/mL. The method was used to show that in blood the distribution of ivermectin favors plasma in a fixed proportion over cellular material, and further to provide a time-course profile of ivermectin in the whole blood of injected cattle. In whole blood, ivermectin concentration peaked between 3 and 5 days and dissipated slowly with a half-life of 3 days.
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Heart failure is an increasingly common problem in the UK, particularly in older patients. This article reviews the available information is available on heart failure in the older population, and provides clinically useful guidelines on the investigation and treatment of patients with this condition.