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Biomedical subjects

J R Cutcliffe

Publications and source records attributed to J R Cutcliffe.

35 records · Page 2Linked to original sources
PubMed1997

Introducing change in nursing: the case of research.

This paper examines the issue of encouraging change in nursing and focuses on how to move from task-orientated to science-based practice. Therefore, it considers the current theory on the process of change and using two clinical vignettes (one from psychiatric and one from general nursing practice) illustrates how science based practice was introduced. From these vignettes it draws four conclusion: (1) small-scale cultural change is possible even within large bureaucracies; (2) the nature and identity of change agents is not always immediately obvious; (3) there is arguably no one singular best way of bringing about change and; (4) change activists need to have an understanding of several models of change. It then makes managerial, educational and structural recommendations based on these conclusions.

Diffusion of Innovation↗
PubMed1997

The nature of expert psychiatric nurse practice: a grounded theory study.

This study examines what psychiatric nurses regard as the nature of expert psychiatric nurse practice. The study focuses on the beliefs and principles of psychiatric nurses currently working within a psychiatric unit. Using grounded theory methodology, data were coded and analysed, producing an integrated framework of expert psychiatric nurse practice comprised of four core variables: 'attitudes/philosophy', 'knowledge', 'skills' and 'roles'. It is suggested that the nature of expert psychiatric practice is an evolutionary concept and that as this practice develops the integrated theory presented will need to develop in parallel.

Attitude of Health Personnel↗
PubMed1995

How do nurses inspire and instil hope in terminally ill HIV patients?

In this study the researcher examined how nurses inspire and instil hope in terminally ill HIV patients. The study therefore focuses on the interventions, attitudes, principles and process utilized by nurses working within a liaison psychiatry unit where in-patient care for terminally ill HIV patients is available. Using grounded theory methodology, the data were coded and analysed, producing an integrated theory of hope inspiration, comprised of four core variables: reflection in action; affirmation of worth; creating a partnership; and the totality of the person. The researcher postulates that hope is inspired in terminally ill HIV patients by means of nursing the totality of the person within the context of a formed partnership, underpinned by the affirmation of the individual's worth, which is assured by the nurse entering into the process of reflection in action. The researcher further suggests that hope inspiration is inextricably linked to effective nursing practice, and is interwoven with the concepts of nursing, caring and helping.

HIV Infections↗
PubMedDate not supplied

Ethical dilemmas in clinical supervision. 1: Need for guidelines.

In this article, the first of two parts, the authors focus on ethical dilemmas in clinical supervision. Given that there may be several factors that contribute to the limited uptake of clinical supervision, the authors suggest that one reason might be the clinician's concern and confusion regarding the potential ethical dilemmas that could arise when providing clinical supervision. Most issues do not produce ethical dilemmas, but some do. Therefore, this article offers a brief description of the purpose and alleged benefits of supervision, and examines the current position of the law in regard to ethical dilemmas within supervision. It then provides six vignettes where supervisors are faced with ethical dilemmas. These will be discussed in the second part of this article.

Conflict, Psychological↗
PubMedDate not supplied

Ethical dilemmas in clinical supervision. 2: Need for guidelines.

In this, the second half of this two-part article, the authors focus on ethical dilemmas in clinical supervision. Referring to the case vignettes included in the first part of this article (Vol 7(15): 920-3), the authors highlight how ethical dilemmas can arise and then provide some discussion on how they might be handled. As a result of the discussion, the authors conclude that there is a clear need for a specific set of guidelines to be produced that would help safeguard best practice within clinical supervision and ensure it remains an opportunity to help and support nurses in reflecting on their dilemmas, difficulties and successes (Cutcliffe and Proctor, 1998a). This would prevent supervision from becoming another form of management monitoring which might inadvertently prevent the resolution of intra- and interpersonal issues affecting the care of clients.

Community Health Nursing↗
PubMedDate not supplied

Personal, professional and practice development: clinical supervision.

This article investigates current research concerns in relation to clinical supervision and offers a rationale for using case studies as a means of evaluation. Three case studies are used to illustrate how development and growth can occur as a result of clinical supervision. The use of case studies as a means of evaluation is analysed. Case studies provide unique insights into the dynamics and processes of clinical supervision. Any improvement in practice ought to bring about improvements in client care, thus case studies can add to the accumulating, qualitative data that support the link between clinical supervision and improved client care. This article recommends that more case studies should be carried out and that the findings are compiled on a centralized database in order that evidence supporting the widespread use of clinical supervision is readily accessible.

Absenteeism↗
PubMedDate not supplied

An alternative training approach to clinical supervision: 1.

This article, the first of two-parts, introduces a new series on clinical supervision. It focuses on the issues of training in clinical supervision. The practice of clinical supervision is considered by the Chief Nursing Officer of the Department of Health to be fundamental to safeguarding standards, the development of expertise and the delivery of quality care. Clinical supervision allegedly brings significant benefits to clients and clinicians, and recent research has produced both quantitative and qualitative evidence to support this argument. Many trusts have already made attempts to introduce widespread implementation of clinical supervision and most developments are concerned with equipping clinicians to be supervisors not supervisees. This presents several logistical and financial problems, and currently neither the infrastructure nor the culture exist in nursing to facilitate its widespread and effective uptake. The authors argue that an alternative method of tackling this problem would be to train nurses to become supervisees not supervisors. Supervisee training could commence following the first year of the common foundation programme component of diploma and undergraduate nurse education.

Attitude of Health Personnel↗
PubMedDate not supplied

An alternative training approach to clinical supervision: 2.

In this, the second of two articles focusing on the issue of training in clinical supervision, the alleged benefits of training students to be supervisees is highlighted. These are: a substantial reduction in training costs and time; a possible standardization of training; the creation of greater equality and intentionality in the working alliance; an increased student awareness and understanding that supervision is for their benefit; the sharing of values, ground rules, terms and aims between the supervisee/supervisor and the organization; a sense of comradeship between peers in a culture that is often described as having a sense of divide and rule; and a greater sense of team cohesion. The development of basic intrapersonal skills (e.g. reflecting on practice, choosing issues, asking for and using help appropriately) in a non-threatening forum is also of great benefit. The authors conclude that an educational model would include both theoretical and experimential components with the theory preceding the clinical supervision experience. Evaluation of this training could be carried out using a methodology similar to that used by Butterworth et al (1997) in evaluating the impact of receiving supervision.

Clinical Competence↗
PubMedDate not supplied

Evaluating expressed emotion and schizophrenia.

This article presents another review from the Network for Psychiatric Nursing Research (NPNR) National Journal Club (see Vol 8(15): 1010-12). The article reviewed was Willets and Leff's (1997) 'Expressed emotion and schizophrenia: the efficacy of a staff training programme'. The collated feedback comments from the regional journal clubs is based on the format proposed by Cormack (1991). The views expressed in this article are those of the journal club members and not necessarily those of the NPNR.

Attitude of Health Personnel↗
PubMedDate not supplied

Fit for purpose? Promoting the human side of mental health nursing.

Currently, preparation of mental health (MH) nurses appears to emphasize tangible, highly visible skills acquisition. While few credible MH nurses would argue with the need for some acquisition of skills during nurse training, it is the emphasis on this acquisition of skills at the expense of the development of certain other qualities that is questionable. This article argues that the 'human side' of MH nursing should not be forgotten or ignored and draws attention to evidence of the invisibility of some aspects of MH nursing. It also draws attention to how 'human-focused' MH nursing practice may be inhibited by market forces, the pressures of economic restraints and the current preoccupation with 'quick-fixes'. It points out that within the field of psychiatry and MH care, there is evidence that some nurses have returned to 1930s neo-Darwinian perspectives of the mind. The article suggests that it is unlikely that current MH nurse training, with its emphasis on neurobiology and masculine approaches to care, adequately prepares MH nurses for ways of working which are described in this article as the 'proper focus of nursing'. Additionally, the article points out that a view of the development of MH nurse training that includes more training in psychotherapeutic approaches to care is not evidence of a fanciful, unrealistic or Utopian view of MH nurse preparation.

Humans↗
PubMedDate not supplied

To record or not to record: documentation in clinical supervision.

Despite the continued interest of nurses in clinical supervision there remain many unanswered questions and unresolved issues. One such key issue is that of record keeping within clinical supervision. Consequently, this article reviews the limited literature that addresses this issue. It is evident that there are three principle discrete positions regarding recording in supervision and these are summarized as (1) the superviser records minimum data to meet the needs of audit (2) the supervisee makes extensive notes for his/her learning journal, reflective diary and (3) the superviser records headings or key words to be used as an aide-mèmoire. The article then uses three case studies to illustrate particular concerns that the trainee supervisees have raised with regard to record keeping that centre around these three positions, and discusses the issues that arise from these concerns. As a result of this discussion, the author reasons that, when entering supervision, either as a new superviser or as a supervisee, it may well be necessary and beneficial to give mind to issues of recording. While it is unlikely that there is one 'perfect way' that will suit every practitioner, the article concludes with some general guidelines whih may help in this deliberation.

Clinical Competence↗