Educating nurses. Interview by Tom Keighley.
Explore the source record for details and available documents.
Education, Nursing, Baccalaureate↗
Biomedical subjects
T Butterworth
Publications and source records attributed to T Butterworth.
The clinical skills of community psychiatric nurses working with patients who have severe and enduring mental health problems: an empirical analysis.
This study describes the use of reliable scales to rate the clinical skills of mental health nurses when working with individuals and families with severe mental health problems. The Cognitive Therapy Scale and the Schizophrenia Family Work Scale were adapted for the study and were shown to have good inter-rater reliability when assessing audio-taped interviews carried out by mental health nurses during their usual course of work with patients with severe mental health problems and their families. The sample of mental health nurses studied were shown to have significantly better general therapy skills than specific cognitive therapy technical skills. The implications for training are discussed.
Clinical Competence↗
Clinical supervision: insider reports of a private world.
An exploratory study, funded by the Department of Health, London and the Scottish Home and Health Department, Edinburgh, was conducted over an 18-month period to provide an informed view on possible assessment tools that could be used to assess the impact of clinical supervision (CS) in nursing and to report on the CS activities in 23 selected sites in England and Scotland. The study not only examined the utility of several standardized research instruments, to be reported separately, but also explored the experience of a small sub-sample of nurses (n = 34) engaged in CS, as supervisors and supervisees. Interviews were undertaken to help better understand some of the issues involved around the domains of structure, process and outcome. Respondents reported an enthusiasm for the opportunity to talk meaningfully to a trusted colleague about their personal circumstances at work. Such opportunities were particularly welcomed by nurses who wished to reflect upon their own practice with patients, especially when dealing with their clinical conditions which were upsetting, or otherwise challenging, and sometimes harrowing. Substantive and methodological areas of interest for future research are suggested.
Adult↗
Establishing good practices in continuing care: a descriptive study of community nursing services for people with HIV infection.
This paper presents findings from a 2-year study of community nursing services for people affected by HIV infection in six health authorities in England. The research, commissioned by the Department of Health, England, aimed to identify the main bridges and barriers to effective home nursing care, focusing on discharge co-ordination, district nursing and multi-agency collaboration. Using a triangulated, case study approach, the main methods of data collection included non-participant observation, case note analysis, semi-structured staff interviews, a postal questionnaire of district nurses and a series of focus groups with service users. Study sites included three cities and surrounding districts in the north west, north and south east of England. Findings suggest there is considerable room for improvement in discharge planning and that good practice is not the preserve of specialist units. District nurses are shown to be willing providers of the majority of home nursing care to this client group, but there is a need for more focused training, greater use of care co-ordinators and more emotional and managerial support.
Adult↗
Perceived professional support and the use of blocking behaviours by hospice nurses.
A prospective study of the impact of training 41 hospice nurses in assessment skills was used to test hypotheses that blocking behaviours would be used more when patients disclosed feelings and used less when nurses perceived that they had satisfactory professional support. Each nurse was asked to assess a patient's current problems before and after feedback training and 8 months later. Audiotape recordings of these interviews were rated by trained raters. They determined the frequency of nurses' responses which had the function of blocking patient disclosure and the emotional level of patient disclosure. Before each patient assessment each nurse was interviewed and questionnaires administered to measure her perceptions of the support she received. Blocking behaviours were most evident when patients disclosed their feelings (Kendalls r = 0.36, P < 0.001). In interviews containing most patient disclosure of feeling, blocking was significantly less (r = -0.24, P < 0.5) when the nurse felt that practical help would be available if needed and when the nurse felt that her direct supervisor was concerned about the nurse's own welfare (r = -0.37, P < 0.005).
Emotions↗
The learning career in the community setting: a phenomenological study of a Project 2000 placement.
The findings of one element of an English National Board-funded research study conducted in two phases between 1989 and 1992 are discussed. The study examined one aspect of the new Project 2000 courses introduced in 13 'demonstration districts' in England in the autumn of 1989. During Phase 2 of the study (1991-1992). 14 district nursing sisters and 12 of the students they supervised were interviewed. Data were re-transcribed and interpreted in 1993; the interpretation was based on a phenomenological paradigm which focused on the subjective perceptions of students and supervisors. Participants identified 'learning', as it took place in the community setting, as a sequential process, which is referred to here as the 'learning career'. Using terminology adopted by participants themselves; the authors identify the stages of the 'learning career' as:'encountering reality'; 'having a go' 'gaining confidence'; 'thinking through and understanding'; 'developing ideas'; 'being independent'; and 'being assessed'. Supervisors could ease their students' passage through this complex and anxiety-provoking sequence of events in a number of ways. They could demonstrate their practice and provide opportunities for students to gain experience for themselves; they could teach their students about nursing, and enable them to reflect on their own practice; and they could also monitor and assess their students' work.
Community Health Nursing↗
First steps towards evaluating clinical supervision in nursing and health visiting. I. Theory, policy and practice development. A review.
The subject of clinical supervision for nurses and health visitors in the UK is considered in this paper. The paper highlights recent debates in thinking and rapid developments in practice. The original concept of clinical supervision, its theoretical propositions and development, recent policy influences and current strategies for evaluation are debated.
Community Health Nursing↗
The current status and future challenges of psychiatric/mental health nursing.
To obtain a global picture of the current status of nursing education and nursing practice in the mental health/psychiatric field, the International Council of Nurses (ICN) sent a questionnaire to 23 of its 101 member associations. The basis for the selection was to obtain information from a broad spectrum of different associations, e.g. state of development--economic and political, language, and geographical region. Of these, 16 (or 69%) returned completed questionnaires, often accompanied by extensive supporting documentation. In addition, four nurses' associations in Africa completed the questionnaire during staff field visits in that region. This paper makes reference to the responses received to the questionnaire and some verbatim quotes are included.
Deinstitutionalization↗
Working in partnership with people who use services; reaffirming the foundations of practice for Mental Health Nursing.
This paper reports on work produced by a Government Review of Mental Health Nursing in England conducted in 1993/4. The Review reported to the British Government in January 1994 and offered 42 recommendations for their consideration. At the heart of the Review Report was a determination that patients, carers and all people who use services should be engaged in a new partnership with nurses in the delivery of care. Within the 42 recommendations there are a number which relate particularly to developing this partnership. This paper discusses these recommendations and the issues which surround them.
Civil Rights↗
Triage: a literature review 1985-1993.
Following an extensive literature review of Accident and Emergency (A & E) nursing from 1985-1993, the authors focused upon triage. A wide range of issues related to triage and its use in A & E departments are examined. An appendix is included to clarify major research finds in this area. Many of the claims made regarding triage require further investigation.
Emergency Nursing↗
The time commitment of the community nursing services to Project 2000.
As part of an English National Board funded research study, the authors sent questionnaires to 2500 individuals with community nursing qualifications. The survey was complemented by a series of interviews with community nurse managers. Data indicated that community nurses were spending very considerable amounts of time with students. The number of placements provided per year varied considerably from one respondent to another, as did the average duration of a placement. Community nurses were providing community experience for a variety of types of nursing students, as well as students of other professions, and the time commitment involved placed them under considerable strain. The authors conclude that there is a need to recognise the time given by community nurses to work with students, and the resource implications of this commitment.
Clinical Competence↗
Grief support in accident and emergency nursing: a literature review 1985-1993.
On completing a wide ranging review of literature related to Accident and Emergency (A & E) nursing, the authors chose to focus upon grief support. The literature ranges from personal experiences to large scale research. A table of studies is included to clarify major research findings in this area. The article concludes by recommending long term support for bereaved relatives and research to demonstrate the value of support for relatives in the community.
Emergency Nursing↗
Clinical support and the Project 2000 nursing student: factors influencing this process.
This paper reports on research commissioned by the English National Board for Nursing, Midwifery and Health Visiting into mentorship and clinical support arrangements for Project 2000 nursing students in the adult and mental health branches. Interviews and observation data were gathered from staff and students in three of the demonstration centres. Findings showed that the terms 'mentorship', 'assessor' and 'supervisor' were used interchangeably and covered diverse roles in both clinical and community settings. Generally there was an impression that staff were willing to help students learn from their experience but felt unprepared for the 'new nursing students'. Several factors emerged which seemed either to promote satisfactory experiences for students or inhibit their learning and enjoyment of the placement. These are discussed under the themes 'supernumerary status', 'team spirit', 'theory and practice', 'diploma level practice' and 'organization of nursing teams'.
Education, Nursing↗
The implementation of Project 2000 in the community: a new perspective on the community nurse's role.
This paper considers some of the initiatives taken by community nurses in England in implementing Project 2000 placements. The data were obtained during an English National Board funded study in two phases. The first phase involved a series of exploratory interviews, a postal questionnaire survey, and semi-structured interviews with 15 managers. In phase two, one Project 2000 demonstration district was studied in depth by means of interviews complemented by small-scale questionnaire studies. Community nurses had confronted a number of difficulties in implementing Project 2000. Among the most serious of these were shortage of time, poor communication with the colleges of nursing and lack of preparation. As a consequence, community nurses took what they saw as independent approaches to students' placements. Many set their own aims and objectives for placements and produced written guidelines and teaching plans for students. Many also asserted the importance of their role in the assessment of students' practical work.
Attitude of Health Personnel↗
Identifying the characteristics of optimum practice: findings from a survey of practice experts in nursing, midwifery and health visiting.
In a questionnaire survey in England of 1221 practising nurses, midwives and health visitors, 18 key characteristics of optimum practice, made up from 77 sub-item categories, were identified by respondents. Five open-ended questions asked respondents to consider various aspects of optimum practice and to comment on factors which encouraged those in practice to deliver care of the highest quality. Consensus of view was obtained through a Delphi approach. The researchers offer commentary on the implications of this research for commissioners, providers and the professions and suggest action for those concerned with the provision of health care.
Adult↗
Working in partnership: a collaborative approach to care. The review of mental health nursing.
The first major review of psychiatric mental health nursing in England since 1968 is now complete. The review was announced in 1992 by the Department of Health, at the Royal College of Nursing Annual Congress. A steering group was convened to conduct a review and its report was published in 1994. At the outset, the multidisciplinary group aimed to identify requirements for skilled nursing responsive to patient need, into the next century. The chairman of the review summarizes in this paper the main issues that characterize its findings. The 42 recommendations are abstracted at the end of this paper, by subject headings from the published report.
Clinical Competence↗
Training in psychosocial intervention: the impact on the role of community psychiatric nurses.
A group of community psychiatric nurses (CPNs) received training via a short part-time course to deliver psychosocial intervention (PI) to families caring for a relative with schizophrenia living at home. The effects on CPNs of training in PI were examined by measuring, over time, a number of variables which reflected; CPNs' attitudes to schizophrenia, their skills, specific aspects of their role (such as visit length and frequency, caseload composition, etc.), and relationships with other disciplines. Analysis of the information showed that CPNs trained in PI changed their attitude to schizophrenia very little. However, evidence was obtained that CPNs' attitudes moved towards behaviour therapy as a preferred treatment approach. All CPNs who received training were competent in the component and global skills of PI at the end of training. These scores derived from blindly rated audiotaped recordings of CPN intervention. The CPNs estimated that caseload size and the proportion of people on caseloads with a diagnosis of schizophrenia did not alter. However, significant increases in the length of CPN sessions with people with schizophrenia and their families were observed. The CPN's liaison role with consumer groups, such as the National Schizophrenia Fellowship, significantly improved. Multi-disciplinary colleagues gave PI-trained CPNs a mixed reaction. Some CPN colleagues seemed pleased to transfer families to the PI-trained CPNs' caseloads, whilst others clearly regarded the PI-trained CPNs as a threat. Overall, the most encouraging reaction came from psychologists and psychiatrists.
Adult↗
The emerging role of the nurse teacher in Project 2000 programmes in England: a literature review.
This paper explores the literature on the role of the nurse teacher in the United Kingdom, in order to support a research study on the role of the nurse teacher as it emerges in Project 2000 programmes in England. Explicit within the reform of nurse education is a change in the role of the teacher. It is being influenced, first, by the creation of colleges of nursing and midwifery and their links to higher education, secondly, by the content and academic level of the course and, thirdly, by the supernumerary status of the student. Studies carried out on the activities nurse teachers undertake highlight the complex and multifaceted nature of the role. Excessive paper work, meetings and lack of autonomy are given as dissatisfying aspects of their work leaving only a small proportion of their time for classroom and clinical teaching. The literature suggests that the nurse teacher is required in Project 2000 to be a nurse, a teacher, a graduate in a specialist subject and clinically and academically credible. The study, which is mentioned briefly in this paper, will critically analyse the key components of the role of the nurse teacher as it emerges in the Project 2000 courses in England. The methodology and findings will be discussed in a later paper.
Counseling↗