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Psychological care by nurses, paramedical and medical staff: essential developments for the general hospitals.

To date clinical psychologists and psychiatrists have given sparse attention to the development of clinical services within general hospitals, despite a literature demonstrating high levels of need. It is argued that attempts to reverse this situation must resolve long-standing obstacles in attitude and practice within the medical and nursing professions as well as the apparent ambivalence of psychologists and psychiatrists towards the endeavour. If projected developments are to hold credence, planned changes in practice must emphasize a preventive approach towards psychological care and must do this primarily through existing resources; that is, the nursing and paramedical professions. A scheme of psychological care designed to be operated by nurses and other professions is outlined. It depends on teaching and supervision by psychologists and psychiatrists, and it emphasizes the basic skills of monitoring psychological state, caring by informing, emotional care and basic counselling. The absorption of these practices into the daily routine is essential in order that psychological care becomes a standard provision for all seriously ill and injured people. Approaches to training are reviewed and an overview is given of the author's experiences in promoting such a scheme within a renal unit.

Counseling↗

Strategies to improve the performance of learners in a nursing college. Part I: Issues pertaining to nursing education.

The aim of this contextual, exploratory, descriptive and qualitative study was to describe strategies to improve the performance of learners in a nursing college. The article seeks to deal with factors relating to nursing education that contribute to the poor performance of learners and to outline related strategies to improve the situation. Three focus group interviews were conducted. One group was formed by seven tutors, and the other two groups were formed by fourth-year learners following a four-year comprehensive diploma course. All participants voluntarily took part in the study. Data was analyzed using the descriptive method of open coding by Tesch (in Creswell, 1994:154-156). Trustworthiness was ensured in accordance with Lincoln and Guba's (1985:290-326) principles of credibility, conformability, transferability and dependability. The findings were categorized into issues pertaining to nursing education as follows: curriculum overload; lack of theory and practice integration; teaching and assessment methods that do not promote critical thinking; tutors' lack of skills and experience; inadequate preparation of tutors for lectures; insufficient knowledge of tutors regarding outcomes-based education approach to teaching and learning; inadequate process of remedial teaching; discrepancies between tutors' marking; lack of clinical role-models and high expectations from the affiliated university as regards standards of nursing development programme by the staff development committee of the nursing college under study for implementation. Future research should focus on the effectiveness of the described strategies to improve the learners' performance. It is also recommended that similar studies be conducted or replicated in other nursing colleges to address the problem of poor performance of learners engaged in a four-year comprehensive diploma course.

Curriculum↗

Pharmacy staff training and development: upside-down thinking in a changing profession.

We suggest that the most fundamental change in staff development that must occur is recognition of the need for a professional belief system as the basis for any pharmaceutical care activity. Values derived from fundamental moral ideals and professional beliefs foster the development of attitudes and behaviors. It would be wrong to suggest or imply that such a change need only occur in postbaccalaureate training. The development of personal and professional value systems in existing primary professional training programs is inadequate--we do not yet do enough to develop people before they enter practice. Nevertheless, to say that this failure of the professional education system precludes us from taking action within professional departments is unwise. The primary skills that must be developed during the next decade involve the ability of the practitioner to competently make informed, patient-specific decisions necessary for effective pharmaceutical care. Such decisions are made not only on the basis of a practitioner's knowledge but on the basis of his or her beliefs and values as well. The practitioner also must be willing to assume responsibility for the consequences of those decisions. The pharmacist who professes to deliver pharmaceutical care can no longer be shielded by assigning to the physician the ultimate responsibility for the patient's drug-therapy outcomes. Facilitating the development of a value system and attitude that enhance the pharmacist's ability to make such decisions must be a principal focus of staff training and development in the coming years.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Pharmacy, Continuing↗

Clinical services provided by staff pharmacists in a community hospital.

A program for developing staff pharmacists' clinical skills and documenting pharmacists' clinical interventions in a large community teaching hospital is described. A coordinator hired in 1984 to develop clinical pharmacy services began a didactic and experiential program for baccalaureate-level staff pharmacists. Fourteen educational modules are supplemented by journal and textbook articles and small-group discussions of clinical cases, and the clinical coordinator provides individual training on the patient-care units for each pharmacist. Monitoring of clinical pharmacy services began in June 1987; each intervention provided by a pharmacist is recorded on a specially designed form. A target-drug program is used to document cost avoidance achieved through clinical services. Information collected through these monitoring activities is used to educate the pharmacy staff, shared with the pharmacy and therapeutics committee, and used to monitor prescribing patterns of individual physicians. The data are used in the hospital's productivity-monitoring system. All pharmacists who were on staff in 1984 have completed the educational modules, and all new employees are in the process. Since monitoring began, the number of clinical interventions has averaged 2098 per month. Cost avoidance has averaged $9306 per month. Over a five-year period, the development of staff pharmacists' clinical services raised the level of professional practice, produced substantial cost avoidance, and increased the number of pharmacist interventions in medication use.

Costs and Cost Analysis↗

Concept mapping as a critical thinking tool for nurse educators.

Nursing educators must use teaching strategies designed to develop critical thinkers. Concept mapping helps fulfill this goal. Staff development instructors should continue the development of new nurse critical thinking skills using concept maps in a variety of ways.

Clinical Competence↗

Building bridges...and strengthening nursing.

In light of current nursing employment trends, nurses and employment specialists in one rural northern Iowa healthcare organization are collaborating to retain and recruit nurses. The purpose of this article is to describe how these individuals worked toward a comprehensive, cohesive approach to the development, implementation, and evaluation of learning opportunities that support these efforts. Staff development educators played key roles in developing program purposes, descriptions, curriculum, and outcome measures.

Humans↗

Eight strategies to stretch your educational resources.

Despite the reduction in resources for staff development in home care, the need of the clinical staff for orientation and continuing education remains. Meeting educational needs cost-effectively in the current environment will require creativity, innovation, and a commitment to explore new options.

Community Health Nursing↗