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Issue 116 - 3 Nov 2009


JOURNAL: Nursing Inquiry
1. Exploring mental health issues
by Buus, Niels. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p177
The author reflects on the humanistic studies of mental health issues that tend to criticize the existing mental health systems. He states that medical psychiatric categories and research instruments could be used as part of humanistic studies of mental health issues because it can hold particular meaning in the collection of data to allow comparisons with other healthcare studies.

2. The power of routine and special observations: producing civility in a public acute psychiatric unit
by Hamilton, Bridget & Manias, Elizabeth. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p178-188
The power of routine and special observations: producing civility in a public acute psychiatric unit This study directly addresses controlling aspects of psychiatric nursing practice, which are currently marginalised in practice and research. We first consider the discursive tensions surrounding the mandated goal of social control in public acute psychiatric units, particularly referring to those units located within medical hospitals. We attest to the enduring social control mandate in psychiatric nursing and explore ways in which it is enacted. Specific nursing practices of ‘doing the obs’ while scanning the ward and ‘special observations’ are investigated as important activities of social control, based on findings from an ethnographic study in one acute psychiatric unit in Australia. These practices are acknowledged as key modes of nursing surveillance. Contrary to past work, they are regarded as productive for engendering civil conduct among patients in acute psychiatric settings. We reframe these activities of surveillance as liberal therapeutic practices in themselves, to the extent that they assist patients to achieve treatment goals and promote self-surveillance and self-control. Instead of effacing practices of control, we encourage nurses to discriminate between more and less liberal modes of control in everyday practice and to build their skills in liberal controlling strategies. [ABSTRACT FROM AUTHOR]

3. Negotiating clinical knowledge: a field study of psychiatric nurses’ everyday communication
by Buus, Niels. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p189-198
Negotiating clinical knowledge: a field study of psychiatric nurses’ everyday communication Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses’ production of clinical knowledge was influenced by the particular social relations on hospital wards. Empirical data stemming from an extended fieldwork at two Danish psychiatric hospital wards were interpreted using interactionistic theory and the metaphor: ‘the game of clinical knowledge’. The results indicated that the nurses’ production of clinical knowledge was highly dependent on the individual nurses’ practical ability to participate in the game. Furthermore, the nurses colluded in their mutual communication to enable the collective display and sense of knowing that protected them against explicit signs of uncertainty about the clinic. The game of clinical knowledge influenced processes of clinical decision-making among the nurses as the game added to a distorted widening of a ‘fictional distance’ between patients and the representations produced by the nurses.[ABSTRACT FROM AUTHOR]

4. As mental health nursing roles expand, is education expanding mental health nurses? an emotionally intelligent view towards preparation for psychological therapies and relatedness
by Hurley, John; Rankin, Robert. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p199-205
As mental health nursing roles expand, is education expanding mental health nurses? an emotionally intelligent view towards preparation for psychological therapies and relatedness Mental health nurses (MHN) in the UK currently occupy a challenging position. This positioning is one that offers a view of expanding roles and responsibilities in both mental health act legislation and the delivery of psychological therapies, while simultaneously generic pre-registration training is being considered. Clearly, the view from this position, although not without challenge and internal discipline dispute, can also offer growing professional prestige, influence and respect from other health disciplines, as well as the wider public. Conversely, if the training, education and strategic enactment for new MHN roles is formulated and delivered from predominantly non-MHN axiomatic and epistemological stances, MHN identity can be seriously and potentially permanently diminished. This paper offers the construct of emotional intelligence as a framework to respond to these future challenges through making individual MHN enablement a primacy. This enablement of MHNs through enhanced emotional intelligence competencies is argued as requiring priority over the standard approach of enhancing strategies alone. [ABSTRACT FROM AUTHOR]

5. From good intentions to real life: introducing crisis resolution teams in Norway
by Karlsson, Bengt et al. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p206-215
From good intentions to real life: introducing crisis resolution teams in Norway In Norway, as in most western countries, the adult services for people experiencing mental health problems have gone through major changes over the last decades. A report submitted to the Norwegian Parliament in 1997 summarized several areas of improvement in the provision of mental health-care to its population, and led to the introduction of a national mental health programme in 1998 for its implementation to be completed by 2008. The most significant recent development in Norway is ‘Crisis Resolution/Home Treatment’ (CRHT) teams that provide an alternative to acute hospital care services. The major aim of this study is to explore an emerging form of community mental health-care, and present a framework for establishment and examination of CRHT teams applying the user perspectives. An illustration of user experiences in an already established CRHT team provides a background for understanding implications of this form of service in relation to service users’ needs in acute crises. [ABSTRACT FROM AUTHOR]

6. Personality disorders: illegitimate subject positions
by Crowe, Marie. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p216-223
Personality disorders: illegitimate subject positions The diagnosis of personality disorder is common in mental health nurse settings and is a term often used without critical consideration. In clinical practice, the term personality disorder has pejorative connotations, which arise out of the way in which these behaviours are constructed as behavioural rather than psychiatric. The discursive construction of categories of personality disorder are inculcated into clinical practice and become taken-for-granted by those in practice culture. The construction of some personalities as disordered and, therefore, illegitimate becomes natural. This paper provides a critical analysis of the diagnosis and suggests an approach to mental health nursing care that is more legitimising for those people who receive psychiatric diagnoses. [ABSTRACT FROM AUTHOR]

7. Humanism in forensic psychiatry: the use of the tidal nursing model
by Jacob, Jean Daniel et al. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p224-230
Humanism in forensic psychiatry: the use of the tidal nursing model The humanist school of thought, which finds resonance in many conceptual models and theories designed to guide nursing practice, needs to be understood in the context of the total institution, where the individual is subjected to a mortification of the self, and denied autonomy. This article will engage in a critical reflection on how humanism has influenced nursing theorists and the subsequent production of conceptual models and theories, especially as they relate to the field of forensic psychiatric nursing. Although humanism provides optimism for nurse–patient relations, this article explores the incapability of such a philosophy to acknowledge the power relationships between individuals and its inability to explain the day-to-day realities experienced in forensic nursing, where the possibility of interpersonal violence reshapes nursing care.The tidal model will be discussed in detail as an example of a recently developed humanistic nursing model. Viewed from this perspective, it is clear that humanistic philosophy and its subsequent models of care are in discordance with the highly specialized field of forensic nursing. [ABSTRACT FROM AUTHOR]

8. Refining the model for an emergency department-based mental health nurse practitioner outpatient service
by Wand, Timothy et al. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p231-241
Refining the model for an emergency department-based mental health nurse practitioner outpatient service The mental health nurse practitioner (MHNP) role based in the emergency department (ED) has emerged in response to an increase in mental health-related presentations and subsequent concerns over waiting times, co-ordination of care and therapeutic intervention. The MHNP role also provides scope for the delivery of specialised primary care. Nursing authors are reporting on nurse-led outpatient clinics as a method of healthcare delivery that allows for enhanced access to health-care, particularly following hospital discharge. However, due to a lack of in-depth substantiation, this mode of service delivery requires more thorough investigation. This study describes the refinement phase undertaken before the implementation and pilot evaluation of a formalised and structured MHNP outpatient service in the ED of a large inner-city hospital in Sydney, Australia. An expert advisory panel (EAP) consisting of key local informants was convened to provide feedback on and refinement to the proposed model. This related to issues such as target population, structure and process considerations, outcome measures and interface within the overall health service. Findings from the EAP meeting are presented and discussed. The importance of linking methods with the appropriate methodology in evaluating a healthcare program is highlighted. [ABSTRACT FROM AUTHOR]

9. How patients and nurses experience the acute care psychiatric environment
by Shattell, Mona Met et al. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p242-250
How patients and nurses experience the acute care psychiatric environment The concept of the therapeutic milieu was developed when patients’ hospitalizations were long, medications were few, and one-to-one nurse–patient interactions were the norm. However, it is not clear how the notion of ‘therapeutic milieu’ is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, ‘What stands out to you about this psychiatric hospital environment?’ Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged-in by the Plexiglas-enclosed nursing station, and patients felt caged-in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse–patient relationship was yearned for by nurses, it was nearly absent from patients’ descriptions. The caring experienced by patients was mainly derived from interactions with other patients. [ABSTRACT FROM AUTHOR]

10. Creating a space for recovery-focused psychiatric nursing care
by Walsh, Jim; Stevenson et al. Nursing Inquiry, Sep 2008, Vol 15 Issue 3: p251-259
Creating a space for recovery-focused psychiatric nursing care Within contemporary mental health-care, power relationships are regularly played out between psychiatric nurses and service users. These power relationships are often imperceptible to the practicing nurse. For instance, in times of distress, service users often turn to or/and ‘construct’ discourses, beliefs and knowledge that are at odds with those which psychiatric nurses rely on to inform them of the mental status of the service user. The psychiatric nurse is in the position to impose knowledge onto service users, usually in concurrence with ‘traditional or bio-psychiatry’, without realizing or failing to acknowledge that the service user may have an alternative explanation of his/her mental health problems/experiences. In this paper, practice examples, based on the experiences of the four authors (from within and outside of services), are used to illustrate this ‘hidden’ power relationship. The authors use Foucault's ideas about: (i) government; (ii) the knowledge/power nexus and resistance; (iii) and his analytic tool of genealogy to help unravel this paradox within psychiatric nursing practice. The authors also use the emerging discourse of recovery as an alternative (and challenge) to ‘traditional bio-psychiatry’ and consider the implications for psychiatric nursing practice. [ABSTRACT FROM AUTHOR]

JOURNAL: Journal of the New York State Nurses Association
11. Overcoming barriers and facing challenges
by Sellers, C R & Whetsell MV. Journal of the New York State Nurses Association, 2009 Spring-Summer; 40 (1): p3

12. Barriers to health care for people with hearing loss: a review of the literature
by Scheier,D B. Journal of the New York State Nurses Association, 2009 Spring-Summer; 40(1): p4-10
Deaf individuals face many barriers when trying to access health care. The reasons why barriers are encountered, difficulties met as a result of the barriers, and ways that health professionals and others working with deaf people can overcome obstacles are included in this review of the literature. A brief summary of Deaf culture and history gives background information to better understand the problems. Misunderstandings by d/Deaf patients and hearing health professionals are addressed, as well as issues related to medical interpreters. This paper aims to make health professionals more aware of the needs and cultural differences that must be considered when providing care to the deaf population.

13. Returning to school: experiences of female baccalaureate registered nurse students
by Kalman M et al. Journal of the New York State Nurses Association, 2009 Spring-Summer; 40 (1): p11-6
Most nurses enter the profession at the associate degree (AD) level, however, the link between nursing education and patient outcomes supports the need for nurses to be educated at the baccalaureate level. The purpose of this phenomenological study of 11 AD nurses enrolled in a baccalaureate nursing program was to describe their perspectives on returning to school. The central question for this study was: "What are the experiences of RNs who return to school for a bachelor's degree after being nurses for at least 3 years?" A total of 11 baccalaurate nursing students were interviewed. Applying a phenomenological data analysis method, the researchers identified four themes in the context of juggling everything that was important in these students' lives: going back, sacrifices, managing, and rewards. Implications for nursing education and practice are made, including the need to encourage, support, and facilitate the process for nurses returning to school.

14. Articulating the value of psychiatric community health nurse interventions: a secondary analysis
by Sturm,B A. Journal of the New York State Nurses Association, 2009 Spring-Summer; 40 (1): p17-23
The purpose of this secondary analysis of qualitative data was to discover and articulate the nature and value of therapeutic nursing interventions (TNIs) utilized by psychiatric community health nurses (PCHNs). PCHNs encounter ethical conflict when faced with increasingly strict payment limitations on nursing practice (Sturm, 2004). This new analysis provides evidence of how TNIs, executed with a high level of sensitivity and skill, enable the PCHN to address and effectively manage the complex healthcare needs of patients with chronic mental illness. The author/researcher specifically analyzed qualitative data from two broad thematic categories of an ethnographic study of PCHN practice to explicate the nature and impact of TNIs employed by PCHNs in efforts to provide high-quality care. Specific TNIs were observed to be an integral part of the nurse-patient relationship and were executed by the PCHN, influencing patient self-esteem, socialization, and the capacity for autonomy.

Journals – Table of Contents

15. From International Journal of Nursing Practice, August 2009, Volume 15, Issue 4

15A. Maintainance of patients' dignity during hospitalization: Comparison of staff-patient observations and patient feedback through interviews
15B. Interventions to reduce psychosocial disturbance following humanitarian relief efforts involving natural disasters: An integrative review
Time for a change to assess and evaluate body temperature in clinical practice
15D. Australian nursing curricula and mental health recruitment
Coping with ageing and failing health: A qualitative study among elderly living alone
15F. Overseas trained nurses' perception of UK nurses' caring attitudes: A qualitative study
15G. The easy option? Australian findings on mothers' perception of elective caesarean as a birth choice after a prior Caesarean section
15H. An evaluation of lecturer practitioners in Ireland
15I. Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study
15J. Cardiopulmonary resuscitation knowledge among nurses working in Bahrain
15K. Turnover rate among registered nurses in Jordanian hospitals: An exploratory study
15L. Collaborative multidisciplinary team approach to fertility issues among adolescent and young adult cancer patients
15M. Implementing interdisciplinary practice change in an international health-care organization
15N. A qualitative study of the experience of oral cancer among Taiwanese men
15O. Addressing service deficits for the physically disabled in New Zealand: An action research study
15P. Parents' perceptions and needs of children's hospital discharge information

16. From The Journal of Continuing Education in Nursing, October 2009, Volume 40, Number 10

16A. Trick or treat? The impact of health care reform discussions
16B. What about social networking?
16C. Providing holistic care to bariatric patients
16D. Bulletin board basics
16E. Preparing the novice critical care nurse: A community-wide collaboration using the benefits of simulation
16F. Research education for clinical nurses: A pilot study to determine research self-efficacy in critical care nurses
16G. Creating a patient education tool
16H. Supporting nurse preceptors through online education
16I. Using a mentorship model to prepare newly graduated nurses for competency

Conferences, training and seminars

17. Patient Safety Congress 2010
The Health Service Journal and the Nursing Times have again teamed up with the NPSA, the Health Foundation, the NHS Institute for Innovation and Improvement and the Department of Health to deliver the next Patient Safety Congress.
Date: 25 - 26 May, 2010
Venue: The ICC,Broad Street,Birmingham

News – National

18. More fibre for a flat tummy
Stuff - 2 Nov 2009
Eating just a little bit more fibre could have a big impact in trimming waistlines, new research shows. American adolescents and teens who increased their fibre intake over a two-year period had significant decreases in the amount of fat around their waists, while young people whose fibre intake fell saw their bellies expand, Dr. Jaimie
N. Davis of the Keck School of Medicine at the University of Southern California in Los Angeles and her colleagues found.

19. Dunedin to get free health clinic
ODT - 30 October 2009
The prospect of a free health centre being open in central Dunedin by Christmas is being lauded by social agencies.

20. Unit for sleep disorder patients opens in Chch
TVNZ - 30 October 2009
A new dedicated unit for patients with sleep disorders has been opened at Christchurch Hospital.The unit investigates and treats patients with sleep disorders, particularly Obstructive Sleep Apnoea which can cause severe daytime sleepiness and is linked with an increase risk of car accidents.

21. One embryo nearly as good as multiples
TVNZ - 30 October 2009
Women who initially receive just one embryo during in vitro fertilization are as likely to produce a child as women implanted with two, Swedish researchers reported.

News - International

22. Flu death alarm as winter nears
The Australian - 3 Nov, 2009
CHINA'S first swine flu death has triggered fears that 100 million people could be infected after the early arrival of winter at the weekend. Premier Wen Jiabao urged tighter prevention measures as temperatures plunged below zero in Beijing for the first time this year. The capital received 15cm of snow on Sunday.,25197,26295825-23289,00.html

23. Gastric banding a 'dinosaur technique'
Sydney Morning Herald - Nov 3, 2009 
Lap band surgery, which has more than doubled in Australia in under five years, has been branded a "dinosaur" technique in the fight against obesity

24. Saudi Arabia begins flu vaccinations
Sydney Morning Herald - Nov 3, 2009 
Saudi Arabia is to begin vaccinating hundreds of thousands of health and hajj workers and domestic pilgrims against swine flu next week, a senior health official said on Monday, as flu deaths in the kingdom hit 62

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