Discursive influences on clinical teaching in Australian undergraduate nursing programs
- Authors: McKenna, Lisa , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 24, no. 3 (2004), p. 229-235
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- Description: Clinical teaching is a vital, yet multidimensional component of Australian undergraduate nursing courses. Unlike other parts of curricula, clinical teaching relies on the both higher education and health care sectors to meet prescribed goals and for effective student learning to occur. As such it is influenced by discourses from within both education and health. Whilst there is considerable literature related to undergraduate nursing clinical teaching; it mainly deals with practical aspects such as effectiveness of clinical teaching or discussions of models employed. Only a small pool of literature exists that discusses the construction of clinical teaching including the factors that have influenced the development of practices both in the past and present. Using the work of Foucault, this paper examines dominant and competing discourses influencing clinical teaching through their constructions within the literature. These are discourses of academia, nursing, and economics. The discussion situates these discourses and discusses how some of the resultant issues surrounding clinical education remain largely unresolved. Crown Copyright © 2004 Published by Elsevier Ltd. All rights reserved.
- Description: C1
- Description: 2003000838
Increased unintended patient harm in nursing practise as a consequence of the dominance of economic discourses
- Authors: Heggen, Kristin , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 41, no. 3 (2004), p. 293-298
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- Description: Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
- Description: C1
- Description: 2003000837
Consumer participation in acute care settings : An Australian experience
- Authors: Wellard, Sally , Lillibridge, Jennifer , Beanland, Chris , Lewis, Michele
- Date: 2003
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 9, no. 4 (2003), p. 255-260
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- Description: Consumer partnerships have been embraced as an important component of building high quality health care services. While nurses have the greatest contact with clients in hospital, little is known of their views about consumer participation or how they facilitate that participation at the bedside. Using focus group interviews and participant observation methods, this project explored nurses' approaches to working with consumers to support their participation in health care delivery. Findings indicate a sharp contrast between the ideas that nurses expressed and the actions observed in practice. It was clear from the interviews that nurses had adopted the rhetoric surrounding consumer participation, yet observational data revealed nursing practices that excluded active participation by consumers. Factors influencing nurses' facilitation of consumer participation were identified as the division of nursing labour in the setting, limited communication between nurses and patients and environmental constraints.
- Description: C1
- Description: 2003000409
Validation of physical activity measurement for people on dialysis treatment
- Authors: Wellard, Sally
- Date: 2003
- Type: Text , Journal article
- Relation: EDTNA/ERCA Journal Vol. XXIX3, no. (2003), p. 140-142
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- Description: Chronic illness frequently contributes to diminished levels of activity, a consequent increased dependence on health related support services and reduced quality of life. Surprisingly few studies have described activity among people with end-stage renal disease (ESRD). The current study examined the utility and validity of the Human Activity Profile (HAP) for describing activity in a sample of Australians with ESRD. A descriptive design supported the primary objective of validating the use of HAP for an Australian renal population. Data was collected from 65 adults with ESRD under the care of one regional and one metropolitan renal unit in Victoria. The HAP measures physical activity across a range of activities of daily living, including a dyspnoea scale. The Sickness Impact Profile (SIP) describes activities associated with daily living in the areas of physical, psychological and independence. The HAP, SIP and a questionnaire summarising demographic and diagnostic details were administered while each person was undergoing dialysis and the results subsequently compared. This study demonstrates that HAP is a valid measure of activity levels for people with ESRD undergoing maintenance haemodialysis. Additionally, scores on SIP and HAP indicate that this group have low levels of daily activity. These findings support the use of HAP in research to understand the activity levels of ESRD patients and the factors associated with decline.
- Description: C1
- Description: 2003000407