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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

The reflective researcher : Analysing research experiences from doing ethnography in a hospital

Clinical nursing professoriate : Reflections on Australian experiences

Assessment of learning in contemporary nurse education : Do we need standardised examination for nurse registration?

  • Authors: Wellard, Sally , Bethune, Elizabeth , Heggen, Kristin
  • Date: 2007
  • Type: Text , Journal article
  • Relation: Nurse Education Today Vol. 27, no. 1 (2007), p. 68-72
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  • Description: In Australia and Norway final examinations to determine eligibility for registration as a nurse were discontinued during the period when nurse education moved into the higher education sector. In response to recent calls for the reintroduction of final examinations we explore the range of knowledge needs for the practice of nursing. These various forms of knowledge demand different forms of mediation and acquisition as well as assessment. There are numerous problems identified in the literature about the shortcomings of examinations as the foundation of assessing clinically based professions. There is a need to develop systems of appropriate assessment to ensure that graduates of nursing demonstrate adequate knowledge and competence to enter their profession. © 2006 Elsevier Ltd. All rights reserved.
  • Description: C1
  • Description: 2003002546

The nursing home as a home : A field study of residents' daily life in the common living rooms

  • Authors: Hauge, Solveig , Heggen, Kristin
  • Date: 2008
  • Type: Text , Journal article
  • Relation: Journal of Clinical Nursing Vol. 17, no. 4 (Feb 2008), p. 460-467
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  • Description: Aim. This Norwegian-based study investigates how and to what extent the idea of the nursing home as a home has been realized. Background. For the last two decades, Norway, as other Western Country has had an explicit national policy that nursing homes should become more like homes. The research literature indicates that residents in nursing home seem to lack the opportunities to maintain a private sphere. Design. A field study design was conducted. Methods. Data were collected in 1999 in two long-term units in a traditional nursing home by using participant observation and interviewing the residents. A phenomenological hermeneutic analysis strategy was used to get an impression of the residents' everyday life. Results. The residents spend most of their time in the common living room. The common living room has an ambiguous boundary between the public and private spheres, unlike the clear boundaries characterizing a home. The relationship among the residents is fragile, and the residents who can, withdraw from the common living room. Conclusions. Despite having single rooms and more home-like interior decoration, the residents in nursing home still have reduced opportunity to develop a private everyday lifestyle. The long-term unit examined in this research had a forced relationship between the residents, and the residents with best health resources systematically withdraw from the common area to control both where and with whom they wish to spend their time. Relevance to clinical practice. This study lays the foundation for rethinking daily routines in long-term units in nursing homes. One way to realize the idea of the nursing home as a home could be to define the living room as a clear public area and to give the residents a chance to develop a more private lifestyle by alternating between their private rooms and a public common living room.
  • Description: C1

Picture of Norwegian clinical learning laboratories for undergraduate nursing students

  • Authors: Wellard, Sally , Solvoll, Betty-Ann , Heggen, Kristin
  • Date: 2009
  • Type: Text , Journal article
  • Relation: Nurse Education in Practice Vol. 9, no. 4 (2009), p. 228-235
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  • Description: Clinical preparation for practice is a vital part of undergraduate education in nursing. This study explored contemporary constructions of clinical skills laboratories in two nursing undergraduate programs in Norway using qualitative collective case study methods. Data were gathered using individual and group interviews and observation during site visits. The data revealed slightly different ways of organizing teaching and experimenting with use of pedagogical methods to facilitate learning of technical skills as well as encouraging students to activate relevant theoretical knowledge. While there was a lively and striking enthusiasm among staff about the way learning was managed within the laboratories, the pedagogical underpinnings for their particular approaches were less certain amongst participants. The paper concludes with the necessity to provide evidence for the outcome of laboratories learning and investigate suitable pedagogical methods for effective teaching and learning of practice skills. Hence, a need for research on transfer of knowledge and skills between the different sites (academy, clinical settings, and laboratories) is identified. © 2008 Elsevier Ltd. All rights reserved.
  • Description: 2003006946

Are laboratories useful fiction? A comparison of Norwegian and Australian undergraduate nursing skills laboratories

  • Authors: Wellard, Sally , Heggen, Kristin
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Nursing & Health Sciences Vol. 12, no. 1 (2010), p. 39-44
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  • Description: Drawing on the findings from studies in Australia and Norway that explored the use of laboratories in the preparation of nursing students for entry to practice, this article identifies the pedagogical challenges for the undergraduate education of nurses. The findings from both countries are compared and, in spite of distinct differences in the level of financial investment, there are striking similarities between the ways in which laboratories are used in the two countries. The laboratories were designed to predominately represent acute care hospital environments. The participants demonstrated a high level of commitment and strongly held beliefs in the laboratory as a safe place to facilitate self-paced learning and as an environment where students can practice until they become competent and confident. However, at the same time, there was a striking lack of evidence to support these views. The participants in both countries reported a common approach to instruction: a proce! ss of teacher demonstration, followed by student repetition and practice. Variability in students' motivation also was reported and the participants especially expressed concern for those students with a low level of interest in the basic skills associated with personal care. The possibilities and limitations of using skill laboratories as part of the practical preparation for nursing are discussed, using the metaphor of laboratories as "fiction".

Evidence-based practice, risk and reconstructions of responsibility in nursing

  • Authors: Heggen, Kristin , Wellard, Sally
  • Date: 2011
  • Type: Text , Book chapter
  • Relation: Professional responsibility new horizons of praxis p. 144-158
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  • Description: "Professional Responsibility: New Horizons of Praxis addresses the manifold and complex challenges inherent in professional responsibility. Since the beginning of the 20th Century, professions have been accorded a conjoined mandate - political and moral responsibility - to serve the interests of individual's and society. The quality of professional work, how professionals understand and live out their responsibilities in practice, is a matter of pervasive concern since increasingly they have such a prominent presence in most people's lives. Until the late 1960's, professionals' roles and responsibilities were rarely questioned, but such trust has since given way to collective scepticism concerning their commitment and willingness to live up to their moral and societal obligations. Abuse of power and privilege by some professionals has contributed to decline in trust by publics, the concept of 'good work' is increasingly challenged, and politicians and policy-makers have sought to regulate and hold professions to account. It is timely, therefore, to investigate critically conflicting discourses and practices on what counts as professional responsibility, to question how professionals understand and are prepared for a life of professional responsibility, and what acting with integrity and authority looks like in practice. One of the distinctive features of this book is the combination of normative and empirical dimensions that are used to dissect this question. The authors indicate from a diversity of disciplinary perspectives how professional responsibility includes particular thoughts and warranted actions yet remains multifaceted and inarticulate"-- Provided by publisher.
  • Description: 2003009457
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