Deidre Wild

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How upskilling nurses can solve the care home crisis

Call for specialist gerontological training and online learning networks

Culture change in care homes: development and facilitation

This article is the second of a two-part series that explores a programme of culture change in care homes. In this article, the authors describe their independent development and facilitation of a flexible learning programme for care homes, designed to meet a quality improvement request made by a care home company. The two selected care homes’ staff conducted a review of their care culture, as a precursor to their creation of a new care philosophy. These activities provided a firm foundation from which the homes could, in theory, become a Remedial Enterprise Active Learning care home. Although the learning programme was not completed due to unavoidable circumstances, the staff’s experiences highlight some of the challenges and successes that may be experienced when seeking to improve care homes’ learning culture and practice.

Digital skills training in care homes: achievement

This article describes digital skills training (DST) for staff and later, residents, as part of a programme of culture change in a large care home with nursing in Glasgow. It presents the successes and challenges arising from DST from the perspectives of the two volunteer information technology (IT) champions (Thomas Sloan and John Thomson), who were also staff members. Using their written reports, questionnaires and subsequent conversations, the IT champions recall the challenges and gains for staff and residents as a result of their initial training. This is supplemented by a follow-up on IT activities in the 18 months after the introduction period.

Implementing digital skills training in care homes: a literature review

This article is the first of a two-part series that informs and describes digital skills training using a dedicated console computer provided for staff and residents in a care home setting. This was part of a programme of culture change in a large care home with nursing in Glasgow, Scotland. The literature review shows that over the past decade there has been a gradual increase in the use of digital technology by staff and older people in community settings including care homes. Policy from the European Commission presents a persuasive argument for the advancement of technology-enabled care to counter the future impact of an increased number of people of advanced age on finite health and social care resources. The psychosocial and environmental issues that inhibit or enhance the acquisition of digital skills in care homes are considered and include the identification of exemplar schemes and the support involved.

Attitudes towards caring for older people: findings and recommendations for practice

Aim To investigate the attitudes of healthcare professionals towards working with older people, including their perception of how other professionals perceived their work in gerontology. Method Data were collected using a 20-item Multifactorial Attitudes Questionnaire (MAQ) in the West of Scotland with a five-point Likert scale for responses ranging from strongly agree to strongly disagree. Questionnaires were distributed to hospitals and community settings by post and by hand in 1999 and 2009, and also by email in 2009. Results In total, 376 healthcare staff working in primary and secondary services not exclusive to older people completed the MAQ in 1999, and 546 staff responded in 2009. The results showed that, although the respondents in 1999 and 2009 were enthusiastic and positive in their approach towards caring for older people, their work carried little professional kudos. Working conditions and the working environment were regarded as detrimental to recruitment of staff in gerontology, and respondents did not think that other health professionals valued their gerontological expertise. Conclusion The use of the MAQ in 1999 and 2009 enabled a comparative analysis of two studies completed a decade apart. Comparison of the MAQ results from 1999 and 2009 show that attitudes towards the care of older people as a recognised specialism have remained largely unchanged, despite a decade of major policy changes to include gerontology in pre- and post-registration nurse training. This finding does not bode well for attracting nurses into a career in gerontology. As a consequence, with increasing numbers of older people living in Scotland, and worldwide, the care and wellbeing of this group may be compromised at a time when it is most needed. The lead author (AK) has used the MAQ for an international study with colleagues from Germany, Sweden, Japan, Slovenia and the US, the results of which will be available shortly.

Attitudes towards caring for older people: literature review and methodology

Care of older people is often referred to as a ‘Cinderella’ service and is not seen as an attractive career option in health care, but with the global population continuing to age, caring for this group will become increasingly important. This article outlines the literature that formed the basis for two studies investigating the attitudes of healthcare staff towards working with older people, including respondents’ perceptions of other healthcare professionals’ attitudes toward this important area of work. The Multifactorial Attitudes Questionnaire was designed to examine five major themes identified from the literature: ageism; learning environment; working environment; professional esteem; and specialist status. This study is presented in two parts: this article discusses the literature and the design of the questionnaire. The second article, to be published in a subsequent issue of the journal, presents the results from two studies done in Scotland, the first in 1999, with a replication study in 2009.

Coming home from war: a literature review

This, the last of three literature reviews, builds on previous articles concerned with the stressors and stresses of pre-deployment (Wild 2003a) and deployment (Wild 2003b) to war in general, and the 1991 Gulf War (GW) in particular.

Participation in warfare: a literature review

Last month’s Emergency Nurse article by Wild (2003) presented literature concerning the potential stressors and stresses of going to war, pre-deployment to war in general and the Gulf War (GW) of 1991 in particular. Attention now turns to the next phase of participation in warfare, deployment, in which preparations for and anticipations of warfare come to fruition. The literature focuses on the deployment experience of GW medical, nursing and paramedical veterans. It addresses the uniqueness of the war, its environmental and potential health stressors, protective measures, occupational and ethical challenges, and conventional and unconventional weaponry stressors.

Going to war: a literature review

During the Gulf War (GW) 1991, many NHS hospitals were placed on standby to receive casualties evacuated from Saudi Arabia. This included transferring patients to free up beds and wards designated for war casualty care, purchasing additional life saving equipment, placing suitably qualified staff often with surgical, trauma and burns experience on standby, increasing security and setting up in-house training to meet the potential and unfamiliar needs of GW casualties.

Trauma course content after the gulf war

The Gulf War ended in the Spring of 1991. It represented a major departure from previous wars, in that it was the first modern war to involve British troops under the threatened use of nuclear, biological and chemical (NBC) warfare agents, as well as those of conventional weaponry (bullets, grenades, mortars, shells; bombs, missiles and mines) (Knudson 1991). In addition, and unlike other UK wars post World War II, the casualty evacuation system in the Gulf (Martin 1991) was set to return casualties speedily back to many NHS hospitals placed on standby in the UK (O’Bryne 1991). These circumstances required a rapid and spontaneous training of standby NHS nursing staff, who as civilians, were unlikely to have been familiar with the causes and effects of either conventional or unconventional warfare (Wild and Brooking 1991).