Roger Watson

Nursing research

Essentials of building a career in nursing research

Background Nursing research is fundamental to driving evidence-based practice and achieving safe outcomes for patients. Underpinning the discussion in this paper are nurse researchers who thought strategically during their undergraduate and postgraduate studies to build a body of credible research influencing patient outcomes and, in so doing, establish their careers. Aim To provide an overview of some of the career essentials that support a transition in role for the beginner or emerging researcher, otherwise known as the early career researcher. Discussion Early career researchers need to acquire research competencies, to get involved in research teams, and to understand the research landscape and the various associated subtleties/vagaries and career trajectories. This is fundamental for establishing their credibility as researchers, and enabling them to undertake research that will influence policy and practice. Conclusion Establishing a research career is challenging, and takes time, effort, patience, perseverance and commitment. For beginner researchers, collegial support and mentoring are essential to support a viable, professional, sustainable, enquiring profession, and a satisfying career. Implications for practice Building individual capabilities and collaborative research teams together is fundamental to research success in adapting to new roles and workplaces.

Quantitative research

This article describes the basic tenets of quantitative research. The concepts of dependent and independent variables are addressed and the concept of measurement and its associated issues, such as error, reliability and validity, are explored. Experiments and surveys – the principal research designs in quantitative research – are described and key features explained. The importance of the double-blind randomised controlled trial is emphasised, alongside the importance of longitudinal surveys, as opposed to cross-sectional surveys. Essential features of data storage are covered, with an emphasis on safe, anonymous storage. Finally, the article explores the analysis of quantitative data, considering what may be analysed and the main uses of statistics in analysis.

Preparing nurses to work in primary care: educators’ perspectives

Aim To report nurse educators’ perspectives of the appropriateness of pre-registration nursing education programmes in preparing nurses to practise in primary care. Method Data were collected through semi-structured telephone and face-to-face interviews with eight nurse educators, and were subject to thematic analysis. Findings Nurse educators believed that nursing education programmes did not adequately prepare newly qualified nurses to work in primary care because they provided limited experience in this setting. Conclusion Factors such as shortage of practice placements in primary care and lack of mentors to supervise and support students were identified as major barriers to student learning and subsequent preparedness to work in primary care.

Measuring competence, self-reported competence and self-efficacy in pre-registration...

Aim To measure competence, self-reported competence and self-efficacy; explore any differences between cohorts and student entry criteria; and explore the relationship between competence, self-reported competence, support and self-efficacy. Method All students undertook a three-station objective structured clinical examination (OSCE) and had previously completed a questionnaire, which included measures of self-reported competence, support and self-efficacy. The performance of two single year cohorts enabled measurement of competence development and progression. Results Students were competent in the core generalist skills of communication and hand decontamination but demonstrated low levels of numeracy. Conclusion Doubts are raised about the explanatory value or practical use of social cognitive theory in pre-registration curricula and questions are raised about the value of self-reported competence. This has implications for nursing and midwifery curricula, which emphasise the importance of self-assessment.

Employment experiences of older nurses and midwives in the NHS

Aim To examine the employment experiences of older nurses and midwives working in the NHS. Method A total of 27 semi-structured telephone interviews were conducted with nurses and midwives to identify positive and negative aspects of their working lives in the NHS. The interviewees were selected from a potential pool of 87 nurses and midwives who had consented to be involved in an earlier part of the study. Data were analysed using QSR NVivo 7.0. Findings Positive and negative issues were identified as having an impact on the quality of working life. These included: access to training, change and Agenda for Change (AfC), quality of management, work demands, patient/colleague contact and nursing and midwifery as a career. Conclusion This study highlighted a number of issues relevant to older nurses and midwives that warrant further study and attention. These include access to training and continuing professional development, issues relating to change and AfC , and general work demands including workload, resources and morale. The ability of staff to remain healthy, committed and able to deliver quality care can be compromised in cases where the staff experience is negative.

Introduction to the Practice of Statistics

This is a very well-written and beautifully presented book. It is north American in origin and, while it will be invaluable for teachers of statistics to nurses and other healthcare professionals, it is probably not suitable for many preor post-registration students in health in the UK. The material is quite advanced and, while well illustrated, exemplified and with numerous examples for students, it takes a fairly mathematical approach in places. Nevertheless, the book has much to commend it, including a CD-ROM package containing tutorials, a statistical package, solutions based on the exercises in the text and case studies.

Nurses’ decision-making in clinical practice

Aim To identify what decisions nurses make in medical, surgical and critical care areas and compare the results. Method A clinical decision-making questionnaire (CDMQ) consisting of 15 statements was developed. A total of 60 nurses completed the questionnaire: 20 from each of three clinical areas. Results Most nurses, in all specialties, regularly made clinical decisions on direct patient care, which included providing basic nursing care and psychological support, and teaching patients and/or family members. Although nurses in all specialties regularly managed the work environment, they did not make decisions on the ward or unit budget, supervise junior staff or mentor student nurses. Critical care nurses regularly made decisions on their extended roles, such as acting in emergency situations and deciding to change patient medication, while medical and surgical nurses only did this occasionally. Length of clinical experience is significantly related to the frequency of decision-making. Conclusion The decisions nurses make are directly related to the clinical areas in which they work. However, it would be interesting to know if nurses showed particular aptitudes for different types and levels of decision-making and if this is related to other factors such as personality, education and experience in nursing.

Older nurses and employment decisions

Aim To investigate the options, decisions and outcomes for nurses aged over 50 in terms of remaining in, retiring from, or returning to, work in the NHS. Method Interviews were conducted with 18 employers, advisers and policy makers linked to the nursing labour market. They were conducted by telephone (n=14) or face to face (n=4), recorded (with consent), transcribed and analysed thematically. Interviews were also held with 84 older nurses who were remaining in nursing, had retired or had returned to nursing. One focus group was held with older nurses who ‘remained’ in Scotland (n=11) and the rest of the data were collected in face-to-face and telephone interviews (n=73). Again, interviews were recorded (with consent), transcribed and analysed thematically. Results There is a gap between the rhetoric of policy and the implementation of practice in the employment of older nurses. Conclusion Older nurses could continue to make a valuable contribution to the NHS, especially in light of the shortage of nurses, but their value is not always recognised. If older nurses are to continue making a contribution then they need good advice about employment, retirement and pension options.

Learning from carers’ experiences: helping older people with dementia to eat and drink

Eating and drinking difficulties are common in people with dementia and yet some health staff are inclined to neglect this important area of care. This article explores how, combined with the skills of nurses, the experiences of those caring for relatives with dementia can help potential problems to be avoided.

Resuscitation decision making and older people

Public expectations of the success of resuscitation have been raised in recent years. However, reality does not always match these expectations. Media attention has highlighted the fact that decisions about resuscitation have, in the past, sometimes been ad hoc and not backed by strict protocol. This article draws attention to the issues and suggests how nurses may improve their skills in helping patients and families decide whether a resuscitation attempt is appropriate.

Eating difficulty in older people with dementia

Difficulty with feeding is a common problem among people with dementia and may pose ethical problems for the care team if decisions about continued feeding arise. Thorough assessment can help with successful management and a team approach, with the full involvement of relatives, is advocated.

Restraint: its use and misuse in brief the care of older people

Restraint is an emotive issue, with legal and ethical dimensions, as well as psychological and physical effects on the person being restrained. Can its use ever be justified in the care of older people?

Medications and older people

The key to benefiting older people through medication lies in the proper diagnosis of...

Controlling body temperature in adults

Aims and intended learning outcomes

The aims of this article...

Hypothermia