Nursing in the year AD 2000*

40 years AD 2000 JAN classic Peggy Nuttall

Nursing in the year AD 2000*

Unknown 03.15 Komentar

Roger Watson, Editor-in-Chief

When I was very young - and even in 1975 when the lecture by Peggy Nuttall on which the paper is based was delivered - the year AD 2000 was one when we would have solved most of the problems of humanity; cars would fly and we would be able to communicate by speaking to our wristwatch. The 'crisis' in the UK National Health Service (NHS) referred to by Nuttall would no longer be an issue as economic and social progress would be such that we could look back over 25 years and laugh at our ignorance.  Well, how wrong was that assessment?  In fact, of the three things mentoined above only one has been achieved: we can speak to people via our wristwatches!  But the NHS remains in crisis and cars seem to be as dependent on tarmacadam roads as they were then.  I learned a great deal from Look and Learn magazine but I think it raised my hopes too much.

I urge you to read this excellent and prescient piece and tick off the issues which Nuttall identifies will be relevant in AD 2000: chronic ill-health; immigration; primary healthcare; retention of nurses in the workforce; the effect of night-shift working on nurses.  All of these are issues now and, while she did not refer to non-communicable diseases or global health, you feel that she could see how these would be issues in the next century.  She also points to the internal strife in nursing, that was evident then and it is evident now.

I think that this JAN classic paper from the first volume indicates the quality of some of our nursing leaders at this time, to whom we probably owe the survival of and the progress made by our profession.  It also demonstrates the vision of Founding Editor Dr James P Smith who ensured that JAN was reflecting the very best thinking about the situation of and the future of nursing; in this case 25 years on.

You can listen to this as a podcast


Reference

Nuttal P (1976) Nursing in the year AD 2000 Journal of Advanced Nursing 1, 101-110

* Peggy Nuttall was Vice Chairman, Royal College of Nursing, London and this was an address, the First Battersea Memorial Lecture, on 7 November 1975 to the Association of Integrated and Degree Courses in Nursing

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Are nursing students imposters?

imposters nursing students undrgraduates

Are nursing students imposters?

Unknown 03.38 Komentar

Roger Watson, Editor-in-Chief

I recall, having been deemed fit to manage the ward, having the keys to the ward slid along the floor to me by the charge nurse as she was going off the ward to dinner and her saying 'you're in charge'; I was a final year student nurse and it was my first time and - yes - I felt like an imposter.  Surely someone else should be doing this and not me.

This article from New Zealand, Australia and the UK by Christensen et al. (2016) titled: 'Do nursing students experience Imposter Phenomenon? An international comparison of final year undergraduate nursing students' readiness for registration' and published in JAN looks at the Imposter Phenomenon in nursing students.  The aim of the study was 'to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia, New Zealand and the UK.'  Over 200 final year nursing students were invovled and completed two questionnaires: one about preparedness to work as a nurse; and one about fear of not being able to perform properly.  The results suggest that 38.5% of the sample could be classifed as 'imposters'.  While the reasons for imposter feelings were not clear the authors conclude: 'nursing students report internalized feelings which suggest their performance and competence once qualified may be compromised' and 'it is recommended that educational programmes designed for this student cohort should be mindful of this internal conflict.'

You can listen to this as a podcast


Reference

CHRISTENSEN M., AUBEELUCK A., FERGUSSON D., CRAFT J., KNIGHT J., WIRIHANA L. & STUPPLE E. (2016) Do nursing students experience Imposter Phenomenon? An international comparison of final year undergraduate nursing students' readiness for registration. Journal of Advanced Nursing doi:10.1111/jan.13034

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Contemplations on the Tasks of Motherhood: 1976 - 2016

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Contemplations on the Tasks of Motherhood: 1976 - 2016

Unknown 03.56 Komentar

Rita H. Pickler, Editor

In the first volume of the Journal of Advanced Nursing, author, researcher, theorist, and educator Reva Rubin wrote:

Pregnancy is more than a period of gestation, growth and development of the fetus…Pregnancy is also a period of identity reformulation, a period of reordering interpersonal relationships and interpersonal space, and a period of personality maturation (Rubin 1976).

Still true.

Rubin, whose work often seems overshadowed by that of her student, mentee, and fellow theorist, Ramona Mercer (i.e. Mercer & Ferketich 1990), introduced the concept of Maternal Role Attainment in the late 1960’s. She described the maternal role as a complex cognitive and social process that is learned, reciprocal, and interactive. Rubin developed her theory through a series of case studies over her many years as nurse and teacher. She observed how mothers used their senses to become familiar with their infants. She was an early proponent of “rooming-in” and other strategies to keep mother and baby together after birth. As a nursing student in the 1970’s, I remember reading, discussing, and applying Rubin’s work to my clinical practice.

But times change and theories, and ideas, go out of style and use. And in fact, much has changed about what we know happens physically, psychologically, and socially to women during pregnancy. We know much more than we did about how a woman’s well-being affects the fetus and her child. We know that what happens during pregnancy, and even before pregnancy, can have long-lasting effects on both mother and child.

Poor pregnancy outcomes throughout the world continue to exact a toll in terms of prematurity, congenital illness, and lifelong risk for poor health. So, we might be wise to rethink Rubin’s “tasks” as important to the repertoire a pregnant woman needs in order to traverse the gap to motherhood. As a nurse long interested in promoting healthy birth outcomes, this re-reading of Rubin’s paper from 30 years ago has given me fresh ideas about ways to facilitate the work of maternal role attainment. For although the language and yes, some of the ideas need refreshing, most certainly the general notion that promoting maternal health and well-being will lead to improved health and well-being for the world’s children will never be out of style.


References

Mercer, R.T, & Ferketch. (1990) Predictors of parental attachment during early parenthood.
Journal of Advanced Nursing, 15, 268–280, DOI: 10.1111/j.1365-2648.1990.tb01813.x

Rubin, R., (1976) Maternal tasks in pregnancy. Journal of Advanced Nursing, 1, 367-376.

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It's not only patients who suffer in emergency care

emergency nurses Nursing trauma

It's not only patients who suffer in emergency care

Unknown 02.03 Komentar

Roger Watson, Editor-in-Chief

When I first read the title of this article when it arrived in manuscript form I assumed it referred to patients but then realised it referred to nurses and the effect that working in emergency care can have on them.  And it makes sense.  I always consider emergency nurses as a relatively robust bunch.  I have to confess - as a nurse who formerly and exclusively worked with older people - that emergency care never appealed to me and my very brief encounters with it as a student and in the army left me a quivering wreck...and nothing even happened.  Imagine if it had.

This article from Scotland by Morrison and Joy (2016) titled: 'Secondary traumatic stress in the emergency department' and published in JAN aimed to 'To investigate the prevalence of secondary traumatic stress among emergency nurses in the West of Scotland and explore their experiences of this.'  It used quantitaive and qualitative methods and studies 80 nurses in 4 hospitals.

The results are alarming in that 75% of nurses reported recently at least one secondary traumatic stress (STS) symptom and 39% could be classified as suffering from STS.  The work shows some similarrity and some differences from previous work on the same phenomenon in the USA.  Acknowledging some limitations of their work, the authors conclude: 'Further research is required to corroborate these results and findings and develop the evidence base further, with particular regard to the effects of STS among Emergency nurses of differing levels of experience and the impact of this on the provision of quality patient care.'

You can listen to this as a podcast

References

MORRISON L.E. & JOY J.P. (2016) Secondary traumatic stress in the emergency department Journal of Advanced Nursing doi: 1 10.1111/jan.13030

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World Sickle Cell Day

anaemia anemia sickle cell disorder

World Sickle Cell Day

Unknown 23.45 Komentar

Roger Watson, Editor-in-Chief

According to the US National Heart, Lung and Blood Institute: 'The term sickle cell disease (SCD) describes a group of inherited red blood cell disorders. People with SCD have abnormal haemoglobin, called haemoglobin S or sickle haemoglobin, in their red blood cells.' Sickle cell disorder leads to crises whereby the small blood vessels in the body become occluded leading to extreme pain in several areas of the body. Such crises require hospitalisation. While understanding of the condition and treatment has improved, sickle cell disorder is life-limiting and in some parts of the world is an economic and family burden.

The condition is unequally distributed geographically with populations of sub-Saharan and African origins being affected more commonly. In some communities, due to the recessive nature of the gene for sickle cell disorder, consanguineous (mainly cousin) marriage is responsible for the prevalence of the disorder.

World Sickle Cell Day is on 19 June and JAN is marking this with a Special Section on sickle cell disorders. These six articles were published in the June issue and covered in an editorial by Diana Wilkie, University of Florida USA.



You can listen to this entry as podcast.

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Lands End & Gloria Steinem: So What’s the Big Deal?

advocacy anti-choice feminism gloria steinem lands end

Lands End & Gloria Steinem: So What’s the Big Deal?

Unknown 14.05 Komentar

The Vice Chairperson of UHPP's Board of Directors, Jill Rafferty-Weinisch, has written a scathing dissertation of Lands End's resent goof regarding Gloria Steinem.

For those of you who may not have heard, Lands End decided to feature a different "icon" every season to appear as a model on their website and in their catalogs.  Gloria Steinem is a prominent American feminist, activist, and author.  She appeared as the first guest in the icon series.  Pretty great, right?  Or maybe not for some.

Some anti-feminist and anti-choice people protested the selection of Steinem as an icon, and threatened boycotts.  Lands End caved, and pulled the feature.

Jill goes on to describe the backlash:

"The response to the apology has been fierce, and although there is no way for me to gauge whether the company has lost more customers because of the original article or the ensuing backlash, damage to their reputation is assured. The company’s liberal “if you’re not satisfied for any reason” policy is leading to mass returns. Their Facebook page has become a rallying point for angry women feeling their trust (and consumer dollars) have been betrayed.
Women and girls are routinely socialized that their rights are acceptable – as long as they do not offend or make anyone else uncomfortable. Our existence is regularly constrained by the possibility we might make someone feel bad, or horny, or angry, or threatened. It has broad and sweeping ramifications in terms of violence against women, educational attainment, workplace equity, the provision of medical care, basic bodily autonomy… virtually every part of our lives."

Read her full blog here.

What Jill doesn't tell you in her blog, is that she gathered up every single article of Lands End clothing she had, no matter how old it was, and returned it. She was a big fan of their stuff, and had accumulated quite a bit of it over the years.  True to their policy, they refunded her every cent; over $2000 worth.

Do you have Lands End clothing in your home?  Are you unhappy with their decision to remove Steinem from their website and materials?  If so, you can do something about it.  Take a stand!

#bringbackgloria
https://www.facebook.com/bringbackgloria/

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The Ongoing-Yet-Completely-Curable Epidemic

advocacy EBP education reproductive health safe sex sex ed sexuality teen

The Ongoing-Yet-Completely-Curable Epidemic

Unknown 07.13 Komentar

By Youth Health Promoter Omiyea Stanford

Omiyea Stanford

Did you know that one out of every four teens becomes pregnant at least once before age 20? Did you know that despite a dramatic decline in teen birth rates and teen pregnancy, the United States still has one of the highest teen birth and pregnancy rates in the industrialized world? Do you know why? Well there are a mess load of reasons, but, a lack evidence-based sex education plays a huge part. Discuss, dissect, and digress? Yes we shall.

A lack of Evidence Based Programming (EBP), is an enormous part of the problem. Abstinence Only Education (AOE), EBP’s bitter enemy and arch nemesis that just won't die, is still used in classrooms across the country. There are so many reasons why AOE programming doesn’t work, including its misogynistic foundations and messages, idealism of heterosexual marriage, sex and gender bias and oppression, lack of consistency in teaching even the most basic aspects of sexual health like anatomy and reproduction, and lack of regulation of information accuracy and bias. However, one of the most prominent problems, is that it is just plain unrealistic! It’s not enough to offer one solution, especially one where the only answer is to do nothing, which is completely impractical and futile. Sex and sexual stimulation are basic human wants and needs, and AOE teachings disregard and create shame around that fact. AOE teachings leave students who become sexually active as teens with zero knowledge of how to protect themselves. EBP, however, works a little bit differently. Ok, actually, it works a lot differently. 

Evidence Based Programming (EBP) teaches that abstinence is an option, but not the only option. EBP prepares students for any path they choose by providing them with accurate, inclusive, and unbiased information that spans every aspect of sexual health, sexual safety and responsibility, and even the aspects of healthy relationships. Despite the facts indicating that EBP is effective in reducing teen pregnancy and STD/HIV rates, it is still is meet with googolplexes of opposition. A common critique, is that if you teach kids about sex, then they will be more likely to have sex. My reply is, "and?"  Firstly, EBP obviously doesn't encourage and teach kids how to have sex. It teaches them what sex is, and how to be safe if/when they have it. Come on people, that one was a given. Secondly, why do adults feel like it is their solemn duty to keep teens from being sexually active? That’s half of the problem in the nutshell! Teens having sex isn’t the issue! That isn’t what we should be trying our very hardest to prevent. It’s ignorance! This urge in adults to stop teens from becoming sexually active is more about keeping teens “innocent” then it is about keeping them safe. Leave them in the dark and hurl a “just don’t do it” at them every time sex comes up, and I guarantee you they’ll be defenseless. Make sure that they are given the information they need about all the aspects of sexual health, and they will have the ability to make informed, safe and healthy decisions about their own sexual health based on what they want for themselves. Sounds like EBP is our cure-all right? Well, not exactly. There is still something vital to sexual health education that is missing from even the EBP curriculum. And what is that? Pleasure and sex positivity! 

Obviously sex isn’t just about reproduction. If it was we’d barely do it, and we’d probably have a lot less humans on earth than we currently do. Humans are one of the very few species of animals on earth that have sex for fun. If this is true, then why is it that pleasure and sex positivity are missing from EBP curricula in our classrooms? Even with EBP, information about sexual health is given in sex negative ways; in other words, sex is only ever really talked about as it relates to anatomy, reproduction, and preventing the negative consequences. The topic of pleasure is treated similarly. This is an extension of our inability to accept and acknowledge true human sexuality and sexual nature. Pleasure positive sex education curricula really means not disconnecting pleasure and positivity from sex. It’s all a matter of keeping a balance between teaching young people that, yes, sex can be dangerous and it can have very serious consequences, but it can also be fun, pleasurable, satisfying, and enjoyable as well. Sex and pleasure positive EBP would provide the information young adults need to be safe, and dispel shame around sexual desire. Four words: two birds, one stone. 

Fellow YHP Blinky Lawrence
making his voice heard

And now for the big question: what do we do? Education is an enormous factor in the teen pregnancy epidemic, but in the larger scheme of things, our issues with sex education is just a symptom of a bigger issue. Our culture and society’s lack of ability to accept and acknowledge true human sexuality and nature is not a problem that can be repaired overnight, and as an extension, neither will the teen pregnancy epidemic. Want to know how you can do your part? Be an advocate for sex positive EBP education! If you’re a parent, make sure your kids are informed. If their school won’t teach them, you teach them. Teens; fight for your right to be educated! Get the right information from anywhere you can. Fight for sex positive EBP in your schools and communities. Last but not least: spread the word. A huge part of why the teen pregnancy epidemic is an epidemic at all is that people don’t know what they’re up against. So get the real numbers and statistics, and put the information into circulation in and around your communities. 

May is National Teen Pregnancy Prevention Month, but efforts shouldn’t end after May 31. Be an advocate 365 days a year! The teen pregnancy epidemic is an incredibly large issue to tackle, but it’s the small efforts of individuals that will bring it down to size. So go ahead people-- get out there and knock this epidemic down a peg or ten.

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