THEMES AND PERSPECTIVES IN NURSING THEMES AND PERSPECTIVES IN NURSING Edited by Keith Sooth ill, Christine Henry and Kevin Kendrick Centre for Health Research, Lancaster University SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. First edition 1992 © 1992 Keith Soothill, Christine Henry and Kevin Kendrick Originally published by Chapman & Hall in 1992 Typeset in 10 on 12 point Sabon by Columns Design and Production Services Ltd, Reading ISBN 978-0-412-43990-2 ISBN 978-1-4899-4435-1 (eBook) DOI 10.1007/978-1-4899-4435-1 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. 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A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication data available Contents Contributors VB Acknowledgements IX Preface X PART I PERCEPTIONS OF NURSING 1 1 Nursing and doctoring: where's the difference? 4 Lesley Mackay 2 The media representation of the nurse: 16 the implications for nursing Joanne Holloway 3 Nursing, advertising and sponsorship: some ethical 41 issues Ruth Chadwick 4 NHS nursing: vocation, career or just a job? 56 Brian Francis, Moira Peelo and Keith Soothill 5 Conceptions of the nature of persons by doctors, 75 nurses and teachers Christine Henry PART II EDUCATION 89 6 The nurses' reformation: philosophy and pragmatics 91 of Project 2000 Kevin Kendrick and Anne Simpson 7 Interpersonal and therapeutic skills in the 'New 101 Curriculum' for nurse education Tom Chapman and Helen Fields 8 Performance indicators and changing patterns of 114 accountability in nurse education Ruth Balogh 9 Professional conceptions of mental illness and 138 related issues Glen Pashley PART III CLINICAL 155 10 Patient advocacy in nursing Paul Witts 158 11 Assessing the stress in persons with cancer: 181 an exploration of the main perspectives of stress in relation to their psychological care Liz Hanson CONTENTS 12 Conceptions of care Helen Ellis 196 13 Nursing wastage from the nurses' perspective 214 Catherine Williams, Jon Barry and Keith Soothill 14 Difficulties in provision of care for the elderly by 231 auxiliaries - implications for the new support worker Emily Griffiths 15 Considerations of personhood in nursing research: 245 an ethical perspective Kevin Kendrick PART IV MANAGEMENT 259 16 Managing nurse wastage Jon Barry, Keith Soothill 261 and Catherine Williams 17 Nurse supply modelling David Worthington 276 18 Angels in red? patterns of union membership 293 amongst UK professional nurses Paul Bagguley 19 Nurses and the prospects of participative 310 management in the NHS Stephen Ackroyd Index 331 Contributors Mr Stephen Ackroyd is an organizational consultant and Lecturer in the Management School, Lancaster University. Dr Paul Bagguley is Lecturer in the Department of Social Policy and Sociology, University of Leeds. Ms Ruth Balogh was Research Officer on the project to develop performance indicators for the English National Board for Nursing, Midwifery and Health Visiting and is currently a freelance research and evalaution consultant. Mr Jon Barry is Research Officer, Centre for Applied Statistics, Lancaster University. Dr Ruth Chadwick is Director of the Centre for Applied Ethics, University of Wales College of Cardiff. Dr Tom Chapman is Principal Lecturer in the Department of Applied Social Sciences, Edge Hill College of Higher Education. Ms Helen Ellis is a course teacher in the Department of Post Basic and Continuing Education, Preston and Chorley School of Nursing. Ms Helen Fields is Assistant Director of Nurse Education, Sefton School of Health Studies. Mr Brian Francis is Assistant Director, Centre for Applied Statistics, Lancaster University. Ms Emily Griffiths is staff nurse on a continuing care ward, Ulverston Hospital, Cumbria, and postgraduate in the Department of Applied Social Science, Lancaster University. Ms Liz Hanson is a former staff nurse at Weston Park Hospital, Sheffield, and is currently Visiting Lecturer, School of Health and Community Studies, Sheffield City Polytechnic. Professor Christine Henry is Dean of the Faculty of Health, Lancashire Polytechnic. Ms Joanne Holloway is a former staff nurse and former student at Lancaster University studying psychology and sociology. Mr Kevin Kendrick is Senior Lecturer in Health Care Ethics, Lancashire Polytechnic. CONTRIBUTORS Dr Lesley Mackay is Senior Research Fellow in the Department of Applied Social Science. Lancaster University. Ms Glen Pashley is Senior Lecturer in Curriculum Development in the Faculty of Health, Lancashire Polytechnic. Dr Moira Peelo is Research Associate, Department of Applied Social Science, Lancaster University. Ms Anne Simpson is Principal of the Lakeland College of Nursing and Midwifery. Professor Keith Soothill is Professor of Social Research in the Department of Applied Social Science, Lancaster University. Ms Catherine Williams is Lecturer in the Department of Nursing and Health Studies, St Martin's College, Lancaster. Mr Paul Witts is Senior Lecturer in the Department of Nursing in the Faculty of Health, Lancashire Polytechnic. Dr David Worthington is Lecturer in Operational Research and Operations Management, the Management School, Lancaster University. Acknowledgements Many people have assisted, both directly and indirectly, in bringing this collaborative project to fruition. To everyone we extend our thanks. In particular, we much appreciate the willingness of our contributors to act on the suggestion of Moira Peelo that any royalties accruing from the book should go to a fund administered by the Centre for Health Research at Lancaster University. The object of the fund is to assist nurses to carry out r~search. Hence, any success that this book achieves will help - albeit in a small way - some nurses to develop their research ideas. We hope that everyone who has supported us in various ways feels that the venture has been worthwhile. Keith Sooth ill Christine Henry Kevin Kendrick Preface The delivery of effective health care IS a major priority for the nursing profession and nurses must therefore confront issues related to all aspects of health and health care reform. A priority is to develop appropriate texts which will not only complement the rapid changes in nursing education, but also encourage confidence in appraisal and allow students of nursing and the qualified practitioner to sensitively utilize their critical skills. The transfer of nursing education to the higher education sector is occurring in different ways on a national and international level. This emphasizes a variety of changes, such as new opportunities in nursing and midwifery career structures, the advancement of nursing research, professional practice and accountability. The positive aspect lies with providing a confident nurse practitioner for the 1990s and beyond. This text therefore presents significant issues and themes which directly relate to the 1990s, and the significant changes, such as perceptions of nursing, education, clinical professionalism and management. Keith Soothill Christine Henry Kevin Kendrick