Exploring nurses’ experiences of providing high dependency care in children’s wards

The care of critically ill children has received much attention in the past decade, and many of the recommendations from reports relating to the provision of paediatric intensive care have been addressed. In comparison, high dependency care has received less attention. This level of care is often provided on ‘general’ children’s wards, yet its impact on nursing staff and care delivery have received little attention. This article presents a study which explores nurses’ experiences of providing high dependency care on children’s wards using focus groups. Following analysis, six categories emerged: definitions and perceptions of high dependency care; having a high dependency unit; problems in district general hospitals; the skills needed for high dependency care; team working; and staffing for high dependency care. These findings have implications for current clinical, managerial and educational practice and for future developments in the field of high dependency care for children

How the observed create ethical dilemmas for the observers: experiences from studies conducted in clinical settings in the UK and Australia

Observational research has a history of controversy, particularly when the research is conducted in a clinical setting. Existing ethical approval processes focus on protecting participants and the researcher\u27s responsibilities, in particular where vulnerable populations are concerned. In this study, the authors explored the less overt and often understated ethical challenges that can arise when conducting observational research in a clinical setting. Reflecting on two recent studies conducted in different clinical settings, the authors described the challenges of blurring role boundaries, the risk of collecting redundant data, and the impact of reverse power relationships between researchers, clinicians, and managers. From their experiences, the authors suggested that the preparatory work undertaken with clinicians and managers onsite, which typically focuses on how the researchers will maintain the ethical robustness of the research and protect the rights of participants and the vulnerable, should also highlight the sometimes overlooked ethical issues associated with participatory research. This can help ensure that participants and managers understand the scope and limitations of the research, and consider the ways in which the observed can influence the researcher and the findings