Delivering effective nursing care to children and young people outside of a hospital setting

This report may be reproduced for the purposes of private research and study; in addition, excerpts may be included in professional journals or conference presentations as long as acknowledgement is given and there is no association with advertisingOver the course of the last fifty years, there has been a reduction of approximately 75 per cent in the total number of children’s hospital beds in the United Kingdom [UK]; at the same time, there has been an increase in the amount and range of care now being provided in other environments that are located within outside of hospital settings. This shift in terms of the location and provision of care has meant that there has been an impact on the preparation and training that healthcare staff require. The Health Outcomes Forum specifically recommended: “That HEE [Health Education England] address the workforce education, training and development requirements (including capacity and capability) to refocus service provision at home or closer to home” (Department of Health, 2012: 52). This scoping project was financed and commissioned by Health Education North Central and East London Local Education and Training Board [HE NCEL LETB] in January 2014 and was undertaken by the University of Hertfordshire between February 2014 - August 2014. The project was funded to facilitate the consideration of the educational needs of the nursing workforce in relation to out of hospital care for children and young people, thus enabling the future potential development of out of hospital services to meet the health needs of the children and young people living in the HE NCEL geographical are

Keep things in perspective: reasons, rationality, and the a priori

Objective reasons are given by the facts. Subjective reasons are given by one’s perspective on the facts. Subjective reasons, not objective reasons, determine what it is rational to do. In this paper, I argue against a prominent account of subjective reasons. The problem with that account, I suggest, is that it makes what one has subjective reason to do, and hence what it is rational to do, turn on matters outside or independent of one’s perspective. After explaining and establishing this point, I offer a novel account of subjective reasons which avoids the problem

Epistemic Worth

Actions can have, or lack, moral worth. When a person’s action is morally worthy, she not only acts rightly, but does so in a way that reflects well on her and in such a way that she is creditable for doing what is right. In this paper, I develop and defend an analogue of the notion of moral worth that applies to belief, which I call epistemic worth. When a person’s belief is epistemically worthy, she not only believes rightly, but does so in a way that reflects well on her and in such a way that she is creditable for believing what is right. The notion of epistemic worth, I suggest, is of interest to both epistemologists and ethicists

Caring for children – ‘24-7’: The experience of WellChild Nurses and the families for whom they are providing care and support

© The Author(s) 2018There is a growing population of children with complex health needs and disabilities who are being cared for at home by their parents 24 hours per day, 7 days per week. Community Children’s Nursing Teams are a major source of support to these children. In 2006, the charity WellChild introduced the first WellChild Nurse (WCN) post specifically focused upon this group of children. In order to gain insight into how the WCN model was supporting this group of children throughout the 24-hour day, semi-structured interviews were undertaken with 12 WCNs and 10 parents of children with a range of long-term clinical care needs. Analysis of the interviews from both groups of study participants revealed complex patterns of decision-making by parents when seeking support and advice particularly ‘out of hours’. This related to four key questions: ‘Why call?’, ‘When to call?’, ‘Who to call?’ and ‘How to call?’. Parents identified how, as a result of the support provided by the WCNs, they are able to draw upon a range of decision-making skills and algorithms that enhance their ability to troubleshoot both clinical and non-clinical problems throughout the 24-hour day.Peer reviewedFinal Accepted Versio

It's not what you said, it's the way you said it: slurs and conventional implicatures

In this paper, I defend against a number of criticisms an account of slurs, according to which the same semantic content is expressed in the use of a slur (e.g. 'chink') as is expressed in the use of its neutral counterpart (e.g. 'Chinese'), while in addition the use of a slur conventionally implicates a negative, derogatory attitude. Along the way, I criticise competing accounts of the semantics and pragmatics of slurs, namely, Hom's 'combinatorial externalism' and Anderson and Lepore's 'prohibitionism'

Fostering confidence in critical thinking and research appraisal skills through Journal Club participation: an action research study

Evidence based nursing is an essential element of modern nursing practice. Nurses require an understanding of research appraisal and critical thinking skills. However, evidence suggests that many nurses lack confidence in these skills. Lecturer observation of post-registration nurses undertaking a ‘top-up’ degree corroborated this and identified weaknesses in research utilisation skills. As a result a single round of an action research model was undertaken. This research aimed to explore the views of these nurses on the impact of the journal club on perceived confidence in appraising and utilising research within the academic environment. Seven undergraduate post-registration intensive care nurses participated in the study during 2014. Focus groups were used to collect data pre and post the journal club programme. Data were analysed using thematic and descriptive data analysis. As a result of the programme, participants reported an increase in confidence following completion of the journal club programme. This study identifies that in this context, participation in a journal club programme improves the confidence of undergraduate post-registration nurses’ skills in engaging with clinical research

Right in some respects: reasons as evidence

What is a normative reason for acting? In this paper, I introduce and defend a novel answer to this question. The starting-point is the view that reasons are right-makers. By exploring difficulties facing it, I arrive at an alternative, according to which reasons are evidence of respects in which it is right to perform an act, for example, that it keeps a promise. This is similar to the proposal that reasons for a person to act are evidence that she ought to do so; however, as I explain, it differs from that proposal in two significant ways. As a result, I argue, the evidence-based account of reasons I advance shares the advantages of its predecessor while avoiding many of the difficulties facing it

Evaluating medico-legal decisional competency criteria

In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria-where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the "Decisional Competency in Medico-Legal Contexts" section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility-it accords with the way decisional competency is understood in a number of everyday contexts-but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the "Primary and Secondary Requirements" section several requirements that decisional competence criteria ought to satisfy. Then, in the "Applying the Framework" section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements