Fatherhood as transition: The contemporary relevance of transition theory

This chapter explores the contemporary utility of ritual transition theory (Van Gennep [1909], 1960). Drawing on qualitative data generated during a longitudinal ethnographic study of men’s transition to fatherhood, the paper describes how the three phases associated with the theory - separation, transition and re-incorporation - provide insight into men’s transition to contemporary fatherhood. It is argued therefore, that despite its earlier structural-functionalist roots the theory remains a valuable and relevant framework illuminating contemporary transitions across the life course

'The body in question': presence, paradox and the practice of nursing

Pro-vice chancellor, in my 30th year of being in nursing, it is very special to stand here today in front of family, friends and colleagues – both past and present – and give my inaugural lecture. Occasions like this are, of course, rites of passage, marking the transitions we make in life, from one status or position to another. But today is not merely a celebration of my own rite of passage to professorship. I want it equally to be a way of formally acknowledging the investment others have made in my journey of becoming. My family who have always, through thick and thin, supported my academic ambitions and aspirations. And of course colleagues both past and present, who have over the years and in many different ways influenced my thoughts and actions. This inaugural is therefore a celebration of all our efforts. I wonder what some of you might have thought, when you read the summary of the lecture content on the posters and invitations. Were you interested? Intrigued? Did you understand it? My family told me there were too many big words! So, I hope that in delivering a theoretical inaugural lecture, I can make it understandable, thought-provoking, entertaining and, perhaps most importantly, relevant to our practice as nurses and educationalists. So, let the lecture begin! With respect to the title, the lecture could be about a whole number of different bodies: the body of nursing, the statutory regulatory body, bodies of knowledge, bodies of evidence, professional bodies, a body of people, the body of the nurse, or the body of the patient. However, what I’m going to focus on is what might be described as the ‘literal’ body (as opposed to metaphors of the body) – the body of the patient in particular, and also the body of the nurse. There has been an explosion of writing over the last 20 years, across a range of disciplines on the body and embodiment – that is what it means to live in and through the body. As a predominantly ‘body-based’ profession, nursing serves to benefit significantly from these theoretical insights and yet, with a few notable exceptions, theoretical and empirical investigation of the body in mainstream nursing has remained largely neglected. So, despite the body being so obvious in the work of nurses – the body of the person ‘to-be-healed’ (the patient) and also the body of ‘the healer’ (the nurse) – its presence is strangely absent. This inaugural lecture is all about this paradox. It is arranged in three parts. The first part – ‘presence’– locates my own interest in this area and briefly describes the centrality of our bodies to our existence and identity and how our presence in the world is all body-based. In the second part – ‘paradox’ – I set out a brief history of the development of different forms of authoritative, body-knowledge before reaching the hub of my argument, which is that despite increasing interest in ‘the body’, the emphasis on ‘body theory’ has, paradoxically, left bodies out. In the final section – ‘practice’ – I ask why all this matters and how, through a process of embodied engagement, we might (with thanks to the sociologist Arthur Frank) ‘bring bodies back in’ to nursing

Ethnography: principles, practice and potential

Ethnography is a methodology gaining popularity in nursing and healthcare research. It is concerned with studying people in their cultural context and how their behavior, either as individuals or as part of a group, is influenced by this cultural context. Ethnography is a form of social research and has much in common with other forms of qualitative enquiry. Whilst classical ethnography was characteristically concerned with describing 'other' cultures, contemporary ethnography has focused it concern to settings nearer to home. This article outlines some of the underlying principles and practice of ethnography and its potential for nursing and healthcare practice

A critical literature review exploring the challenges of delivering effective palliative care to older people with dementia in the acute hospital setting

Aim. This paper considers the challenges of delivering effective palliative care to older people with dementia and the possible strategies to overcome barriers to endof-life care in these patients. Background. In UK alone, approximately 100 000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliative care should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliative care services. Method. A review of English language literature published after 1996 to the present day relating to older people with dementia during the terminal phase of their illness. Results. Twenty-nine articles met inclusion criteria for the review. Most originated from North America and UK and were mostly quantitative in nature. Four key themes were identified: difficulties associated with diagnosing the terminal phase of the illness (prognostication); issues relating to communication; medical interventions; and the appropriateness of palliative care intervention. Conclusions.This review reinforces the importance of providing appropriate palliative care to individuals suffering from end-stage dementia and identifies some of the barriers to extending such specialist palliative care provision. Relevance to practice. There is an urgent need to improve palliative care provision for older people with end-stage dementia and, in addition, more research is required on the needs of patients entering the terminal phase of dementia to assist the allocation of appropriate resources and training to ensure quality and equality in the provision of end-of-life care

Crossing the Threshold: Students' Experiences of the Transition from Student to Staff Nurse

Current policy in the health services emphasises nursing students’ fitness to practice at the point of registration. There has also been some suggestion that pre-registration education has not equipped them with the necessary knowledge and skills. Other research findings have indicated that students can find this transition stressful. Due to the massive investment in nurse education and the need to retain nurses in the workforce, we wanted to understand the factors that might better support this transition. Using telephone interviews with former students of The Open University part-time, distance learning, pre-registration nursing programme, we explored nurses’ experiences of their first 3-6 months of qualified practice. A number of recurring themes emerged which were then exposed to theoretical analysis using Van Gennep’s theory of transition and Bridges’ work on organisational change. In at the deep end Here students talked of their feelings associated with their increased accountability and of their anxiety in those early days following qualification. Changing identities As sponsored Health Care Assistants (HCAs), OU nursing students regularly juggle the transition from HCA to student but then make a further transition to staff nurse. Many talked about the impact of this on former HCA colleagues and the significance of the uniform as a symbol defining their new identity. Coming together In this theme, participants talked of how things started to come together, their growing confidence and their satisfaction of being able to apply their knowledge in practice. Scaffolding This was the name given to the formal and informal support structures participants described as useful during their transition. These included their educational preparation, organisational support and the individual support of mentors and family

'It was a real good show': the ultrasound scan, fathers and the power of visual knowledge

Drawing on an ethnographic study of the transition to contemporary British fatherhood, this paper discusses men's experiences of the ultrasound scan. Seeing the baby on the screen seemed to herald an escalation of their awareness of the baby, reinforcing its reality. Visual knowledge, as opposed to other forms of knowledge, therefore became a primary means of knowing the baby. In this paper I provide a theoretical analysis of men's empirical accounts of seeing the baby during the ultrasound scan. After a description of method, I set the context by presenting data to illustrate the significance of the ultrasound within men's pregnancy experience. The paper then sets up the theoretical foundations for an analysis of these accounts by first, examining the development of the primacy of vision within medicine and secondly, discussing the illumination of the body interior, initially by dissection but now via contemporary technologies of vision including ultrasound. The final section, draws upon further data and discusses how ultrasound can be constructed as simultaneously both a medical and a social event with the potential to generate epistemological conflicts

Reflections on teachers' work and careers

This commentary reflects upon a set of papers relating to teachers' work which are significant for a number of reasons. Firstly they begin to fill a gap in the understanding of the experience of Scottish teachers, and how they see their work and careers in teaching. Secondly the research has impacted, with other forces, upon policy at national level, by raising awareness of teachers' experiences of employment and support within a context where the focus of rhetoric is long-term professional development. Arrangements for the support of new teachers have now changed. The analysis presented here sets the papers' findings in a wider context of the changing nature of work and of career, and of the shape these take in teaching, and questions assumptions made about the current and future nature and length of teachers' careers. Teachers' work is work, public sector work and professional work and each additional characteristic shapes its nature. Contextually, globalisation and new managerial agendas have brought changes in work and career and the findings of the papers are analysed within this framework. The Scottish context, with its educational history, ways of working and recent changes in teachers' work, provides its own unique setting for understanding teachers' work and the impact of modernisation. It is concluded that while some common effects of modernisation are clearly identifiable for Scottish teachers' work, satisfaction with autonomy unusually remains high. The new arrangements for teachers following from the implementation of the McCrone agreement are considered as a force for sustaining that satisfaction

The relationship between research question and research design

The need for all health care professionals to develop research appreciation skills has been recognized and emphasized. Otherwise, research remains irrelevant and unrelated to practice. Traditional research textbooks have used the format of the research process which makes research seem even more difficult and remote. This book is different. Because the purpose of research appreciation is to enable practitioners to use research to develop and improve practice, it focuses instead on the skills of research appreciation and application which are distinct from the skills necessary to undertake research.It prepares you to access, critically evaluate, understand and use research-based literature within the multi-disciplinary context of today's health services, and emphasises: the range of sources of knowledge, which inform nursing practice; Contemporary research and the context in which health care research and development takes place; Critical evaluation of research reports and research-based literature, examining the implication of project design and conduct; and the range of skills needed for the application of research findings and innovation within practice

Transforming dementia and end-of-life care by investing in learning and development

Improving care for people with dementia is now recognised as an international priority. However, this is a complex issue as the quality of dementia care is dependent on a wide range of care-providers including registered practitioners, support staff and informal carers. In this guest editorial we discuss how learning and development can play a vital role in transforming care and equipping staff with the knowledge, skills and confidence they need in order to provide high quality, person-centred and compassionate care