The place of volunteering in palliative care

This chapter discusses the place and development of volunteering in palliative care in the context of hospice service provision in the UK. It draws on recent qualitative research undertaken in a large hospice in England. The research explored a range of issues connected to the process and experience of voluntary work in this setting including who volunteers, what roles volunteers take up, how they are trained and supported and the ways in which role boundaries are established and maintained. The research revealed that hospice volunteering is rewarding but often emotionally challenging and is now highly routinised and closely monitored in ways paralleling practices in the paid labour market. Although volunteers freely give their time to the work of hospice, their activities are subject to significant management prescription, with hospices increasingly adopting sophisticated business models to underpin their operation and, in many cases, their expansion (Watts, 2010)

Teaching a distance higher education curriculum behind bars: challenges and opportunities

The provision of education that is both effective and relevant to the needs of students within prison is challenging on a number of levels. The uniqueness of prison culture with a regime characterised by a focus on security measures such as lock-downs and head counts constrains the possibilities for learning. The absence of a supportive learning environment together with an emphasis on punishment rather than rehabilitation has the effect of marginalising education in prison so that ‘education’ has come to be seen by some as ‘off limits’. Education in basic skills such as literacy and numeracy that contributes to ‘life skills’ is given priority. In contrast, access to higher education is more problematic with this generally perceived by both prisoners and prison staff as an ‘elite’ activity. This article adopts a case study approach to consider the barriers to higher education distance learning in the prison setting. It focuses on the practical and organisational constraints faced by educators in their efforts to help students in prison negotiate the different worlds of prison and higher education. It also highlights the value of one-to-one tutorial support in facilitating learning in less than optimum teaching conditions

Considering the role of social work in palliative care: reflections from the literature

Social work is integral to the professional practice of the multidisciplinary palliative care team both in hospice and hospital settings. Alongside nursing, medicine and a range of other clinical and complementary therapists, social work provides practical and psychosocial support to those coming to the end of their lives. Death and dying involves loss and transformation and for many can be experienced as overwhelming such that they require help to manage their feelings and come to terms with this significant transition (Mallon, 2008). Loss is always both personal and social and so the focus of social work practice in this area includes family and social network responses to the end of life (Reith and Payne, 2009: 7). Whilst the literature has devoted much space to discussing the nature of the work of clinical and pastoral practitioners within the multidisciplinary palliative care team (see for example, Payne et al, 2004; Nolan, 2012), less has been written about the role played by social work. Drawing on both professional and academic literatures, this article sets out to explore in more detail the complex and diverse nature of palliative care social work. In outlining the psychosocial and practical tasks undertaken by social workers, consideration is also given to the allied work of psychologists and the potential for disciplinary role overlap in the provision of both psychological and psychosocial support

To publish or not to publish before submission? Considerations for doctoral students and supervisors

Postgraduate research education is multi-faceted incorporating the teaching of a range of skills and study behaviours. A key skill for doctoral students is that of scholarly writing that Aitchison (2009) argues is often difficult to teach, with students unclear about the standards required for doctoral work. One benchmark of standards of academic literacy is published outputs, with Kamler (2008) pressing for greater pedagogical attention to be given to writing for publication within doctoral education. However, the case for pursuing publication as part of doctoral research experience is subject to a number of variables. This discussion paper debates some of these variables to consider writing for publication within diverse doctoral education. Features of difference will be discussed to reveal that the choice of whether or not to “publish as you go” (Taylor & Beasley, 2005: 130) is influenced by the personal, disciplinary and institutional context that frames the doctoral undertaking

Women working in construction management roles: is it worth it?

Although women’s experience of working in management has been the subject of extensive comment, the particular challenges they face in this role within male-dominated professions continue to be under-reported. Drawing on ethnographic research into the career experiences of women civil engineers in the UK, this article critically discusses how women perceive management careers in construction in light of what some regard as limited financial rewards for the high levels of stress and the long hours expected in this highly competitive industry. A feminist theoretical framework has been used to thematically analyse data from thirty-one in depth interviews with women working in both the consulting and contracting parts of the business. The study highlights cultural issues of visibility and the presenteeism ethos of the sector. It also draws attention to the material constraints of construction sites where women in authority roles are ‘embattled’ and not taken seriously because the hostile work environment enables men to put women in a subordinate place in the construction hierarchy. Women are taking up senior management posts in construction but only in very few numbers. Their success depends on assuming ‘male’ behavioural norms and intensified work patterns because ‘belonging’ in construction workplace cultures is highly gendered

Spiritual care at the end of life: whose job is it?

Interest in and recognition of the function of religious and spiritual coping in adjustment to serious illness has been growing. In particular, there has been increasing interest in the importance of understanding and valuing patients' individual spirituality as a function of providing appropriate support, particularly as part of nursing practice. This stems partly from the influence and application of palliative care principles in a range of care settings and not just hospices. Four decades of professional rhetoric have emphasised the importance of care for the 'whole' person in terms of spiritual as well as psychological, physical and social needs, without evaluating its impacts on patients or considering whether this approach is realistic in every case. Professional ideology within palliative care has been dominant in influencing a culture of openness between professional health workers and dying patients in their care, with attention to spiritual needs an increasing part of professionals' remit. New ways to both assess and address spiritual concerns as part of overall quality of life are being developed by health care practitioners as part of a package of support for people with critical and terminal illness (Randall and Downie, 2006; Watts, 2008). For this support to be meaningful, however, it is necessary to determine which dimensions of spirituality are relevant and the ways in which the human spirit can be celebrated in the face of life-threatening illness (Cobb and Legood, 2008). The ultimate value of such exploration is to make it possible for us to die the way we live (Hockey, 2002)

Working with emotion: Challenge and resource in palliative day care settings

Although it is useful to adopt a cross-disciplinary approach in exploring both theory and practice (and the value of organisational theory to the discussion of emotionality at work remains significant), it is important to reflect that the labour of paid care, despite bureaucratic attempts to commodify this, remains not just a service or business interaction but one that requires substantial emotional input on the part of the employed worker (Edwards and Wajcman, 2005). This is especially the case in respect of end of life care where the emphasis on what I will term ‘continuous personal relationship work’ is key to guiding practice. This particular form of ‘relationship work’, with emotion and the outward expression of feelings at its core, holds both challenges and opportunities for practitioners and also for volunteers whose positive contribution to day care is now well recognised (Andersson and Ohlen, 2005). Drawing on recent research conducted at a community hospice cancer drop-in day care facility (see Watts, 2008b for a discussion of the study’s methodological aspects), some of these challenges are explored below

Cancer, life review and the boundary between the 'personal' and academic research

Much social research and commentary derives from the personal position and interest of the writer with, in recent years, a marked increase in the use of case histories, vignettes and auto ethnography, as legitimate methodological research tools. This article, drawing on that tradition, is a reflective commentary on the author's experience of supporting a friend through a critical life-threatening illness, highlighting the dual aspects of personal engagement and academic reflection. The ways in which the 'personal' can be opportunity for methodological and empirical reflection, but also serve as ethical constraint, are considered. An underpinning concern is the requirement for ethical probity, both in maintaining confidentiality within the account and in considering the issue of consent, in reporting the personal details of the author and those of the friend whose critical health episode is central to the discussion. Attention is also drawn to the importance of life review on the part of those who face life-limiting illness. Discussion focuses on the experience of life review from the perspective of both the author and friend, suggesting that this may be a more meaningful support in the form of intimate exchange rather than as clinical therapeutic intervention. The article argues that the personal, rather than disrupting critical social research, particularly in the field of health and well-being, can contribute positively to shaping new understandings and insights

Leaders of men: women 'managing' in construction

Although women's experience of working in management has been studied extensively, the particular challenges they face in this role within male-dominated professions merits further attention. This article draws on research into the career experiences of women civil engineers in the UK to critically discuss the possibilities for women to pursue a management pathway within construction. A feminist theoretical framework has been used to analyse data from thirty-one in depth interviews with women working in both the consulting and contracting parts of the industry. The study highlights cultural issues of visibility and the presenteeism ethos of the sector as well as the material constraints of construction sites. Women are taking up senior management posts but only in very few numbers. Their success depends on assuming 'male' norms and in these roles they straddle a marginal territory that is bordered by exclusion and resistance

An integrated literature review of death education in pre-registration nursing curricula: key themes

Recent policy has raised the profile of end-of-life care internationally, with the aim of increasing access to quality care for everyone experiencing life-limiting illness. This reflects an international shift in the provision of palliative care to encompass chronic conditions other than cancer. Nurses have an important role in delivering this care and need to be equipped with particular knowledge and skills. However, pre-registration nursing curricula have traditionally had a limited emphasis on death and dying and nurses report feeling unprepared to care for dying patients. This has led to claims that death education in pre-registration curricula is inadequate. This integrated review explores published literature that reports on death education within pre-registration nurse education. Presenting an international overview, the aim of the review is to contribute to knowledge about the nature and extent of death education in pre-registration curricula. In the context of this paper, death education encompasses both palliative and end-of-life care. Electronic searches of major bibliographic databases found inconsistencies across educational provision with variations in quantity, content and approach. Despite an increasing amount of death education in pre-registration curricula, there remains a deficit in key areas such as knowledge, skills, organisation of care and teamwork