Abstract: This phenomenological study describes the lived experience of pain inflicted in the context of medically prescribed treatment, explores the meanings of such pain for patients who endured it and for nurses whose actions contributed to its generation, and presents a thematic description of the phenomenon of clinically inflicted pain. The study is informed by phenomenology, both in terms of its premises and orientation, and its research design and method.The participants in the study were 14 adult patients, admitted to hospital following burn injuries, or receiving intravenous chemotherapy upon diagnosis of cancer, and 20 nurses involved in their care. Data collection took place over a period of five months and included participant observation and compilation of field notes, and a total of 89 tape-recorded interviews (48 with patients and 41 with nurses). Through the process of hermeneutic interpretation a number of themes were identified and used to describe the phenomenon of clinically inflicted pain and the structure or the lived experience of the patients and the nurses concerned.The phenomenon of clinically inflicted pain is described in terms of four isolated themes: (1) the hurt and painfulness of inflicted pain; (2) handing one's body over to others; (3) the expectation and experience of being wounded, and (4) restraining the body and the voice. These themes point to the embodied nature of pain experience and the extent to which the person is involved not only in the enduring of pain but also in its generation. The broader lifeworld of clinically inflicted pain, often as punishment and almost always a something avoidable, and in turn being constituted by their experiences in terms of losing and seeking to regain a sense of embodied self and of personal situation, and by changed experiences of lived space and lived time.Nurses who themselves helped to generate pain, frequently overlooked the patient's lived experience and thus the essential nature of inflicted pain as painful, wounding, and demanding cooperation and composure from the patient. Instead, the pain frequently become invisible to nurses involved in its infliction, or when it could not be overlooked or ignored, it was perceived inevitable , non-harmful and even as beneficial to patients' recovery. The strategic responses that nurses adopted to pain infliction included detachment from the perceived impact and consequences of their own actions and objectification of the person in pain as a body-object on whom certain tasks had to be performed. An alternative to the strategy of detachment and objectification was involvement in a therapeutic partnership between the nurse and the patient, where shared control over pain infliction and relief helped to sustain trust in the relationship and preserve personal integrity of the patient and the nurse.The study points to dangers for both patients and nurses when clinically pain is ignored, overlooked or treated with detachment. It also points a way toward nursing practice, that is guided by thoughtfulness and sensitivity to patients' lived experience, and awareness of freedom and responsibility inherent in nursing actions, including those involved in inflicting and relieving pain. The study raises questions about nurses' knowledge, attitudes, and actions in relation to clinically inflicted pain, and highlights the need for nursing education and practice to consider the contribution of a phenomenological perspective to the understanding of human experience of pain, and the nursing role in its generation, prevention and relief

Abstract: This phenomenological research project focused on one womans experience following total removal of her larynx and aimed to faithfully capture the essential structure of the phenomenon of voice as it emerged for her. For women in particular gaining a new artifical voice following surgery that is considerably lower sounding, plus the large visible opening in the lower neck is psychologically challenging and can be socially isolating. Most literature relating to laryngectomy and rehabilitation comprises quantitative research with limited attention to womens issues. This could be attributed to the small number of women undergoing this surgery. A review of nursing literature revealed minimal research, with none referring specifically to women. Nor were any studies using entirely qualitative methods identified.This research project used a phenomenological approach informed by the work of Michael Crotty, described as within the parameters of mainstream phenomenology. Based on a traditional common core foundation which is critical, holistic and individualistic, mainstream phenomenology requires achieving co-researchership between researcher and participant while exploring phenomena as objects of authentic human experience.The study began with discussing Crottys stepwise method emphasising the activity of bracketing. The co-researcher was then left to ponder or meditate on her experience following bracketing all her prior understandings and ideas, as if this was the first time she had encountered the phenomenon. Three conversations followed which allowed exploration of the co-researchers written statements. The seven interwoven dimensions that emerged represented the essential structure, meaning and essence of 'what voice is for this woman following total laryngectomy

Abstract: This is a report of a study into the night-time experience of elderly hospitilised adults and the nurses who care for them. A grounded theory approach was used for the analysis of data and subsequent generation of a theoretical description an partial explanation of patient experiences, nursing actions and nurse-patient interactions.Data were gathered through observation, interview, document audit and literature review; tow general medical wards in a large regional hospital were the focus of field methods of data collection.It is argued that the night-time experiences of elderly hospitalized adults are to a large degree dependent on the individual patterns of sleep and waking behaviour of these people in their normal environments. If individualised care is given, nurses must be aware of people's usual patterns of behaviour.Nurses working at night engage in a series of complex decision sin the course of their interaction with patients. They work under constraints not present during the daytime, and are highly dependent on co-operation from colleagues on other shifts for information which would enable them to deliver optimum care at night. At the same time, night nurses have access to information from and about patients which would be invaluable to a total assessment of any patient's health state.Considerations of sleep and sleep are relevant to nurses working all shifts. The findings of the study have implications in terms of nurses' knowledge of all aspects of sleep; assessment practices; nurse-patient and nurse-nurse communication; nurse-patient relationships at night; wars management; and the independence of nurses

Abstract: This field project undertaken in 1981 was designed to compare and contrast the role perspective with the practice perspective. Job descriptions were used as the role data and this role data was then considered in relation to information gained from field observations. The discussion looked at the findings in the current context of debate surrounding the future “roles” of nurses in the community

Abstract: The relevance of Nursing Curricula and the degree of effectiveness of their outcomes for the 'consumer' ( clients, students, a given society) are seen as commiserate to the degree that a curriculum is developed with due regard for the 'social realities' of a society. "Social realities' are defined as the actual conditions, pressures, disabilities and abilities, limitations and resources that exist in the lifespan of people and form the environment within which Nursing practices. A Curriculum relevancy process ( CRP) has been developed for use as the main analytical tool of the study. CRP has been designated as an information seeking, problem solving and evaluative process. It consists of three phases with a major emphasis on the first phase, information seeking. Information has been gathered about contemporary social realities ( the year of 1979) and related Socio- health disorders. Information has been gathered and analysed from official ad voluntary sources and the findings related to curricular choices for Nursing education

Abstract: The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor. Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk. Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people.

Abstract: The purpose of this study is to examine aspects of the behaviour of Nurses towards persons with alcohol related problems. Similarities and differences in helpful and unhelpful behaviour as perceived by providers and users of care are identified using the behaviour to alcoholism management ( B.R.A.M.) scale. The research covers two phases. In phase One 27 Registered Nurses and 12 members of Alcoholics Anonymous completed critical incident questionnaires which furnished a list of helpful behaviours and a list of unhelpful behaviours. These have been analysed and a set of descriptive statements prepared which constitutes the B.R. A.M. scale. In Phase Two this has been administered to 67 Registered Nurses and 46 members of Alcoholics Anonymous and the results assessed. The findings show that Nurses and Problem Drinkers view the same behaviour as helpful. There is however a significant difference between the two groups on the types of behaviour they consider to be unhelpful. This finding has consequences for those who provide care for problem Drinkers and for Teachers and students in education programs for Nurses