In presenting a preliminary model of nursing workload, it is hoped that nursing workload might be better understood so that it becomes more visible and recognizable. Increasing the visibility of nursing workload should have a positive impact on nursing workload management and on the provision of patient care.

Student self-report measures of change are widely used in evaluation research to measure the impact and outcomes of an educational programme or intervention.Traditionally the measures used to evaluate the impact of an educational programme on student outcomes and the extent to which students change is a comparison of the student's pretest scores with their posttest scores. However, this method of evaluating change may be problematic due to the confounding factor of response shift bias.Response shift bias occurs when the student's internal frame of reference of the construct being measured, for example research ability or critical thinking, changes between the pretest and the posttest due to the influence of the educational programme. To control for response shift bias the retrospective pretest method was used to evaluate the outcomes achieved from students completing a research module at master's level. The retrospective pretest method differs from the traditional pretestposttest design in that both posttest and pretest perceptions of respondents are collected at the same time. The findings indicated that response shift bias was evident in student self-reports of change, especially in subjects the student had been previously exposed to at undergraduate level. The retrospective pretest design found that the programme had significantly greater impact on outcomes that that identified using the traditional pretest-posttest design leading to the conclusion that students may overestimate their ability at the commencement of an educational programme.The retrospective pretest design is not a replacement for the traditional pretest-posttest measures but may be a useful adjunct in the evaluation of the impact of educational programmes on student outcomes.

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Publication informationNursing inquiry, 12 (2) ABSTRACTThis article is based on a discourse analysis of the complete nursing records of 45 patients and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jürgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly biocentric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation 2 depicted the colonisation of the socio-cultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent -the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice.

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Existing literature highlights the functional aspects of nursing documentation. In contrast, this paper explores the way in which nurses, through their documentation, constitute themselves and the nursing profession. In this way, nursing documentation is viewed as a social practice and a conduit through which particular power effects are produced and reproduced, rather than simply a matter of, for example, knowledge, individual choice or good practice.

The aim of this research study was to explore, within an Irish context, HIV-positive patients' experiences of hospitalization and particularly their experiences of nursing care. This article reports on one of the dominant themes to emerge in the study--the experience of stigma during hospitalization among persons with HIV. A volunteer sample of 10 former inpatients of hospitals in the Republic of Ireland's capital, Dublin, were interviewed in depth, and the resulting data were analyzed using a qualitative content analysis. Findings indicate that while some participants experienced stigma from nurses, such stigma was stratified according to the means by which the disease had been contracted, with drug users expressing the greatest feelings of stigma from nurses. Data also suggest that the type of nursing care favored by many participants was that of segregated care within specialized units. This type of care was preferred because it enabled the patient to avoid being discredited by other patients who did not have the virus. This environment also offered the potential of social support from other patients with similar diagnoses. Finally, patients experienced breaches in confidentiality because of institutional policies that made their disease conspicuous and from some nurses' nonchalance in handling information about their disease. The analysis used in this study draws on Goffman's conceptualizations of stigma to explain the social process underlying the accounts given by study participants.