Purpose
Experiencing bereavement in childhood can cause profound changes to developmental trajectories. This paper aims to evaluate the feasibility of implementing a public health intervention in schools to encourage pupils aged 12-15 years to independently explore ideas of death, dying, loss and end of life care in a structured and creative format.
Design/methodology/approach
A co-produced storytelling intervention was implemented in an independent school in Norwich, UK. Pupils wrote up to 1,000 words in response to the title, “I Wish We’d Spoken Earlier”. Their participation was voluntary and extra-curricular. Stakeholder feedback was used in addition to the submissions as a measure of acceptability, appropriateness, adoption and feasibility.
Findings
In total, 24 entries were submitted. Pupils demonstrated their ability to engage thoughtfully and creatively with the subject matter. Feasibility for the storytelling intervention was demonstrated. Importantly, the intervention also prompted family conversations around preferences and wishes for end of life care.
Research limitations/implications
To determine whether the intervention has psychological and social benefits will require further study.
Practical implications
Educational settings can be considered as anchor institutions to support a public health approach to end of life care.
Originality/value
The positive response from all stakeholders in delivering and supporting the intervention indicates that schools are a community asset that could be further empowered to support children and families affected by death, dying and loss.
The reviewed paper details findings from a study using the Practice Environment Scale of the Nursing Work Index (PES-NWI) to measure care quality. A snapshot of nurses' perceptions of their environment and comparison with known profiles from Magnet and other US hospitals were offered. The PES-NWI was used in the RN4CAST studies (Zander et al., 2016), therefore comparison with European data would have provided an informative context. Yet this study makes the case to attract attention to challenges that nursing faces in Greece and a baseline to enable tracking over time and interventions. The study found dissatisfaction with the extent to which nurses participated in policy decisions and governance and their career advancement; the lack of focus on care quality and nurses' contribution to it; and leadership and staffing levels. Only collegial nurse-physician relationships were perceived to be of just an acceptable level. The levels of dissatisfaction were higher than their comparators. Nursing shortages threaten almost all European countries. Nurse vacancy rates in England are between 10% and 16% and there are 36,000 vacancies (Health Education England, 2017). In Greece, 1 in 3 full-time nursing positions are reported as vacant in state hospitals, and ratios of 1 nurse to 40 patients (Kolasa-Sikiaridi, 2017) (previously 1 to 9 or 10; Zander et al., 2016) show a decline due to prolonged austerity. Funding of public hospitals has been cut by more than 50% since 2009, and there has been an exodus of clinical staff and an increase in the use of public hospitals by the public (Karamanoli, 2015). According to the Organisation for Economic Cooperation and Development (2018) (latest data period 2013-2016), there were 3.2 nurses per 1000 inhabitants in Greece and 7.9 nurses per 1000 in the UK. The study confirmed staffing shortages and gave insight into implications: lack of opportunity to spend time with patients, to discuss patient care problems with other nurses, to provide quality patient care and to get the work done. Indeed, the concept of 'missed care' as a result of low staffing and its catastrophic impact on patient outcomes has
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