Currently considerable emphasis is placed on the promotion of person-centred care, which has become a watchword for good practice. This paper takes a constructively critical look at some of the assumptions underpinning person-centredness, and suggests that a relationship-centred approach to care might be more appropriate. A framework describing the potential dimensions of relationship-centred care is provided, and implications for further development are considered.

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A range of issues surrounding admission to either residential or nursing home care are considered from the perspectives of older people and their family carers. Drawing on the literature and a number of studies conducted by the authors, the processes and perceptions that shape and influence admission to care are identified. On the basis of the interaction of these factors a four-stage typology of admission is suggested: the positive choice, the rationalized alternative, the discredited option, and the fait accompli. The characteristics of each admission type are discussed and the implications for professionals, particularly nurses, working with older people and their carers are addressed.

This paper considers the activity and interaction levels amongst three differing populations of elderly patients (long-stay, short-stay and respite). It begins with a consideration of the literature on staff-patient interactions in care environments for elderly patients, highlighting the virtual absence of preplanned, purposeful activity. Data are then presented which suggest that, despite the emphasis nurses place on communicating with their patients, many patients continue to spend most of their time inactive. It is suggested that if the quality of care elderly patients receive is to improve, nursing staff must see the provision of activity as an integral part of their role and function.

The need for a functioning system of continuing professional education (CPE) in nursing, midwifery and health visiting has received increased attention in recent years. However, whilst the literature describes a number of benefits, detailed empirical studies have been limited. There is, in particular, a dearth of information on nurses' perceptions of the important components of a CPE programme. Using the results of a recent evaluation of the Welsh National Board's Framework for Continuing Education, this paper highlights a number of key issues identified by practitioners, educators and managers throughout Wales. Using a structure-process-outcome model, attention is focused on the outcomes of CPE and the structure and process variables which facilitate or inhibit success. The results indicate a strong commitment to the principles of CPE and identify a complex range of perceived benefits. Potential barriers inhibiting both the uptake of CPE and the achievement of subsequent change are discussed and the need to create an equitable, well-resourced system is stressed.

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In this article those factors which influence the job satisfaction and morale of nurses are considered. It is suggested that action is needed if the profession is to continue to grow and develop.

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