Student nurses' professional development arises through socialisation in nursing knowledge, values and behaviours. Students are expected to demonstrate compassion; however, compassion is a complex concept, one that creates emotional challenges. A grounded theory study was undertaken to explore student nurse socialisation in compassionate practice. In-depth interviews were undertaken with 19 students in the north of England during 2009-2010, and their concerns and concern management emerged. Students expressed several concerns, one being their emotional vulnerability and uncertainty of the emotional requirements for compassionate practice. A core category of 'balancing future intentions' was identified: that students managed feelings of vulnerability and uncertainty through balancing their intentions towards and away from engagement in compassionate practice, depending upon perceived impact on their emotional well-being. The findings are discussed in relation to emotional labour and moral distress, and courage, resilience and self-compassion are explored as a means to enable sustainable compassionate practice.
Objectives The objective of this study was to identify what children and young people in a health district in a large urban area experience as positive -and not so positive -about their local health services, in the light of a growing expectation that users play a more central role in the design and delivery of services.Design A qualitative study incorporating a range of methods, including interviews, play techniques and a website.Setting Schools, nurseries, community groups, in-and outpatient settings in an inner London health authority.Participants Young people aged between 4 and 19 years, from community (n ¼ 92) and clinical (n ¼ 57) settings. This included Ôhard-to-reachÕ children, including those leaving care, those in touch with the criminal justice system, asylum seekers, and those with learning disabilities.Results Alongside planning and environment issues, young people particularly emphasized the impact of communication and relationships with staff on their experience of health services.Discussion and conclusions Using a range of flexible and ageappropriate techniques, young people, even those as young as 4 or 5, are able to comment helpfully on their experiences of service provision. What children had to say is revealing but not astonishing to those working in the National Health Service (NHS). Clinicians and managers, to whom our findings were fed back, made this clear. If we have known for so long that the issues raised here are problems, why are we so poor at acting on this knowledge? The authors suggest four explanations.
Changes in the human migration systems of Hurricane Katrina- and Rita-affected Gulf of Mexico coastline counties provide an example of how climate change may affect coastal populations. Crude climate change models predict a mass migration of “climate refugees,” but an emerging literature on environmental migration suggests most migration will be short-distance and short-duration within existing migration systems, with implications for the population recovery of disaster-struck places. In this research, we derive a series of hypotheses on recovery migration predicting how the migration system of hurricane-affected coastline counties in the Gulf of Mexico was likely to have changed between the pre-disaster and the recovery periods. We test these hypotheses using data from the Internal Revenue Service on annual county-level migration flows, comparing the recovery period migration system (2007–2009) to the pre-disaster period (1999–2004). By observing county-to-county ties and flows we find that recovery migration was strong, as the migration system of the disaster-affected coastline counties became more spatially concentrated while flows within it intensified and became more urbanized. Our analysis demonstrates how migration systems are likely to be affected by the more intense and frequent storms anticipated by climate change scenarios with implications for the population recovery of disaster-affected places.
As a study involving diabetes care demonstrates, children sometimes have a much more sophisticated capacity for taking charge of their own health care decisions than is usually recognized in bioethics. Protecting these children from their disease means involving them in their treatment as much as possible, helping them to understand it and take responsibility for it so that they can navigate the multitude of daily decisions that become part of the diabetes medical regimen.
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