Although, overwhelmingly, participants doubted they would actually be able to change the reality of practice. The identified care episode and the nurse-patient relationship, according to participants, did change their clinical practice but often not for the better.

Objective The objective of this study was twofold: to gain an understanding of the perceptions of individual pharmacists in relation to their role in the provision of healthcare for people with intellectual disabilities, and to identify barriers impacting on successful implementation of this role; secondly to explore strategies and solutions for improving pharmacists' involvement in the delivery of healthcare to this group. Setting A purposeful sample of 10 community pharmacists, located in the Loddon Mallee Region, north central rural Victoria, Australia. Method A descriptive qualitative design was adopted in this study. Data collection was via face‐to‐face, one‐to‐one, semi‐structured interviews. The data were analysed thematically via a three‐stage coding process: open, axial and selective coding. Key findings The study highlighted factors such as time resources; education, training, and experience in the field of intellectual disabilities; inadequate interprofessional communication; and the client's communication abilities and capacity to understand to be the most significant barriers to the provision of healthcare to people with intellectual disabilities, for this sample of community pharmacists. Suggested solutions to these barriers included emphasising the need for education and training, and increased staff recruitment. Community pharmacists emphasised the need for adequate collaboration with other health professionals, and the importance of communication with people with intellectual disabilities and their carers. Conclusion The research study highlighted a significant number of barriers perceived by the sample of community pharmacists, and proposed solutions to overcome these barriers in order to better assist community pharmacists in providing healthcare to people with intellectual disabilities.

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This paper details one of the findings of a large phenomenological study into the effects of nurse-patient encounters on clinical learning and practice. Every nurse faces the challenge of caring for a patient with cancer at some point in his or her nursing career. The participants, 392 nurses, were asked to discuss a care episode from their practice and the impact this encounter had on clinical learning and practice. The data collection method was by way of a written narrative/clinical exemplar. Meaning units and themes were identified using the Nvivo computer program. The procedural method of Giorgi was followed in all phases of analysis. The participants provided a detached description of the patients' diagnoses but tended to become emotive when discussing the cancer treatment experience. Nurses detailed care episodes with insight and understanding of the consequences of cancer for the patient. Nurses used powerful language to illustrate the enormity of the cancer experience for the patient and family. Although the nurses recognized the emotional impact themselves, they attempted to understate it. Participants spoke of their frustration and their sadness when describing the nurse-patient encounters. The life-threatening potential of cancer for the patient and the perception of potential or actual suffering do impact on nurses, their learning and their clinical practice. This is particularly evident when the cancer experience for the patient is not predictable. Participants clearly felt the influence of patients' cancer experience, personally and professionally. Participants detailed learning from the encounters and reflected with great insight on themselves and their practice. Identifying the learning potential of nurse-patient encounters can contribute to change in clinical practice.

This qualitative pilot study explored nurses' attitudes toward their role in patients' discharge medication education and collaboration with pharmacists. Purposive sampling was used, and data were collected by a focus group interview. The findings give a clear indication of the need for extensive staff development. It is unfortunate that nurses in this study appeared not to value their role in educating patients on medications prior to discharge. They were somewhat resistant to collaboration with pharmacists, and they tended to accept limited responsibility for improving patient discharge medication adherence or compliance. Although the findings are of concern, they do provide clear evidence of the need for intensive staff development.