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Biomedical subjects

A Hewison

Publications and source records attributed to A Hewison.

At least 19 recordsLinked to original sources
PubMed2001

Values in the National Health Service: implications for nurse managers.

AIM: The values of an organization are key factors which influence the way it is managed. The purpose of this paper is to examine the values of the National Health Service and consider the implications they have for nurse managers. BACKGROUND: Three reports have been published recently which place values at the heart of the debate concerning the nature and purpose of the NHS. The development of these values is discussed and the clashes that arise between them are identified. CONCLUSION: It is argued that this situation presents an opportunity to strengthen the position of nurses in management and thus ensure health care management retains a patient focus.

Health Policy↗
PubMed1999

The new public management and the new nursing: related by rhetoric? Some reflections on the policy process and nursing.

The importance of health policy in terms of its effects on nursing is now recognized as an issue of concern for nurses; however, the essentially dynamic character of policy requires that consideration of its nature and consequences is continuous. This paper addresses the parallel development of the New Public Management (NPM) and the New Nursing as a means of demonstrating the perceived disjunction between events in nursing and the wider policy arena. The nature of policy is discussed and the relationship between the NPM and the New Nursing is explored. An examination of the unintended consequences of policy implementation and the role of rhetoric in the development of the NPM and the New Nursing demonstrates that these contrasting ideologies have emerged from a similar set of circumstances and have developed along a broadly similar timescale. The final effects of this process, however, are not yet clear. It is suggested that although the processes of policy formation and implementation are inherently complex there is an opportunity for nurses to exert some influence over them. Finally it is argued that if nurses become skilled in the art of rhetoric and combine this with a thorough understanding of the policy process they may be able to shape policy directly when and where it is implemented.

Health Care Reform↗
PubMed1997

The language of management: an enduring challenge.

The language used in health care organizations has a profound effect on the way people conduct their work. The aim of this paper is to highlight and examine the significance of language in health care organizations, and raise awareness of its relevance to nurse managers. This is achieved by exploring three main themes. The contrasting views of health care, reflected in the language of management and nursing; the management of rhetoric; and researching language. It is argued that the material effects of language need to be recognized by nurse managers, if they are to fulfil their role effectively, and that language can also be used as a resource in the pursuit of this goal. Recommendations are made concerning the need for nurse managers to become sensitive to the varied dimensions of language and a means of initiating this process is suggested.

Communication Barriers↗
PubMed1996

The theory-practice gap in nursing: a new dimension.

The existence of a theory-practice gap in nursing in the United Kingdom has been an issue of concern for many years. However recent events have resulted in a new dimension of the theory-practice gap emerging. This paper explores the origins of the contrasting values attributed to nurses and health care managers and identifies areas of conflict. It is argued that the theory-practice gap in nursing is being compounded by a more fundamental divergence of approaches to the delivery of health care and that this represents a major challenge to nurse educators. Nursing is at a crossroads in its development, and if it is to survive it must incorporate some elements of the new managerialism whilst demonstrating to managers the importance of recognizing professional values. The future of nursing can be secured, but it will involve partnership and cooperation with the new managers.

Administrative Personnel↗
PubMed1996

Organizational culture: a useful concept for nurse managers?

The use of the term culture, in the context of health care organizations, has become commonplace in a wide range of literature, however, the exact meaning intended when this word is used is not always clear. This paper questions the current widespread recourse to the concept of organizational culture as a way of explaining all 'soft' organizational issues and suggest a greater degree of clarity is necessary if the concept is to retain its explanatory utility. Using three components of the concept as an organizing framework to guide the analysis, its application to health care organizations, and nursing in particular, is examined. This demonstrates how the concept can be effectively utilized without losing an appreciation of its inherent complexity. The dimensions of the concept identified for this purpose are: instrumental; cognitive; and interpretive. It is argued that, when clearly defined and appropriately applied, culture can be a useful concept for nurse managers in that it increases understanding of, and thereby contributes to, the effective management of complex health care organizations.

Humans↗
PubMed1995

Nurses' power in interactions with patients.

Power in interactions between nurses and patients, as mediated through language, is examined in this paper. The findings from an observational study confirm much previous research in that the majority of nurse-patient interactions were superficial, routinized and related to tasks. It was found that nurses exert a lot of control over interactions and the linguistic devices used to achieve this are explored. Links are established between macro-level factors, such as the institution, and the micro-level of nurse-patient encounters, to demonstrate how wider forces affect and are reflected in interactions. Examination of the interactions also reveals issues of conflict arising from the caring and controlling functions that nurses perform. It is suggested that the power dimension inherent in the relationship constitutes a barrier to open and meaningful communication between nurses and patients.

Adult↗
PubMed1995

Ethical health care management: is it possible?

Recent changes in the United Kingdom (UK) National Health Service (NHS) have resulted in the application of private sector management methods, in an attempt to improve the efficiency of service delivery. However, this has also led to concern regarding the appropriateness of such methods in a public service organization. This paper examines how the new 'business' culture of health care has led to conflict between the core values of nursing and management. It is argued that the central focus of the two roles is essentially different and this is at the heart of the conflict. Consideration is given to how the service may be managed in the future and the need for mutual understanding and collaboration is advocated as a means of reconciling these differences.

Ethics, Nursing↗
PubMed1994

The politics of nursing: a framework for analysis.

The phrase the 'politics of nursing' has become part of the language of the nursing profession. However, the meanings attributed to this phrase in the literature are not always clear. The difficulties involved in arriving at an accurate definition of the term are discussed and the suggestion is made that this emerging area of study would be advanced if greater accuracy, in using the terminology, was employed when discussing and researching nursing politics. A framework, drawing on approaches that have been taken to address similar problems in the study of power, is proposed as a means of arriving at 'tighter' definitions for the terms involved. The conclusion is that if a degree of conceptual clarity is introduced, the work to expand the field of knowledge can progress in a more systematic way through the investigation of specific areas and levels of interrelated political activity. The debate is at an early stage and more work is needed to increase our understanding of this phenomenon.

Humans↗
PubMed1994

Managing to care: the importance of using existing information to guide service provision for informal carers.

All managerial decisions are taken on the basis of the information that is available. It is important that managers use appropriate information to base their decisions upon about service provision to ensure efficient use of resources. This basic premise serves as a framework for examining how quantitative and qualitative information can be of help to nurse managers in taking these decisions in the context of developing services for informal carers. The current emphasis on surveys as a means of assessing client need is questioned and it is suggested that a wealth of evidence, relating to the experience of carers, already exists. Examples of accounts which express the needs of informal carers are presented and their utility, in terms of highlighting the carers' perspective, is discussed to reinforce the importance of utilizing this information. The paper concludes that nurse managers can use these sources as a basis for decision-making in the area of service provision and this may result in a more effective use of resources through a needs-based approach.

Caregivers↗
PubMed1993

The language of labour: an examination of the discourses of childbirth.

Language is a central component in our understanding of the social world. Not only is it our main form of interpersonal communication; it also constructs and reflects the wider social reality we all experience. Through examination of the language and terminology of childbirth different social meanings of language can be discovered. It is suggested that attention to the language reveals this diversity and increases our understanding of this area of social life and would be a fruitful area for research.

Female↗
PubMedDate not supplied

Education for management: a contingency approach.

There are many changes currently facing the nursing profession. Creative approaches are needed to meet the challenges these represent. The combined nature of a contingency management approach offers one way of achieving a positive outcome for the individual, the organisation and the patient.

Delivery of Health Care↗
PubMedDate not supplied

Dysmenorrhoea, menstrual attitude and GP consultation.

This study examined the prevalence, source and type of treatment for dysmenorrhoea, and menstrual attitudes. It was expected that negative menstrual attitudes would be related to GP consultation in dysmenorrhoeic subjects. Seventy undergraduate nursing students completed the study. The prevalence of dysmenorrhoea was high, but was not associated with sociodemographic, menstrual cycle and health-related variables. The prevailing menstrual attitude was 'bothersome' and 'anticipation and prediction', but this was not related to GP consultation. Treatment for dysmenorrhoea was predominantly self or 'lay', for which a high rate of satisfaction was observed. Less than one-third of dysmenorrhoeic subjects consulted their GP for treatment, and two-thirds of those who did were dissatisfied with the treatment offered.

Adolescent↗