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Biomedical subjects

Fiona Timmins

Publications and source records attributed to Fiona Timmins.

At least 19 recordsLinked to original sources
PubMed2006

An exploratory study identifying the programme related stressors amongst qualified nurses completing part-time degree courses.

The aim of this paper is to explore the leading programmatic stressors and associated age related stressors experienced by two cohorts of students (n=132) completing part time degree programmes in nursing in two third level institutions in the Republic of Ireland. To date the literature has exclusively focused on the day to day stressors that undergraduate nursing student's experience. The design chosen was descriptive utilising a questionnaire as the mode of data collection. 'Preparing assignments for submission', 'trying to balance work commitments and the required study', 'doing the course assignments', 'the demands of writing an assignment to the necessary level', the prospect of the final examination' and 'preparing for the course examination' were all ranked as the leading stressors. The younger participants in this study were more likely to register higher degrees of stress as a result of the process stressors of their studies owing to the negative correlation with age. Process stressors were associated with the academic workload and time management difficulties. The findings have wider implications for educationalists in relation to course development and ongoing student support. Educationalists need to be cognizant in particular of the age related stressors associated with completing part time degree programmes.

Adaptation, Psychological↗
PubMed2006

A critical analysis of the potential contribution of Orem's (2001) self-care deficit nursing theory to contemporary coronary care nursing practice.

BACKGROUND: Over the last three decades, nurse theorists have strongly advocated the use of conceptual models of nursing to guide nursing practice. Within coronary care units, conceptual model-based care has had inconsistent application and is currently challenged by contemporary approaches such as pathways of care. AIMS: This paper aims to critically analyze the use of Orem's self-care deficit nursing theory as a modus operandi to effectively meet the needs of hospitalized patients in coronary care. RESULTS: Although complex both in the language and construction, the self-care model , provides a comprehensive and holistic approach to the care of people in coronary care. CONCLUSIONS: This paper highlights the potential contribution the application of the self-care deficit nursing theory to the coronary care setting from a philosophical and practical perspective. Orem's conceptual model of nursing and current practice in coronary care units share certain similarities that render a useful model for use in practice. However, while it is recommended for consideration for use in both practice and educational settings, further empirical work is required in the area, together with realistic and practical application of the theory to practice in a way that embraces contemporary notions.

Coronary Care Units↗
PubMed2006

Conceptual models used by nurses working in coronary care units--a discussion paper.

In the UK, Europe and the USA conceptual models of nursing are features of many undergraduate nursing curricula [Alligood MR. The nature of knowledge needed for nursing practice. In Alligood MR, Marriner-Tomey A, editors. Nursing theory utilisation and application. London: Mosby, 2002, Tierney AJ. Nursing models extant or extinct? J Adv Nurs 1998;8(1):77-85] and commonly used in practice. However, UK nurses in practice continue to be dissatisfied with conceptual model use [Griffiths P. An investigation into the description of patients' problems by nurses using two different needs-based nursing models. J Adv Nurs 1998;28(5):969-977, Mason C. Guide to practice or 'load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland. J Adv Nurs 1999;29(2):380-387, Murphy K, Cooney A, Casey D, Connor M, O'Connor J., Dineen B. The Roper, Logan and Tierney Model: perceptions and operationalization of the model in psychiatric nursing within one health board in Ireland. J Adv Nurs 2000;31(6):1333-1341]. An association with increased paperwork and documentation together with a belief that these abstract concepts do not quite fit with the practice setting has resulted in a generalised apathy towards their use in some areas [Timmins F. Critical care nursing in the 21st Century. Intensive Crit Care Nurs 2002;18:118-127]. In an era of concerns about both cost and quality, together with an increased impetus towards multi-professional working patterns and role expansion, alternative models of care, such as critical pathways and care pathways are gaining increased favour in the clinical setting [Johnson S, editor. Pathways of care. Oxford; Blackwell Science 1997]. The aim of this paper is to consider whether or not the traditional conceptual models of nursing are apt for today's practicing coronary care nurse. Specific questions to be addressed are: what is the research evidence that informs conceptual model use in coronary care and what are the conceptual models that commonly inform contemporary practice in coronary care nursing? Suggested ways forward for conceptual model use within nursing are also proposed.

Attitude of Health Personnel↗
PubMed2006

Exploring the concept of 'information need'.

Identifying information needs is frequently espoused in textbooks, policy documents and reports of research studies; provision of health-care is also now described as 'needs-based', rather than 'service-based'. Yet, there is little understanding or clear definitions of this construct in the literature on the topic. The purpose of this paper is to explore the concept of information need, using concept analysis, with the aim of providing greater clarity. Rodgers' evolutionary approach to concept analysis was used to identify common attributes, antecedents and consequences, of the term information need. Information need emerged as a want or desire for information to be shared by professionals using appropriate communication skills. Information-seeking behaviour manifests in individuals as a response to a stimulus that is perceived as either a challenge or a threat. This attempt to provide a greater clarification of the term was prompted by the ubiquitous use of the term with little consistent definition. It is hoped that this conceptual clarification will guide further study in this area, particularly in relation to the subjective nature of contemporary information needs and its role in coping behaviours of individuals and groups.

Humans↗
PubMed2005

Programme-related stressors among part-time undergraduate nursing students.

AIM: The aim of this paper is to report a study exploring the perceived stressors identified by a group of 70 students who undertook a part-time degree at one Irish university. BACKGROUND: In the literature on stress, part-time nursing students who are undertaking continuing education programmes appear to have received little attention. Stress amongst nurses is evident within the nursing literature but little information is available on the specific stressors that affect Registered Nurses who undertake further academic study. Anecdotally, students attending part-time programmes while working full-time report high levels of stress. METHOD: Quantitative methods were used. While many instruments exist to measure overall stress, this study aimed to explore student's perceptions of specific stressors associated with academic study. We used a questionnaire developed from the literature on the topic. RESULTS: Factors related to writing assignments at degree level, fulfilling personal needs and academic demands, were perceived as major stressors by these students. Factors of little concern were financial issues and attendance on the programme. Individual items receiving highest mean scores were: trying to balance work commitments and the required study (mean 3.89, sd = 1) and the prospect of the final examination (mean 3.86, sd = 1). This study was limited by the use of convenience sampling and self-report methods. Larger studies are required to support the findings. In addition, student stress was not observed or measured. CONCLUSION: Those involved in the delivery of nurse education programmes to part-time students need to consider the impact of the workload on student welfare, and to prepare students for demands of the programme.

Adult↗
PubMed2005

Nurses' and midwives' assertive behaviour in the workplace.

AIM: This paper reports a study describing the assertive behaviour of a group of professional nurses and midwives and exploring potential barriers and facilitators to the use of assertiveness skills in the workplace. BACKGROUND: As nurses and midwives move away from traditional roles, it is increasingly being recognized that they need to behave in an assertive manner. Much literature supports the use of assertive behaviour in clinical practice. Although specific individual assertive behaviours and skills have been examined in many settings, little empirical evidence exists about the frequency and use of assertiveness skills by nurses and midwives in the workplace. While there is evidence on barriers to the use of assertive skills, there is little information about factors that may facilitate their use. METHOD: A survey design was adopted, using a 44-item questionnaire to collect data from a 2.5% random sample of nurses/midwives registered with the National Nursing Board of Ireland. The data were collected in 2003. RESULTS: While respondents frequently complimented their colleagues and often allowed them to express opinions, they were less accomplished at expressing their own opinions or making requests. Assertive behaviours were used more frequently with nursing/midwifery colleagues than with management/medical colleagues. Most used assertiveness skills with other grades of staff in their own profession. Responsibility to patients/clients emerged as a supporting factor for using assertive behaviour. Managers, the work atmosphere and fear were viewed as obstacles. CONCLUSION: Nurses and midwives needs to learn how to behave assertively, and this should be included in both pre- and post-registration education programmes. As use of assertiveness skills was reported to be least frequent with nurse/midwife managers, local policies and guidelines may be needed to encourage clinical practitioners to act autonomously and as client advocates.

Adult↗
PubMed2005

How assertive are nurses in the workplace? A preliminary pilot study.

AIM: This paper aims to outline the development and results of an instrument that describes the assertive behaviour of nurses. BACKGROUND: As a largely female dominated profession, nurses are anecdotally regarded to be in traditional subservient roles. In addition, nurses aspire to public images of nurses as "nice". These factors are thought to reduce nurses' capacity to behave in an assertive manner. However, little empirical evidence exists that describes the assertive skills of today's practicing nurse. METHODS: A 44-item questionnaire collected data from 27 registered nurses. RESULTS: Items that feature strongly in the respondents reported behaviour are allowing others to express opinions, complimenting others and saying no. These findings suggest that nurses behave in a passive way, conforming to the image of a nice nurse. Nurses were less adept at disagreeing with others opinions and providing constructive criticism. Differences emerged in behaviours between the three groups. CONCLUSION: Assertive behaviour is a skill, i.e. utilized according to interpersonal and role relationship. Factors within the work environment such as colleagues and atmosphere can support or prevent these behaviours.

Adult↗
PubMed2005

Stressors associated with qualified nurses undertaking part-time degree programmes--some implications for nurse managers to consider.

The aim of this exploratory study was to explore and describe aspects of the programme that caused stress to students and suggested measures for reducing this stress. Perceived personal and professional benefits were also explored. A descriptive exploratory study utilizing a survey design was utilized. Stressors associated with the programme included trying to balance work commitments and the required study emerged as the number one stressor. "Balancing" was a significant feature of many of these nurses' lives. Meeting work commitments in addition to study was a reported stressor for almost every nurse. Employers and managers within the health care setting need to be responsive to the needs of nurses undertaking postregistration study, and explore flexible working options and aim to provide support and encouragement to nurses who are motivated towards study. Results indicate overall benefits for both the nurses' personal and professional practice, therefore adequate infrastructure to suitably support these nurses is required that may have potential benefits for patient/client care.

Adult↗
PubMed2003

Information needs of myocardial infarction patients.

The main objectives of this study were to assess the perceptions of patients immediately after their first myocardial infarction of their needs in a cardiac education programme and to compare these with their perceptions 6 weeks after the event and also with their nurse educators. The data were collected by a questionnaire, the cardiac patients' learning needs inventory which was administered to both patients and nurses. It comprised 37 "needs" items grouped into seven categories, each item to be scored into one of five levels of importance. There were 27 patients interviewed on the first occasion, of whom 18 responded to a postal questionnaire on the second occasion. A census of three groups of nurses was taken in the study, namely all nurses employed in one coronary care unit and in a cardiac ward at a large Dublin Hospital and all nurses employed as cardiac rehabilitation nurses/officers in Ireland at the time of commencement of the study. Sixty-eight nurses responded, a response rate of 80%. A key finding was that the responses were highly skewed, with two-thirds in the top grade ("very important") and less than 1% in the two lowest grades ("not important" and "somewhat important"). The overall response score distribution of the patients differed somewhat from that of the nurses, but this difference was accounted for by mainly three items, all in the "physical activity" category, namely "when to resume driving", "when to resume sexual activity", and "when to resume work", which the nurses scored high and the patients low. Both patients and nurses gave the highest mean scores to four items, namely "what to do when in chest pain", "what are the symptoms of a heart attack", "when to call a doctor", and "what to do to reduce the chance of another heart attack". The first three of these are in the "symptom management" category. These findings support previous studies on the topic. The findings also support the need for individualised nurse/patient negotiated cardiac teaching programmes that can be tailored to suit each patient's needs.

Activities of Daily Living↗
PubMed2002

Attitudes to absenteeism among diploma nursing students in Ireland - an exploratory descriptive survey.

Nurse education within Ireland is currently in a transition period. October 2002 heralds the national implementation of a third-level four-year degree based programme for the preparation of nurses, to replace the current three-year diploma system. Anecdotally, one concern expressed by nurse educators regarding this move, is the regulation and monitoring of student non-attendance. This study explores the views of those involved in nurse education in Ireland to absenteeism among diploma nursing students to ascertain whether or not concern exists. The findings reveal absenteeism as a potential problem among nursing students. Most respondents agree that student attendance at both the practical and theoretical aspect of current education programmes is a problem. There is overwhelming agreement that student attendances while on the clinical area should be monitored, while the majority of respondents agree that attendance monitoring during lectures should take place. Some divergent views emerge among the lecturers and tutors with the lecturers seeming more 'liberal' on average than the tutors, reflecting perhaps the different traditions of their environments. Mostly however, the differences between the two groups are small and statistically insignificant. Overall responses indicate a continued commitment to monitoring and control of absenteeism in this population. Systematic policies need to be developed and enforced and key personnel need to be employed to support attendance monitoring in the third level setting.

Absenteeism↗
PubMed2002

Aspects of nurse education programmes that frequently cause stress to nursing students -- fact-finding sample survey.

This study examined reported stress in 12 areas commonly reported to cause stress to nursing students. A questionnaire was distributed to 110 third-year nursing students, and the results indicate that stress exists for students in both the clinical and academic aspects of the programme. Financial constraints and academic-related concerns emerged as the most stressful areas for the students. A third of the students reported that relationships with teachers and staff on the ward cause some degree of stress. Factor analysis revealed that five factors emerged as sources of stress. Firstly, 'academic' stress factors. The second and third components concern relationships, the former involving teaching-related staff, and the latter involving the clinical experience. The last two components suggest that finance and death of patients are independent sources of stress. Major restructuring is about to take place in nurse education in Ireland, with the introduction of degree preparation for all nursing students in 2002. It is imperative that those involved with nursing students, both in the clinical area and in education settings, take cognisance of the stress that current students face. Recommendations for educators include adequate support structures for clinical areas, preceptorship programmes and the availability of student counselling services.

Attitude of Health Personnel↗
PubMed2002

Using the Roper, Logan and Tierney model in a neonatal ICU.

The Roper, Logan and Tierney nursing model is one of the most well-known in the UK and Ireland and is used in many other countries. This paper examines nurses' views on the model as described in the literature. It examines the model's usefulness in a neonatal care unit and focuses on the care of a premature baby, using the model as a basis for assessment and care.

Humans↗
PubMedDate not supplied

Nurses' knowledge of chest drain care: an exploratory descriptive survey.

Chest drains are a common feature of patients admitted to acute respiratory or cardio-thoracic surgery care areas. Chest drains are either inserted intraoperatively or as part of the conservative management of a respiratory illness or thoracic injury. Anecdotally, there appears to be a lack of consensus among nurses on the major principles of chest drain management. Many decisions tend to be based on personal factors rather than sound clinical evidence. This inconsistency of treatment regimes, together with the lack of evidence-based nursing care, creates a general uncertainty regarding the care of patients with chest drains. This study aimed to identify the nurses' levels of knowledge with regard to chest drain management. The research objective of this study was to describe the nurses' levels of knowledge regarding the care of the patient with chest drains. The data were collected using survey method. The results of the study revealed deficits in knowledge in a select group of nurses. Several service-led options exist with regard to improving knowledge in this area, such as service study days as well as ward-based tutorials. However, in an era of increasing accountability together with the impetus for each nurse to provide evidence-based care, it is crucial for individual nurse responsibility in the pursuit of knowledge in this area. Nurses must be supported by local practice development and through personal portfolio use to identify gaps in knowledge and seek appropriate training and resources.

Adult↗
PubMedDate not supplied

A review of the information needs of patients with acute coronary syndromes.

The individual nature of information required by hospitalized patients with coronary heart disease (CHD) has been of concern to nurses for over 20 years. An information need is not necessarily a gap in knowledge that can be satisfied by education. It represents what the patient wants to know from the professional in order to cope effectively with the current situation. Through analysis of available literature, it seems that patients appear to prioritize information that is pertinent to survival, such as symptom management, rather than broader lifestyle issues such as exercise and diet. Although information needs are individual and subjective to each patient, trends emerge within patient groups. Information needs of patients with CHD in coronary care unit and ward setting occur across eight or more common areas. Through patient-centred communication, patients' f preferences for information in these topics can be derived and used as the basis for information delivery. Individual idiosyncratic needs can also be noted and addressed.

Adaptation, Psychological↗
PubMedDate not supplied

Using the Roper-Logan-Tierney model in neonatal transport.

In recent years approaches to nursing practice have changed. Nursing theorists have advocated the need for nursing practice to be carried out using a systematic rather than an intuitive approach. A process of nursing has been developed as a method of organizing and delivering nursing care. This change in nursing practice has resulted in the need to establish a knowledge base that relates specifically to nursing. Conceptual models of nursing, advocated by nursing theorists, have come into use in Ireland, the UK and the USA. These models aim to promote greater understanding of people and their nursing needs. They advocate a certain approach to nursing and attempt to define nursing as a role independent from other health care roles. The need to develop a knowledge base specific to nursing remains a central tenet of the profession (Aggleton and Chalmers, 2000). Nursing models serve to provide this knowledge base through the description of the nature of people, health, environment and nursing. The aim of this article is to explore the use of the Roper-Logan-Tierney (RLT) nursing model in a neonatal transport setting. The first section provides an overview of the model. The second section describes the background information on a selected patient, followed by a detailed assessment of this patient using the activities of living. The final section evaluates the use of the model in this clinical situation with reference to literature on the topic.

Activities of Daily Living↗