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PubMed2004

Vigilance: the experience of parents staying at the bedside of hospitalized children.

Although the incorporation of a family-centered model of care delivery and open visitation policies have supported parents at the bedside of hospitalized children, little research has been conducted exploring the daily experience of vigilant parents. The purpose of this qualitative ethnographic study was to explore the experience of vigilance and specifically to examine the meaning, patterns, and day-to-day rhythms of parents who stay at the bedside of their hospitalized children. Ten parents of hospitalized children on a general pediatric unit were purposively selected to participate in the study. Qualitative data analysis supported the themes generated by previous studies of vigilance: commitment to care, resilience, emotional upheaval, dynamic nexus, and transition (Carr & Clarke, 1997; Carr & Fogarty, 1999). The knowledge generated from this study helps to support the theoretical understanding of vigilance and enhances the ability of health care providers to provide care that is congruent with the needs of parents and their children.

Adaptation, Psychological↗
PubMed2004

Doing criticism in 'symbiotic niceness': a study of palliative care nurses' talk.

This paper examines how palliative care nurses do criticism of other professionals in talk within settings for care of the dying (two hospices and one general hospital). Strategies for the production of moral identities include the use of direct criticism, indirect criticism and quoted speech, hence 'inverted comma criticism'. Criticism is done through the construction and reconstruction of 'atrocity stories'. Atrocity stories are used as a medium by nurses to express their opinions and feelings about doctors who might have behaved insensitively. At the same time, it allows doctors to redeem themselves. The analysis of talk reveals that the voices of absent patients are reactivated and co-opted into the nurses' talk. The stories serve to produce an image of nurses as caring, morally responsible patient advocates and loyal characters to their medical colleagues. Through the analysis of talk, the communication skills and strategies for the maintenance of interactional order are made visible and displayed. Skills for the production of the palliative care team work are also made visible. Emotional labour is analysed as a project for the production of particular kinds of niceness which in turn require particular types of emotional labour. This paper argues that educators should aim to identify and make conscious use of nurses' own available interactional skills, and focus on valuable cultural (rules of decorum) and material resources (the disease process) which are readily available and accessible for nurses, as a starting point in communication training. The theory of an account of co-production of niceness which benefits each other, hence, symbiotic niceness, reveals that being nice to each other can be rewarding and therapeutic in that it helps to smooth, distance and ameliorate problems occurring in the reality of palliative care nurses' and their patients' life-worlds.

Anecdotes as Topic↗
PubMed2006

Meaning and coherence of self and health: an approach based on narratives of life events.

Using contributions from the fields of interactionist sociology and narrative studies and the results of an empirical study, in this article we examine the subject's mediation between life events and state of health. Examining narratives focusing on significant life events from 26 men and women aged between 51 and 73 from the administrative region of Ile de France, we suggest that dimensions of meaning and coherence of self need not be taken as internal dispositions, but rather as the product of sociocognitive work on self-narration. The characterisation of the types of causal relationships that the narrators establish between significant events and other events, situations or periods in their lives, opens up avenues for the development of a methodological tool to replace traditional ways of measuring sense of coherence and meaning/purpose in life using psychometric methods. This alternative perspective based on a conception of the self as narrative might provide a remedy for certain conceptual and methodological difficulties that are found within the field of coping research.

Adaptation, Psychological↗
PubMed2006

Women's stories of birth: a suitable form of research evidence?

In the past one to two decades, midwifery care has taken a new direction, which encompasses a valuing of women's birth experiences. This move has been contingent upon, and congruent with the adoption of 'woman centred' care and a renewed emphasis on normal birth. In line with these developments, women's stories and anecdotes of birth and midwives stories of experience increasingly form the basis of presentations at midwifery conferences and forums. Overall, this philosophical realignment, which commenced in Australia in the early 1990s, has been applauded by many midwives in terms of a greater valuing of the wishes and experiences of childbearing women and as being consistent with a greater promotion of normal birth. Nonetheless, it also gives rise to several questions, regarding the suitability of this form of research evidence. In a bid to answer some of those questions, this paper aims to evaluate the use of stories and anecdotal evidence within midwifery. First, an overview is presented of the way in which stories of pregnancy and birth appear in the literature. Secondly, the value of stories as evidence is critiqued and, finally, the ratio of story based publications, compared to traditional research methodologies, is reviewed. This review aims to address an area poorly attended in the literature and asks specifically: Are women's birth stories a suitable form of research evidence in midwifery?

Anecdotes as Topic↗
PubMed2006

Challenging midwifery care, challenging midwives and challenging the system.

The purpose of this paper is to generate debate and discussion about the state of midwifery services in Australia today. While numerous reports have been published that highlight what women want in maternity care, widespread change has not occurred. This paper presents the story of Alice (a real woman with a fictitious name). Alice's story highlights the challenges that women face in dealing with a system that is often inflexible. While the health systems, and those who work within them, usually have the best intentions to try to provide the type of care that women want, they are not always successful. The paper summarises the evidence and support for models of continuity of midwifery care and outlines a series of strategies to ensure that change can occur. Finally, the paper challenges all midwives to work towards widespread, system-level change in Australian maternity services.

Adult↗
PubMed1995

Substance abuse in the perioperative setting.

Published information and extensive anecdotal reports from perioperative nurses reveal an alarming amount of substance abuse in the perioperative setting. In addition to the familiar controlled substances (eg, narcotics, tranquilizers), practitioners must be familiar with the potential abuse of anesthesia induction agents such as ketamine, nitrous oxide, and general inhalation anesthetics. Perioperative nurses need to be aware of the problem of substance abuse in the perioperative setting, increase their knowledge of substance abuse practices, be alert to signs and symptoms of chemical dependency, and have plans for responding to reported substance abuse situations when on duty.

Anecdotes as Topic↗