Writing Violence: the legal, moral and aesthetic Implications of creative non-fiction.

This essay began as a hybrid critical/creative paper that was presented as part of an all-female panel discussing the intersections between writing and extreme violence. My own paper was on the relationship between my creative nonfiction novel The Museum of Atheism and the real life murder of six-year-old beauty queen, JonBenet Ramsey. This essay is an attempt to represent the writing process of the creative nonfiction author, and to consider the ways in which critical theory can be used to highlight, or conversely obscure, fictional writing. In addition to considering the effect of using a real story, a true crime, as the basis for a semi-fictional work, this essay will also consider the relationship I had as a writer to my publisher, editor and agent, and their interventions in the writing process to ensure that facts were deliberately skewed or warped in order to avoid litigation. Finally, I will consider my own relationship to the material, and the impact that this had on the writing process.

Intensive care survivors’ experiences of ward-based care: Meleis’ theory of nursing transitions and role development among critical care outreach services.

Aims and objectives. To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow-up and liaison services. Background. Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse-led critical care outreach, follow-up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward-based care has also been identified, but the evidence base for role development is currently limited. Design and methods. Twenty participants were invited to discuss their experiences of ward-based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.’s mid-range theory on experiencing transitions. Results. Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries. Conclusion. These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer. Relevance to clinical practice. Meleis et al.’s work has resonance in terms of explicating intensive care patients’ experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow-up and liaison services may be more theoretically informed.