Resigning: a classic grounded theory of working within constraints when caring for stroke patients in the acute general care setting

This research aims to explore the challenges nurses face, when caring for stroke patients on a general medical/surgical ward, in the acute care setting and identify how nurses resolve or process this challenge. Healthcare environments continue to face the pressures of constraints such as reduced staffing levels, budgets, resources and less time, which influence care provision. Patient safety is central in care provision where nurses face the challenge of delivering best quality care when working within constraints. The incidence of stroke is increasing worldwide and internationally stroke units are the recognised minimum standard of care. In Ireland with few designated stroke units in operation many stroke patients are cared for in the acute general care setting. A classic grounded theory methodology was utilised for this study. Data was collected and analysed simultaneously through coding, constant comparison, theoretical sampling and memoing. Individual unstructured interviews with thirty two nurses were carried out. Twenty hours of non-participant observations in the acute general care setting were undertaken. The main concern that emerged was working within constraints. This concern is processed by nurses through resigning which consists of three phases; idealistic striving, resourcing and care accommodation. Through the process of resigning nurses engage in an energy maintenance process enabling them to continue working within constraints. The generation of the theory of resigning explains how nurses’ resolve or process working within constraints. This theory adds to the body of knowledge on stroke care provision. This theory has the potential to enhance nursing care, minimise burnout and make better use of resources while advocating for best care of stroke patients.

Effects of tidal range on mooring systems of wave energy converters

Wave energy converters are currently proposed to be deployed near coastal area for the closeness to the infrastructure and for ease of maintenance in order to reduce operational costs. The motivation behind this work is the fact that the deployment depths during the highest and lowest tides will have a significant effect on the mooring system of WECs. In this paper, the issue will be investigated by numerical modelling (using ANSYS AQWA) for both catenary and taut moorings to examine the performance of the mooring system in varying tides. The case study being considered is the ¼- scale wave energy test site in Galway Bay off the west coast of Ireland where some marine renewable energy devices can be tested. In this test site, the tidal range is macro-tidal with a range of approximately 6 m which is a large value relative to the water depth. In the numerical analysis, ANSYS AQWA suite has been used to simulate moored devices under wave excitation at varying tidal ranges. Results show that the highest tide will give rise to larger forces. While at lower depths, slackening of the mooring occurs. Therefore, the mooring lines must be designed to accommodate both situations.