So what if students are poor at numeracy?

The numeracy skill of student is a continued concern with numeracy highlighted as a key skill in Foundation degrees and other vocational courses such as nursing (DfES 1999, NMC 2007). Numeracy is seen as a requirement to being able to undertake work based skills that require the use of numbers and calculations. However numeracy skills developed in the classroom does not necessarily prepare students for work-based calculations and similarly nor does poor numeracy skills necessarily mean that students cannot perform complex mathematical calculations in their work place. This paper will explore the role of context, the difference between formal and work based mathematics and questions the continued focus on numeracy skills, using examples from my own research with nurses.

The impact of the nursing workforce on patient outcomes in intensive care

Introduction: Evidence from studies conducted mainly in the US and mainland Europe suggests that characteristics of the workforce, such as nurse patient ratios and workload (measured in a number of different ways) may be linked to variations in patient outcomes across health care settings (Carmel and Rowan 2001). Few studies have tested this relationship in the UK thus questions remain about whether we are justified in extrapolating evidence from studies conducted in very different health care systems. Objectives: To investigate whether characteristics of the nursing workforce affect patient mortality UK Intensive Care Units. Data: Patient data came from the case mix programme, Intensive Care National Audit and Research Centre (ICNARC), while information about the units came from a survey of all ICUs in England (Audit Comission 1998). The merged data set contained information on 43,859 patients in 69 units across England. ICNARC also supplied a risk adjustment variable to control for patient characteristics that are often the most important determinants of survival. Methods: Multivariate multilevel logistic regression. Findings: Higher numbers of direct care nurses and lower scores on measures of workload(proportion of occupied beds at the time the patient was admitted and mean daily transfers into the unit) were associated with lower mortality rates. Furthermore, the effect of the number of direct care nurses was greatest on the life chances of the patients who were most at risk of dying. Implications: This study has wide implications for workforce policy and planning because it shows that the size of the nursing workforce is associated with mortality (West et al 2006). Few studies have demonstrated this relationship in the UK. This study has a number of strengths and weaknesses and further research is required to determine whether this relationship between the nursing workforce and patient outcomes is causal.

Bridging the gap with teamwork: collaborative leadership for communities of practice in the learning and skills sector

Collaborative approaches in leadership and management are increasingly acknowledged to play a key role in successful institutions in the learning and skills sector (LSS) (Ofsted, 2004). Such approaches may be important in bridging the potential 'distance' (psychological, cultural, interactional and geographical) (Collinson, 2005) that may exist between 'leaders' and 'followers', fostering more democratic communal solidarity. This paper reports on a 2006-07 research project funded by the Centre for Excellence in Leadership (CEL) that aimed to collect and analyse data on 'collaborative leadership' (CL) in the learning and skills sector. The project investigated collaborative leadership and its potential for benefiting staff through trust and knowledge-sharing in communities of practice (CoPs). The project forms part of longer-term educational research investigating leadership in a collaborative inquiry process (Jameson et al., 2006). The research examined the potential for CL to benefit institutions, analysing respondents' understanding of and resistance to collaborative practices. Quantitative and qualitative data from senior managers and lecturers was analysed using electronic data in SPSS and Tropes Zoom. The project aimed to recommend systems and practices for more inclusive, diverse leadership (Lumby et al., 2005). Collaborative leadership has increasingly gained international prominence as emphasis shifted towards team leadership beyond zero-sum 'leadership'/ 'followership' polarities into more mature conceptions of shared leadership spaces, within which synergistic leadership spaces can be mediated. The relevance of collaboration within the LSS has been highlighted following a spate of recent government-driven policy developments in FE. The promotion of CL addresses concerns about the apparent 'remoteness' of some senior managers, and the 'neo-management' control of professionals which can increase 'distance' between leaders and 'followers' and may de-professionalise staff in an already disempowered sector. Positive benefit from 'collaborative advantage' tends to be assumed in idealistic interpretations of CL, but potential 'collaborative inertia' may be problematic in a sector characterised by rapid top-down policy changes and continuous external audit and surveillance. Constant pressure for achievement against goals leaves little time for democratic group negotiations, despite the desires of leaders to create a more collaborative ethos. Yet prior models of intentional communities of practice potentially offer promise for CL practice to improve group performance despite multiple constraints. The CAMEL CoP model (JISC infoNet, 2006) was linked to the project, providing one practical way of implementing CL within situated professional networks.The project found that a good understanding of CL was demonstrated by most respondents, who thought it could enable staff to share power and work in partnership to build trust and conjoin skills, abilities and experience to achieve common goals for the good of the sector. However, although most respondents expressed agreement with the concept and ideals of CL, many thought this was currently an idealistically democratic, unachievable pipe dream in the LSS. Many respondents expressed concerns with the 'audit culture' and authoritarian management structures in FE. While there was a strong desire to see greater levels of implementation of CL, and 'collaborative advantage' from the 'knowledge sharing benefit potential' of team leadership, respondents also strongly advised against the pitfalls of 'collaborative inertia'. A 'distance' between senior leadership views and those of staff lower down the hierarchy regarding aspects of leadership performance in the sector was reported. Finally, the project found that more research is needed to investigate CL and develop innovative methods of practical implementation within autonomous communities of professional practice.

Violence and aggression in the emergency department: factors impinging on nursing research

This paper examines issues involved in the debate regarding the role of research in nursing. The authors take the example of violence and aggression in the emergency field to discuss methodological, philosophical, professional, logistical, power differentials and leadership theory that influence and explain the process of conducting research surrounding violence and aggression experienced by nurses working in emergency departments. The paper examines the importance of research and discusses practical issues that impinge or frustrate clinical nursing staff who wish to conduct original research.

Meeting the health needs of people with learning disabilities: guidance for nursing staff

This guide has been produced to support registered nurses and nursing students in primary and secondary care, who are trained in branches other than learning disabilities, to deliver high quality health care to people with learning disabilities.