Legal, Ethical and Professional Issues

The chapter addresses the professional, legal and ethical issues associated with medicines management and the role of the nurse. To ensure safe practice it is imperative safeguards are recognised and applied; therefore pertinent legislative frameworks, policy and professional regulation are discussed. Safeguarding patients when administering prescribed medicines means the nurse must have up-to-date knowledge and skill and a key aspect of this is to ensure consent to treatment from the service user is secured; for this reason drawing on relevant legislation, the consensual process is reviewed. Not infrequently medicine management provokes ethical and legal challenges for the health care professional; these demand reflection and careful consideration; consequently in this chapter legal and ethical parameters and professional boundaries are appraised.

Understanding the Patient Experience Through the Power of Film: a Mixed Method Qualitative Research Project

Film is a highly attractive teaching instrument for the study of different terminal diseases, exploring bioethics (Beauchamp and Childress, 2009) and is a preferred medium over traditional lectures (Edmunds, 2013) to provide realistic examples for adult learners. It can tap into ethical issues; facilitate decision-making; and examine underlying issues such as euthanasia; assisted suicide; and professional responsibility. Contrast this with standard means of teaching, such as scenarios- although a useful pedagogic tool, these are limited because students must imagine the clinical scenario. Film can fill that imaginative gap (Volandes, 2007). It can be utilised as an active teaching strategy for a variety of topics in nursing (Edmunds, 2013) providing a unique way to promote active learning in nursing education (Herrman, 2006). The objectives of the study, aim to help pre registration student nurses from each year of study to engage with their role as health care professionals; provide open discussion and debate on how they view the personal experience of illness/disease/disability/death and to reflect on their role and provision of patient care. It is delivered in 3 tiers to provide a range of data for thematic analysis; 1) Film screening followed by a ‘5 minute reaction’ discussion and post screening questionnaire; 2) Pre screening guided activities for reflection and discussion; 3) Focus groups. This project meets identified aims from the UK Professional Standards Framework (UKPSF) by fostering creative and innovative approaches to teaching and learning; facilitating and supporting the design and delivery of continuing education development programmes and activities; and demonstrates professionalism that staff and institutions bring to teaching. Preliminary feedback and themes will be presented.

The Personal and Professional Selves of Teachers: Stable and Unstable Identities

In much educational literature it is recognised that the broader social conditions in which teachers live and work, and the personal and professional elements of teachers' lives, experiences, beliefs and practices are integral to one another, and that there are often tensions between these which impact to a greater or lesser extent upon teachers' sense of self or identity. If identity is a key influencing factor on teachers' sense of purpose, self‐efficacy, motivation, commitment, job satisfaction and effectiveness, then investigation of those factors which influence positively and negatively, the contexts in which these occur and the consequences for practice, is essential. Surprisingly, although notions of ‘self’ and personal identity are much used in educational research and theory, critical engagement with individual teachers' cognitive and emotional ‘selves’ has been relatively rare. Yet such engagement is important to all with an interest in raising and sustaining standards of teaching, particularly in centralist reform contexts which threaten to destabilise long‐held beliefs and practices. This article addresses the issue of teacher identities by drawing together research which examines the nature of the relationships between social structures and individual agency; between notions of a socially constructed, and therefore contingent and ever‐remade, ‘self’, and a ‘self’ with dispositions, attitudes and behavioural responses which are durable and relatively stable; and between cognitive and emotional identities. Drawing upon existing research literature and findings from a four‐year Department for Education and Skills funded project with 300 teachers in 100 schools which investigated variations in teachers' work and lives and their effects on pupils (VITAE), it finds that identities are neither intrinsically stable nor intrinsically fragmented, as earlier literature suggests. Rather, teacher identities may be more, or less, stable and more or less fragmented at different times and in different ways according to a number of life, career and situational factors.

Methodological Synergy in a National Project: The VITAE Story

VITAE was a four-year research project designed to explore the work and lives of a purposive sample of 300 Key Stage 1, 2 and 3 (English and maths) teachers at different phases of their careers in 100 primary and secondary schools in different socioeconomic contexts, drawn from seven local authorities in England. Its focus was upon identifying variations in different aspects of teachers' lives and work and examining possible connections between these and their effects on pupils as perceived by the teachers themselves and as measured by value-added national test scores. An integrated mixed-method approach was developed in addressing the research questions. The results showed that there were associations between teachers' work, lives and identities, that teachers' perceived and relative (valueadded) effectiveness varied within each of six professional life phases, and that this variation depended upon their capacity to manage a number of moderating and mediating factors. Statistically significant relationships were found between teacher commitment, resilience and the value-added pupil test scores. The findings from the study shed new light upon the meanings and measurement of teacher effectiveness and the complex nature and trajectories of teachers' work, lives and effectiveness in different school contexts.

Best Practice for Providing Social Care and Support to People Living with Concurrent Sight Loss and Dementia: Professional Perspectives

Purpose-Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach-The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings-Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications-Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications-There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications-People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value-This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care