Mapping the ethical journey of experienced nurses now practising in rural and remote hospitals in central and south-west Queensland and in domiciliary services in Brisbane : a grounded theory approach

The aim of this thesis has been to map the ethical journey of experienced nurses now practising in rural and remote hospitals in central and south-west Queensland and in domiciliary services in Brisbane. One group of the experienced nurses in the study were Directors of Nursing in rural and remote hospitals. These nurses were “hands on”, “multi-skilled “ nurses who also had the task of managing the hospital. Also there were two Directors of Nursing from domiciliary services in Brisbane. A grounded theory method was used. The nurses were interviewed and the data retrieved from the interviews was coded, categorised and from these categories a conceptual framework was generated. The literature which dealt with the subject of ethical decision making and nurses also became part of the data. The study revealed that all these nurses experienced moral distress as they made ethical decisions. The decision making categories revealed in the data were: the area of financial management; issues as end of life approaches; allowing to die with dignity; emergency decisions; experience of unexpected death; the dilemma of providing care in very difficult circumstances. These categories were divided into two chapters: the category related to administrative and financial constraints and categories dealing with ethical issues in clinical settings. A further chapter discussed the overarching category of coping with moral distress. These experienced nurses suffered moral distress as they made ethical decisions, confirming many instances of moral distress in ethical decision making documented in the literature to date. Significantly, the nurses in their interviews never mentioned the ethical principles used in bioethics as an influence in their decision making. Only one referred to lectures on ethics as being an influence in her thinking. As they described their ethical problems and how they worked through them, they drew on their own previous experience rather than any knowledge of ethics gained from nursing education. They were concerned for their patients, they spoke from a caring responsibility towards their patients, but they were also concerned for justice for their patients. This study demonstrates that these nurses operated from the ethic of care, tempered with the ethic of responsibility as well as a concern for justice for their patients. Reflection on professional experience, rather than formal ethics education and training, was the primary influence on their ethical decision making.

Information sharing with key suppliers : a transaction cost theory perspective

Purpose: The purpose of this paper is to explain variations in discretionary information shared between buyers and key suppliers. The paper also aims to examine how the extent of information shared affects buyers’ performance in terms of resource usage, output, and flexibility. ----- ----- Design/methodology/approach: The data for the paper comprise 221 Finnish and Swedish non-service companies obtained through a mail survey. The hypothesized relationships were tested using partial least squares modelling with reflective and formative constructs.----- ----- Findings: The results of the study suggest that (environmental and demand) uncertainty and interdependency can to some degree explain the extent of information shared between a buyer and key supplier. Furthermore, information sharing improves buyers’ performance with respect to resource usage, output, and flexibility.----- ----- Research limitations/implications: A limitation to the paper relates to the data, which only included buyers.Abetter approach would have been to collect data from both, buyers and key suppliers. Practical implications – Companies face a wide range of supply chain solutions that enable and encourage collaboration across organizations. This paper suggests a more selective and balanced approach toward adopting the solutions offered as the benefits are contingent on a number of factors such as uncertainty. Also, the risks of information sharing are far too high for a one size fits all approach.----- ----- Originality/value: The paper illustrates the applicability of transaction cost theory to the contemporary era of e-commerce. With this finding, transaction cost economics can provide a valuable lens with which to view and interpret interorganizational information sharing, a topic that has received much attention in the recent years.

Resistance is hopeless : assimilating queer theory

This paper seeks to assimilate Queer Theory: that is, to bring it within the gambit of a ‘mainstream’ or ‘dominant’ space: the academy. It does so by historicising Queer Theory, and investigating, if not what it is, then at least what it has been. This makes it possible to engage critically with Queer Theory. Suggesting that Queer Theory has often employed tropes of assimilation, the paper turns to another cultural site at which such language is popular - science fiction - in order to investigate the assumption of these metaphors. It goes on to suggest some of the assumptions about cultures which underlie these metaphors. Finally, it points to other sites in Queer Theory which undermines these assumptions, and provide other ways - quite uninterested in assimilation - in which to think Queer.

Contemporary children's literature and film : engaging with theory

Bringing together the voices of leading and emerging scholars, this book provides critical approaches for reading children's literature and film. It argues for the significance of theory for reading texts written and produced for young people and integrates a wide range of critical perspectives, including schema theory, theories of space and place, cultural globalization, feminism, ecocriticism, adaptation theory, postcolonialism, and posthumanism.

Introduction : bringing back theory

In a report in the New York Times about a public symposium on the future of theory held at University of Chicago in 2002, staff writer Emily Eakin suggests that theory appears to have taken a back seat to more pressing current affairs – the Bush Administration, Al Qaeda, Iraq. Further, she reports that the symposium’s panel of high-profile theorists and scholars, including Homi Bhabha, Stanley Fish, Fredric Jameson, seemed reticent to offer their views on what is often touted as the demise or irrelevance of theory. The symposium and other commentaries on the topic of theory have prompted the view that the ‘Golden Age of Theory’ has passed and we are now in a ‘Post-Theory Age’. Given these pronouncements, we need to ask – Does theory matter any longer? Is it time for the obituary? Or are reports of the death of theory greatly exaggerated? The question remains whether to mourn or celebrate the demise of theory, and whether the body has in fact breathed its last. The title of this Introduction – ‘Bringing back theory’ – suggests a resurrection, or perhaps a haunting, as if the funeral has passed and, like Banquo’s ghost, theory returns to unsettle or disturb the celebration. It also suggests an entreaty, or perhaps a return performance. Rather than settle on one meaning, one interpretation, we are happy for all possibilities to coexist. The coexistence of different theories, different approaches, different interpretations also reflects the state of literary and cultural studies generally and children’s literature criticism in particular. No single theory or viewpoint predominates or vies for hegemony. Yet, one further question lingers – what is theory?

The potential of critical race theory in decolonizing university curricula

This paper critiques our experiences as non-Indigenous Australian educators of working with numerous embedding Indigenous perspectives curricular projects at an Australian university. Reporting on these project outcomes alone, while useful in identifying limitations, does not illustrate ways in which future embedding and decolonising projects can persist and evolve. Deeper analysis is required of the ways in which Indigenous knowledge and perspectives are perceived, and what ‘embedding’ IK in university curricula truly means to various educational stakeholders. To achieve a deeper analysis and propose ways to invigorate the continuing decolonisation of Australian university curricula, this paper critically interrogates the methodology and conceptualisation of Indigenous knowledge in embedding Indigenous perspectives (EIP) in the university curriculum using tenets of critical race theory. Accordingly, we conduct this analysis from the standpoint that EIP should not subscribe to the luxury of independence of scholarship from politics and activism. The learning objective is to create a space to legitimise politics in the intellectual / academic realm (Dei, 2008, p. 10). We conclude by arguing that critical race theory’s emancipatory, future and action-oriented goals for curricula (Dei, 2008) would enhance effective and sustainable embedding initiatives, and ultimately, preventing such initiatives from returning to the status quo (McLaughlin & Whatman, 2008).

Decolonising curricula in an Australian university : re-imagining curriculum through critical race theory

The recognition of Indigenous knowledge in western academic institutions challenges colonial discourses which have informed and shaped knowledge about Indigenous peoples, cultures and histories. Deeper analysis is required of the ways in which Indigenous knowledge and perspectives are perceived, and the processes through which university curricula can accommodate Indigenous knowledge in teaching and learning. To achieve this deeper analysis, and to invigorate the continuing decolonisation of Australian university curricula, this paper critically interrogates the methodology and conceptualisation of Indigenous knowledge in embedding Indigenous perspectives (EIP) projects in the university curriculum by drawing from tenets of critical race theory and the cultural interface (Nakata, 2007). Accordingly, we conduct this analysis from the standpoint that Indigenous knowledge in university curricula should not subscribe to the luxury of independence of scholarship from politics and activism. The learning objective is to create a space to legitimise politics in the intellectual / academic realm (Dei, 2008, p. 10). We conclude by arguing that critical race theory’s emancipatory, future and action-oriented goals for curricula (Dei, 2008) would enhance effective and sustainable embedding initiatives, and ultimately, preventing such initiatives from returning to the status quo (McLaughlin & Whatman, 2008).

Controlling chaos? The value and the challenges of applying complexity theory to project management

The literature abounds with descriptions of failures in high-profile projects and a range of initiatives has been generated to enhance project management practice (e.g., Morris, 2006). Estimating from our own research, there are scores of other project failures that are unrecorded. Many of these failures can be explained using existing project management theory; poor risk management, inaccurate estimating, cultures of optimism dominating decision making, stakeholder mismanagement, inadequate timeframes, and so on. Nevertheless, in spite of extensive discussion and analysis of failures and attention to the presumed causes of failure, projects continue to fail in unexpected ways. In the 1990s, three U.S. state departments of motor vehicles (DMV) cancelled major projects due to time and cost overruns and inability to meet project goals (IT-Cortex, 2010). The California DMV failed to revitalize their drivers’ license and registration application process after spending $45 million. The Oregon DMV cancelled their five year, $50 million project to automate their manual, paper-based operation after three years when the estimates grew to $123 million; its duration stretched to eight years or more and the prototype was a complete failure. In 1997, the Washington state DMV cancelled their license application mitigation project because it would have been too big and obsolete by the time it was estimated to be finished. There are countless similar examples of projects that have been abandoned or that have not delivered the requirements.

Getting to know a stranger-rural nurses' experiences of mentoring : a grounded theory

Background: Mentoring is often proposed as a solution to the problem of successfully recruiting and retaining nursing staff. The aim of this constructivist grounded theory study was to explore Australian rural nurses' experiences of mentoring. Design: The research design used was reflexive in nature resulting in a substantive, constructivist grounded theory study. Participants: A national advertising campaign and snowball sampling were used to recruit nine participants from across Australia. Participants were rural nurses who had experience in mentoring others. Methods: Standard grounded theory methods of theoretical sampling, concurrent data collection and analysis using open, axial and theoretical coding and a story line technique to develop the core category and category saturation were used. To cultivate the reflexivity required of a constructivist study, we also incorporated reflective memoing, situational analysis mapping techniques and frame analysis. Data was generated through eleven interviews, email dialogue and shared situational mapping. Results: Cultivating and growing new or novice rural nurses using supportive relationships such as mentoring was found to be an existing, integral part of experienced rural nurses' practice, motivated by living and working in the same communities. Getting to know a stranger is the first part of the process of cultivating and growing another. New or novice rural nurses gain the attention of experienced rural nurses through showing potential or experiencing a critical incidence. Conclusions: The problem of retaining nurses is a global issue. Experienced nurses engaged in clinical practice have the potential to cultivate and grow new or novice nurses-many already do so. Recognising this role and providing opportunities for development will help grow a positive, supportive work environment that nurtures the experienced nurses of tomorrow.

Grounded theory : a methodological spiral from positivism to postmodernism

Aim. Our aim in this paper is to explain a methodological/methods package devised to incorporate situational and social world mapping with frame analysis, based on a grounded theory study of Australian rural nurses' experiences of mentoring. Background. Situational analysis, as conceived by Adele Clarke, shifts the research methodology of grounded theory from being located within a postpositivist paradigm to a postmodern paradigm. Clarke uses three types of maps during this process: situational, social world and positional, in combination with discourse analysis. Method. During our grounded theory study, the process of concurrent interview data generation and analysis incorporated situational and social world mapping techniques. An outcome of this was our increased awareness of how outside actors influenced participants in their constructions of mentoring. In our attempts to use Clarke's methodological package, however, it became apparent that our constructivist beliefs about human agency could not be reconciled with the postmodern project of discourse analysis. We then turned to the literature on symbolic interactionism and adopted frame analysis as a method to examine the literature on rural nursing and mentoring as secondary form of data. Findings. While we found situational and social world mapping very useful, we were less successful in using positional maps. In retrospect, we would argue that collective action framing provides an alternative to analysing such positions in the literature. This is particularly so for researchers who locate themselves within a constructivist paradigm, and who are therefore unwilling to reject the notion of human agency and the ability of individuals to shape their world in some way. Conclusion. Our example of using this package of situational and social worlds mapping with frame analysis is intended to assist other researchers to locate participants more transparently in the social worlds that they negotiate in their everyday practice. © 2007 Blackwell Publishing Ltd.

The impact of rhetoric and reality on community anticipation of risk in the development of multi-purpose services (MPS) : A grounded theory study

better health service.Conclusion:This research provides an insight into the perceptions of the rhetoric and reality of community member involvement in the process of developing multi-purpose services. It revealed a grounded theory in which fear and trust were intrinsic to a process of changing from a traditional hospital service to the acceptance of a new model of health care provided at a multi-purpose service.

The acquisition and exercise of nephrology nursing expertise : A grounded theory study

Aims and objectives. This purpose of this study was to describe the process of expertise acquisition in nephrology nursing practice. Background. It has been recognized for a number of decades that experts, compared with other practitioners in a number of professions and occupations, are the most knowledgeable and effective, in terms of both the quantity and quality of output. Studies relating to expertise have been undertaken in a range of nursing contexts and specialties; to date, however, none have been undertaken which focus on nephrology nursing. Design. This study, using grounded theory methodology, took place in one renal unit in New South Wales, Australia and involved six non-expert and 11 expert nurses. Methods. Simultaneous data collection and analysis took place using participant observation, semi-structured interviews and review of nursing documentation. Findings. The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Each stage was typified by four characteristics, which altered during the acquisitive process; these were knowledge, experience, skill and focus. Conclusion. This was the first study to explore nephrology nursing expertise and uncovered new aspects of expertise not documented in the literature and it also made explicit other areas, which had only been previously implied. Relevance to clinical practice. Of significance to nursing, the exercise of expertise is a function of the recognition of expertise by others and it includes the blurring of the normal boundaries of professional practice. © 2006 Blackwell Publishing Ltd.

Total theory (vertical) and total theory (horizontal)

The works depicted two ostensibly plaster figures 'cocooned' in protective overalls. The pose of both figures had a sense of instability, balancing improbably due to internal weights. This teetering, arching quality, combined with the empty sleeves of the overalls, made reference to the Rodin's Balzac and its aura of heroic subjectivity. As the Tyvek suits depicted in the works are a common part of my studio paraphernalia, these works sought to draw a line between these two opposing aspects of the subjectivity of the artist - the transcendent and the quotidian. The works were shown as part of ‘The Day the Machine Started’ for Dianne Tanzer Gallery + Projects at the 2010 Melbourne Art Fair. The works received citations in The Age and The Australian newspapers.