Perceptions of the Nurse Practitioner Role in Facilitating the Implementation of an Onsite Pain Management Team in Long Term Care

Background: One strategy to improve pain management in long term care (LTC) is to optimize the emerging role of the nurse practitioner (NP) in LTC. The purpose of this sub study was to learn about the NP role in implementing an onsite, interdisciplinary Pain Team in the LTC home setting.

Methods: We used a case study design that included two NPs who worked at separate LTC homes. Each of the NPs completed a weekly questionnaire of pain-related activities that they engaged in over a one-year implementation period; and a diary, using critical reflection, about their experiences and strategies used to implement the Pain Team. Descriptive statistics and thematic content analysis were used to analyze the case study data.

Findings: NPs tended to be most engaged in pain assessment and collaborated more with licensed nurses and personal support workers; less with pharmacists. NPs were more involved in organizational level activities, such as participating in committee work or assisting with the development of policies and procedures about pain. NPs created palliative care and pain service protocols; engaged in policy development, in-servicing, quality assurance and advocacy; and encouraged best practices. NPs were challenged with time constraints for pain management and balancing other role priorities and felt that increased scope of practice for them was needed.

Conclusions: The results of this study highlight how NPs implemented a Pain Team in LTC which may be helpful to others interested in implementing a similar strategy to reduce residents’ pain.

The Developing Habitus of the Anti-Social Behaviour Practitioner: From Expansion in Years of Plenty to Surviving the Age of Austerity

Specialist anti-social behaviour units are common within social housing providers, with many established in response to the policies of the New Labour governments of 1997–2010. These units now find themselves operating in a different political and financial environment. Following the English riots of 2011, the Coalition government, whilst imposing budgetary cuts across the public sector, called on social housing providers to intensify their role in tackling disorder. This article explores the habitus or working cultures within anti-social behaviour units post-New Labour. It does so through empirical research conducted in the aftermath of the English riots. The research finds that practitioners view their work as a core function of social housing provision. They have developed an understanding of human behaviour, which crosses the criminal and social policy fields with a wide skillset to match. A number of factors including national policy, community expectations, and multi-partnership engagement influence their dynamic working culture.

M level Inquiry Across Disciplinary Boundaries: Using Reflective Sketchbooks

Debates unfolding around the recent development of M Level programmes for teacher education are not unfamiliar to those being addressed in other professional disciplines such as business. A strong theme in our analysis is that reflective practitioners could be provided with a wider range of tools and methods to support them in their reflection. Considerable energies have been expended on e portfolios, but our experience of use of paper based reflective
sketchbooks suggests that they may have some distinct advantages over text-dominated electronic media. In fact such sketchbooks challenge typed text as the dominant route to learning and communication (Gilbert 1998), (New, 2005), (Hickman, 2007). Professionals in teacher education are currently exploring ways in which M level can be conceived in terms of professional learning. This is also important terrain in other professions. For example, best practice in business management involves constant innovation so that students do not experience a split between the research context of the business faculty and the experience of operating in the business situation. This is paralleled in education by the concern that trainees do not experience a split between the research or scholarly informed approach of university tutors, and the experience of practical teaching in school. Our research question is concerned with how a consciously developed reflective sketchbook method can generate levels of critical thought that are both postgraduate and professionally valued in the workplace. We are also interested in the contribution this form of enquiry at M Level can make in terms of life long learning.