Focusing on patients : differences between the practice of expert and non-expert nephrology nurses

Specialisation in nursing enables a nurse to focus, in much greater depth, on the requisite knowledge and skills for providing patients with the best possible care. Nephrology nursing is one such area where specialisation has evolved. The characteristic focus of practice emerged as an important feature during a study into the process of expertise acquisition in nephrology nursing practice. Using grounded theory methodology, this study involved 6 non-expert and 11 expert nurses and took place in one renal unit in New South Wales. Nephrology nursing practice was observed for 103 hours, and this was immediately followed by semi-structured interviews. The characteristic of focus was conceptualised as the nurses' centre of attention or concentration while they were undertaking nursing activities. Focus ranged from inexperienced non-expert nurses concentrating predominantly on the immediate task at hand, experienced non-expert nurses who focussed on the medium term to expert nurses who viewed actions (and their possible consequences) more broadly and in the longer term. Of significance to nursing, is how nephrology nurses alter their focus of practice as they acquire and exercise their developing expertise in this specialty.

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Uncovering the evidence of non-expert nephrology nursing practice

Expertise in nursing has been widely studied although there have been no previous studies into what constitutes expertise in nephrology (renal) nursing. This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, provides evidence of the characteristics and practices of non-expert nephrology nurses. Using the grounded theory method, the study took place in one renal unit in New South Wales, Australia, and involved six non-expert and 11 expert nurses. Sampling was purposive then theoretical. Simultaneous data collection and analysis using participant observation, review of nursing documentation and semistructured interviews was undertaken. The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Non-expert nurses showed superficial nephrology nursing knowledge and limited experience; they were acquiring basic nephrology nursing skills and possessed a narrow focus of practice.

Recognition of expertise : an important concept in the acquisition of nephrology nursing expertise

The present article, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the concept of recognition of expertise. The study used grounded theory methodology and involved 17 registered nurses who were practising in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participant observations and interviews. According to nurses in this study, patients, doctors and other nurses recognized that some nurses were experts while others were not. In addition, being trusted, being a role model and teaching others were important components of being recognized as an expert nephrology nurse. Of importance for nursing, the results of the present study indicate that knowledge and experience are not sufficient to ensure expert practice; recognition of expertise by others is an important function of expertise acquisition.

Producing the magnum opus : A metaphor for nephrology nursing expertise acquisition

Aim. This paper elucidates the nature of metaphor and the conditions necessary to its use as an analytic device in qualitative research, and describes how the use of metaphor assisted in the analytic processes of a grounded theory study of nephrology nursing expertise. Background. The use of metaphor is pervasive in everyday thought, language and action. It is an important means for the comprehension and management of everyday life, and makes challenging or problematic concepts easier to explain. Metaphors are also pervasive in quantitative and qualitative research for the same reason. In both everyday life and in research, their use may be implicit or explicit. Methods. The study using grounded theory methodology took place in one renal unit in New South Wales, Australia between 1999 and 2000 and included six non-expert and 11 expert nurses. It involved simultaneous data collection and analysis using participant observation, semi-structured interviews and review of nursing documentation. Findings. A three stage skills-acquisitive process was identified in which an orchestral metaphor was used to explain the relationships between stages and to satisfactorily capture the data coded within each stage. Conclusion. Metaphors create images, clarify and add depth to meanings and, if used appropriately and explicitly in qualitative research, can capture data at highly conceptual levels. Metaphors also assist in explaining the relationship between findings in a clear and coherent manner. © 2005 Blackwell Publishing Ltd.

Accommodating serendipity in the active studio

This paper presents a series of ongoing experiments to facilitate serendipity in the design studio through a diversity of delivery modes. These experiments are conducted in a second year architectural design studio, and include physical, dramatic and musical performance. The act of designing is always exploratory, always seeking an unknown resolution, and the ability to see and capture the value in the unexpected is a critical aspect of such creative design practice. Engaging with the unexpected is however a difficult ability to develop in students. Just how can a student be schooled in such abilities when the challenge and the context are unforeseeable? How can students be offered meaningful feedback about an issue that cannot be predicted, when feedback comes in the form of extrinsic assessment from a tutor? This project establishes a number of student activities that seek to provide intrinsic feedback from the activity itself. Further to this, the project seeks to heighten student engagement with the project through physical expression and performance: utilising more of the students’ senses than just vision and hearing. Diana Laurillard’s theories of conversational frameworks (2002) are used to interrogate the act of dramatic performance as an act of learning, with particular reference to the serendipitous activities of design. Such interrogation highlights the feedback mechanisms that facilitate intrinsic feedback and fast, if not instantaneous, cycles of learning. The physical act of performance itself provides a learning experience that is not replicable in other modes of delivery. Student feedback data and independent assessment of project outcomes are used to assess the success of this studio model.

The legitimacy of graduated response schemes in copyright law

In an attempt to curb online copyright infringement, copyright owners are increasingly seeking to enlist the assistance of Internet Service Providers (‘ISPs’) to enforce copyright and impose sanctions on their users.1 Commonly termed ‘graduated response’ schemes, these measures generally require that the ISP take some action against users suspected of infringing copyright, ranging from issuing warnings, to collating allegations made against subscribers and reporting to copyright owners, to suspension and eventual termination of service.

Qualified indefeasibility and the careless mortgagee

In recent years a great deal of case law has been generated in relation to mortgages where the mortgagee has not engaged in adequate identity verification of the mortgagor and the mortgage has subsequently been found to be forged. As a result, careless mortgagee provisions operate in Queensland as an exception to indefeasibility. Similar provisions are expected to commence soon in New South Wales. This article examines the mortgagee’s position with the benefit of indefeasibility and then considers the impact of the careless mortgagee provisions on the rights of a mortgagee under a forged mortgage, concluding that the provisions significantly change the dynamic between a registered mortgagee and registered owner who has not signed the mortgage. These provisions appear to give the mortgagee a conditional indefeasibility, with the intention of reducing the State’s exposure to the payment of compensation in the case of identity fraud. They are however, more successful in the case of forgery by a third party rather than forgery by a co-owner.

Support teachers, learning difficulties and secondary school culture

This thesis will report on mixed method research which examined secondary Support Teachers Learning Difficulties (STLDs) and their modes of operation in New South Wales (NSW) government schools, Australia. Four modes of operation were identified in the literature as consultancy, team teaching, in-class support and withdrawal. An additional area of other duties was also included to examine the time when STLDs were not functioning in the four identified modes of operation. NSW government policy is in keeping with the literature as it recommends that STLDs should spend the majority of their time in consultancy and team teaching while in class with a minimum of withdrawal of students from their main classrooms for individual or small group instruction. STLDs, however, did not appear to be functioning in the recommended way. A number of factors identified in the literature, which may influence the modes of operation, can be grouped under the heading of school culture thus this research involved the examination of the effects of school culture on the modes of operation with the aim of expanding our understanding of the functioning of STLDs and providing suggestions for improvement. The theoretical base of social constructionism has informed this research which included survey and case study methods. Case studies of the STLDs in three secondary schools led to the conclusion that, in conjunction with factors such as flexibility and commitment, the involvement of the STLD in a sub-culture of learning support may lead to functioning in the recommended modes of operation.