Why do nursing students who consider leaving stay on their courses?

A global shortage of nurses means there is an increasing interest in attrition rates among nursing students. This UK research by Julie Bowden looked at attrition from the perspective of those who almost left, but ultimately stayed. It highlights the importance of the support provided by personal tutors.

Workplace violence and intentions to quit: results from a survey of London nurses

Study Objective: Work-place violence, harassment and abuse is an increasing feature of nurses’ experience of work in many countries. There is some evidence that the experience of workplace violence affects levels of job satisfaction (Hesketh et al 2003) and career decisions (e.g. Mayer et al 1999, Fernandes et al 1999). This paper reports on verbal and physical abuse by patients, relatives and carers, as well as racial and sexual harassment in Acute Hospitals in London and investigates whether workplace violence affects nurses’ intentions to leave either their current job or the nursing profession, controlling for a number of other factors that are known to affect career decisions, such as workload, pay and own health. Method: A questionnaire designed by two of the authors (Reeves and West) to assess many different aspects of nurses work life was used in a postal survey of nurses grades A to I practising in twenty London acute trusts in 2002. A total of 6,160 clinical nurses were mailed the questionnaires and 2,880 returned completed questionnaires, resulting in an overall response rate of 47%, discounting undelivered questionnaires. Respondents worked in a wide variety of clinical settings but mainly in acute medical and surgical wards. In addition to descriptive statistics, results were analysed using logistic regression with robust standard errors: the appropriate test when the dependent variable is dichotomous and the individual respondents clustered within units (nurses working within hospitals are not statistically independent). Results: Our results show high levels of racial (%), sexual (%) and other, unspecified forms of harassment (%), as well as verbal and physical abuse (14% had been physically assaulted with 5% being assaulted more than once), over the previous 6 months. A very small number (1%) reported experiencing all three forms of harassment; 12% two forms and 29% one form. Only 45% of this sample intended to stay in nursing for at least 3 years; 40% were undecided and 15% intended to leave. Logistic regression estimates showed that reported levels of abuse and harassment had a significant impact on respondents’ career intentions, even in models that controlled for known factors affecting career decisions. About 70% of our respondents reported that they had had too little training in dealing with aggressive behaviour—or none at all—but there was no statistical relationship between lack of training and reported assaults. Conclusions: The international shortage of health care workers is due at least in part to low retention rates. It is crucial to investigate nurses’ experiences of work to identify the factors that shape their career decisions. Workplace violence is increasingly acknowledged as an international, service-wide, health care problem. This paper adds to the literature that shows that workplace violence has an impact on nurses’ career decisions. The implications for managers and policy makers are that strengthening systems of security and providing nurses with training in interpersonal relationships including dealing with aggressive patients could slow nurse turnover.

New public management of Higher education, Foucault and power

The theory of New Public Management (NPM) suggest that one of the features of advanced liberal rule is the tendency to define social, economic and political issues as problems to be solved through management. This paper argues that the restructuring of Higher Education (HE) in many Western countries since the 1980s has involved a shift from an emphasis on administration and policy to one of its efficient management. Utilising Foucault’s concept of governmentality rather than the liberal discourse of management as a politically neutral technology, managerialism can be seen as a newly emergent and increasingly rationalised disciplinary regime of governmentalising practices in advanced liberalism. As such the contemporary University as an institution governed by NPM can be demonstrated to have emerged not as the direct outcome of democratic policies that have rationalised its activities (so that the emancipatory aims of personal development, an educated workforce and of true research can be fully realised), nor can it be understood as the instrument through which individuals or self-realising classes are defeated through the calculations of the state acting on behalf of economic interests, rather it can be seen as the contingent and intractable outcome of the complex power/knowledge relations of advanced liberalism. I analyse the interlocking of the ‘tutor-subject’ and ‘student-subject’ as a local enacting of policy discourse informed by the NPM of HE that reshapes subjectivity and retunes the relationship between tutor and student. I put forward suggestions for how resistance to these new modes of disciplinary subjectification can be enacted.

Natural iron fertilization of the Atlantic sector of the Southern Ocean by continental shelf sources of the Antarctic Peninsula

In large parts of the Southern Ocean, primary production is limited due to shortage of iron (Fe). We measured vertical Fe profiles in the western Weddell Sea, Weddell-Scotia Confluence, and Antarctic Circumpolar Current (ACC), showing that Fe is derived from benthic Fe diffusion and sediment resuspension in areas characterized by high turbulence due to rugged bottom topography. Our data together with literature data reveal an exponential decrease of dissolved Fe (DFe) concentrations with increasing distance from the continental shelves of the Antarctic Peninsula and the western Weddell Sea. This decrease can be observed 3500 km eastward of the Antarctic Peninsula area, downstream the ACC. We estimated DFe summer fluxes into the upper mixed layer of the Atlantic sector of the Southern Ocean and found that horizontal advection dominates DFe supply, representing 54 ± 15% of the total flux, with significant vertical advection second most important at 29 ± 13%. Horizontal and vertical diffusion are weak with 1 ± 2% and 1 ± 1%, respectively. The atmospheric contribution is insignificant close to the Antarctic continent but increases to 15 ± 10% in the remotest waters (>1500 km offshore) of the ACC. Translating Southern Ocean carbon fixation by primary producers into biogenic Fe fixation shows a twofold excess of new DFe input close to the Antarctic continent and a one-third shortage in the open ocean. Fe recycling, with an estimated “fe” ratio of 0.59, is the likely pathway to balance new DFe supply and Fe fixation.

Mental Health Social Work and the Troubles in Northern Ireland: A Study of Practitioner Experiences

• Summary: During the last decade increasing attention has been paid to the impact of the Troubles1 on social work in Northern Ireland. In this paper, the authors describe the first survey used to test some of the assumptions which exist in the literature. An 87-item questionnaire was applied to a range of social work staff currently working in, or associated with, mental health settings. One hundred and one questionnaires were returned: it is estimated that this represented over 70 per cent of mental health social workers in Northern Ireland. • Findings: The design of the questionnaire elicited both qualitative and quantitative data. The findings reveal a workforce with complex religious and national identities and many of the respondents have experienced relatively high levels of Troubles-related incidents whilst carrying out their duties in a variety of organizational and geographical settings. High proportions of respondents received minimal agency support and training to equip them to deal with Troubles-related problems faced by them during this period. • Applications: The authors conclude that the profession and employing agencies should pay greater attention to past and present effects of the Troubles on social work practice and develop appropriate strategies for supporting, training and resourcing staff in this neglected area.

Children's Views on Children's Right to Work:Reflections from Belfast

The purpose of this article is to examine children’s attitudes regarding the right to work. The article is based on comments made by 245 15-year-old children on child employment and is supported by focus group interviews with 56 boys and 38 girls and tape-recorded interviews with 15 working pupils. One of most dominant themes to emerge from the data is children’s perception that they have a right to work. The article examines the legislation regarding child employment in Northern Ireland and the role of the state in determining the legislation. The author suggests that within this legislation, children are seen as vulnerable and in need of protection. Traditionally the protection of children in the workforce has been achieved by limiting the hours they can work and the occupations they can enter. Yet when children’s own views are taken into account, they move beyond the limits of protecting them through exclusion to suggesting frameworks whereby their protection may be achieved by empowering them within the labour market.

Recruitment and Retention in Front-line Services: The case of childcare

This article highlights how problems of recruitment and retention in front-line services create a particular challenge to traditional HRM models and solutions. Private day nurseries make an interesting example of the challenges facing managers in the service sector as the combination of a feminised workforce, a price-sensitive service, public-private competition and state regulation create particular difficulties. We report on a study of 33 day nurseries involving interviews with managers and employees over an eight-month period. Our findings show that childcare providers have to cope with recruitment and retention problems associated with high-end interactive service provision compounded by gender segregation and small business characteristics. Our analysis of employer and employee perspectives examines labour market issues affecting recruitment, and categorises the reasons for staff turnover into internal 'push' factors, external 'pull' factors, outside factors and functional turnover.

Local, European and global: An exploration of migration patterns of social workers into Ireland

Whilst the project to increase workforce mobility is part of a common labour force policy across the European Union, for some social workers, it has also been coupled with an aspiration to develop a pan-European identity within the profession (Lorenz, 1994, 2000; Frost, 2008). In this article, taking the island of Ireland as an example, we examine empirical data on the movement of social workers in recent years, both within Ireland and inward from outside the island, and consider the challenges and opportunities this has presented for the profession, also drawing on the British experience. From this analysis, some tentative conclusions are drawn about what is happening, what is possible and what is desirable in balancing aspirations for increased mobility within the European Union and a pan-European social work identity against the needs and interests of local, European and global communities.

Will attracting the creative class boost economic growth in old industrial regions? A case study of Scotland

Attracting in-migration of the creative class has been argued by Florida (2002) to be a route to higher economic growth in the era of the knowledge economy. This paper critically evaluates this proposition in relation to old industrial regions using the example of Scotland. The paper presents an assessment of, in the first instance, to what extent there is a shortage of skilled, talented and entrepreneurial individuals and, in the second instance, whether a talent attraction strategy alone can hope to attract such people to Scotland. It is proposed that for most migrants the availability of appropriate economic opportunities is a prerequisite for mobility. However, despite uncertain evidence that place attractiveness is a catalyst to mobility among the so-called creative class, this is not a reason for dismissing talent attraction programmes. Instead it is argued that talent attraction programmes have the potential to contribute to old industrial economies, but their success will be greatest when talent attraction is carefully targeted and based on economic realities rather than the marketing of ethereal conceptions of place attractiveness.

Research priorities of adult intensive care nurses in 20 European countries: a Delphi study.

Aims: This paper is a report of a three round Delphi study of intensive care nursing research priorities in Europe (October 2006–April 2009).

Background: Internationally, priorities for research in intensive care nursing have received some attention focusing on healthcare interventions and patient needs. Studies as early as the 1980s identified priorities in the United States, United Kingdom, Hong Kong and Australia. Research priorities of intensive care nurses across the European Union are unknown.

Methods: The participants, invited in 2006, included 110 intensive care nurses, managers, educators and researchers from 20 European Critical Care Nursing Associations. Delphi round one was an emailed questionnaire inviting participants to list important areas for research. The list was content analysed and developed into an online questionnaire for rounds two and three. In round two, participants ranked the topics on a scale of 1–6 (not important to extremely important). Mean scores of round two were added to the questionnaire of round three and participants ranked the topics again.

Results: There were 52 research topics in 12 domains. There was a dominance of priorities in five main areas: patient safety; impact of evidence based practice on outcomes; impact of workforce on outcomes; well being of patients and relatives; and impact of end-of-life care on staff and practice.

Conclusions: The results reflect worldwide healthcare concerns and objectives and highlight topics that nurses view as fundamental to the care of critically ill patients. These topics provide a platform for future research efforts to improve clinical practice and care of patients in intensive care.

An exploration of the importanceof emotional intelligence in midwifery

Background, Recognition of the importance of Emotional intelligence dates back as far as Aristotle (350BC). More recently the notion of emotional intelligence features in social psychology literature; it has also been embraced within personnel management and is now beginning to appear in nursing, medical and midwifery journals. Emotional intelligence involves possessing the capacity for motivation, creativity, the ability to operate at peak performance and the ability to persist in the face of setbacks and failures. Emotional intelligence refers to the ability to recognise our own feelings and those of others and it enables us to manage emotions effectively in ourselves and in our relationships. Midwives are constantly responding to change and challenges within maternity services. This paper examines how emotional intelligence can assist midwives in dealing with pressures which involve delivering the Government reforms, providing choice to women and facing current issues within the midwifery workforce. Midwives need emotional intelligence in order to express their feelings and recognize the feelings of others. Enhancing our relationships with colleagues and clients will ultimately impact on the quality of care delivered to women. Overall the aims of the paper are to create an awareness of the importance of emotional intelligence in practice and define emotional intelligence.

Dietary patterns and smoking in Northern Irish men: a population at High risk of coronary heart disease

This study evaluated dietary habits of Northern Irish men who are at high risk of cardiovascular disease, stratified as never-, ex-, moderate-, or heavy-smokers. Participants were male volunteers (30 - 49 years) from a single workforce in Belfast (n = 765). Dietary information was collected using a validated food frequency questionnaire. For 'a priori' diet scores, never- and ex-smokers had a significantly higher fruit and vegetable score, Mediterranean diet score, and alternative Mediterranean diet score than moderate or heavy-smokers (all p

Donor identification and consent for deceased organ donation: summary of NICE guidance.

Organ donation plays a major role in the management of patients with single organ failure of the kidneys, liver, pancreas, heart, or lung, or with combined organ failure of heart and lung (such as in cystic fibrosis) or of kidney and pancreas (such as in diabetes). A shortage of transplant organs has resulted in long waits for transplantation. Currently about 500 people in the United Kingdom die each year because of a shortage of donated organs,1 and at 31 March 2011 almost 7000 patients were waiting for a kidney transplant1 and would be having costly dialysis with serious morbidity and impact on quality of life. This shortage of organs is partly the result of relatively low numbers of road traffic deaths (lower than in many countries) but is also the result of inefficiencies in the donor identification and consent processes. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on improving donor identification and consent rates for deceased organ donation.2

Creating a spontaneous conversational speech corpus

Speech recognition and language analysis of spontaneous speech arising in naturally spoken conversations are becoming the subject of much research. However, there is a shortage of spontaneous speech corpora that are freely available for academics. We therefore undertook the building of a natural conversation speech database, recording over 200 hours of conversations in English by over 600 local university students. With few exceptions, the students used their own cell phones from their own rooms or homes to speak to one another, and they were permitted to speak on any topic they chose. Although they knew that they were being recorded and that they would receive a small payment, their conversations in the corpus are probably very close to being natural and spontaneous. This paper describes a detailed case study of the problems we faced and the methods we used to make the recordings and control the collection of these social science data on a limited budget.

Cities Ready for Energy Crises - Building Urban energy Resilience

Various sources indicate that threats to modern cities lie in the availability of essential streams, among which energy. Most cities are strongly reliant on fossil fuels; not one case of a fully self-sufficient city is known. Engineering resilience is the rate at which a system returns to a single steady or cyclic state following a perturbation. Certain resilience, for the duration of a crisis, would improve the urban capability to survive such a period without drastic measures.
The capability of cities to prepare for and respond to energy crises in the near future is supported by greater or temporary self-sufficiency. The objective of the underlying research is a model for a city – including its surrounding rural area – that can sustain energy crises. Therefore, accurate monitoring of the current urban metabolism is needed for the use of energy. This can be used to pinpoint problem areas. Furthermore, a sustainable energy system is needed, in which the cycle is better closed. This will require a three-stepped approach of energy savings, energy exchange and sustainable energy generation. Essential is the capacity to store energy surpluses for periods of shortage (crises).
The paper discusses the need for resilient cities and the approach to make cities resilient to energy crises.