Research shows that racism affects the working lives of nurses and nurse academics, as well as healthcare service delivery and outcomes. This book looks at the impact of racism, from experiences of microaggression to discrimination and structural and institutionalised racism.
Focusing on the work of six doctoral researchers and practitioners who have chosen to address and investigate the racism they experience, witness or observe in the UK’s National Health Service and Universities, this book includes personal reflections on their findings. The substantive chapters are framed by a discussion of policy and research on racism, thoughts on research supervision within this field and a drawing together of the key themes developed through this book.
Giving voice to nurses’ and lecturers’ responses to racism in nursing education and practice, this is an important contribution for students, researchers and practitioners with an interest in health inequalities, healthcare organisations, research methods and workforce development.
Thanks to all of the contributors/speakers and to the RCN for organising and hosting this event. Thank you to Wendy Irwin for introducing the event and chairing proceedings.
Here’s the book’s Table of Contents
Foreword by Sheilabye Sobrany
1 Introduction: Researching racism in nursing Helen Allan
2 Doctoral research – the personal is academic Michael Traynor
3 On listening to Migrant Women Ann Mitchell
4 Experiences of perinatal British mental health services: reflections on conducting research with migrant women from Sub-Saharan Africa Gabriel Ngalomba
5 An ethnography of Islamophobia Dave Ring
6 The Nursing and Midwifery Council’s role in Integrating Internationally Educated Nurses in the UK healthcare Monday Ugiagbe
7 An exploration of the experience of Black and Minority Ethnic nurse educators in UK universities Donna Scholefield
8 Racism in nursing: the more things change, the more they stay the same Petula Gordon
In April 2020 the adult child midwifery (ACM) department at Middlesex University started using online screen-based simulation (OSBS) software sourced from Oxford Medical Simulation[1] (OMS). OMS was originally designed to be used with virtual reality hardware and delivered in the classroom setting. However, due to COVID-19 restrictions the delivery of the programme was remote and online only i.e. students participated in these simulations on their own computers, and mostly at home.
This simulation platform places students into a virtual ward or single bedded area, students are then able to control their environment and interact with the surrounding equipment as in clinical practice. There is a usually a support worker present in the room who the student can interact and communicate with. Each of the simulations features a patient presenting with a specific medical condition with certain scenarios also involving patients presenting with a variety of social or psychological issues. The student is then required to undertake a clinical assessment of that patient, using their clinical knowledge to draw conclusions and make decisions regarding patient care within a safe environment.
Evaluation
The independent evaluation of this OSBS initiative was commissioned by the ACM department in April 2020 and data collection was carried out between June and September 2020. The mixed methods evaluation was led by Mike O’Driscoll and Prof. Michael Traynor, incorporating an online survey and online focus groups with students who had participated in the OSBS initiative as well as an online focus group with staff. Relevant secondary data (such as the number of times students participated in each scenario), which was available via the OMS system, was also analysed.
Learning Objectives
Learning objectives for 3rd Year (adult and children and young people) nursing students who were to go into practice earlier than anticipated (through an opt in ‘extended placement’) because of the increased need for staff as a result of the COVID-19 pandemic: included
To develop knowledge and understanding of the physical assessment of an acutely unwell patient and reflect on their practice.
To develop the technical and non-technical skills required when assessing and intervening with the acutely unwell patient and reflect on their practice.
To upskill current third year adult and children and young people nursing students to prepare them for being deployed as a result of the COVID-19 pandemic.
The OSBS initiative was also aimed at adult and children and young people third year nursing students who did not opt for the ‘extended placement’ and with adult and children and young people second year students; mental health nursing students (2nd and 3rd year); nursing associates (2nd year); third year midwifery students and PG Dip 2nd year students. For these groups there were slightly different learning objectives:
Enable healthcare students to develop knowledge and understanding of the physical assessment of the acutely unwell patient.
Enable healthcare students to develop technical and non-technical skills required when assessing and intervening with the acutely unwell patient.
Evaluation Findings
The response rate to the online survey was 25% (617 students invited, 154 wholly or partially completed questionnaires obtained). 13 students took part across two online focus groups. Seven members of staff took part in an online focus group and one took part in a one to one interview (as they had been unable to attend the focus group).
There is strong evidence of the OSBS learning objectives having been met, particularly from survey evidence regarding which skills students perceived they had gained which could be transferred into practice and learning outcomes or objectives they felt they had achieved, and this is supported by focus group evidence. A very large majority of respondents felt that they had gained skills in making clinical decisions based on their observations and prior knowledge; escalating issues to senior members of staff and using time effectively across different activities.
Respondents were very positive (mean ratings above four on a scale of 1 to 5 about the last scenario participated in, on a range of measures including realism, usefulness and overall satisfaction. Most respondents did not consider there were serious barriers to their participation in OSBS and there were no statistically significant differences in perceived barriers to participation by scenario, age, learning style, programme or year of programme and few differences on gender. However, a considerable limitation of the evaluation is that those who took part in the evaluation had participated in the OSBS (i.e. those who experienced barriers (or did not like OSBS for whatever reason) were under-represented in the evaluation).
If you have any queries about this research or would like to discuss a research project please contact Mike O’Driscoll (m.odriscoll@mdx.ac.uk) or Professor Michael Traynor (m.traynor@mdx.ac.uk).
Helen Allan has secured a Visiting Scholarship to the Centre for Reproduction Research at De Montfort University from January to March 2019. Helen will be working on papers with Professor Nicky Hudson and her team which arise from the Early Parenthood after IVF study. Helen’s collaborators on this study have been Professor Olga van den Akker (MU), Professor Lorraine Culley (DMU), Dr Ginny Mounce (University of Oxford), Jo Killingley, Lindsay Ahmed and Therese Bourne (MU) and Ruth Hudson (Surrey & Borders NHS Trust).
Research by Professors Sue Dyson and Olga van den Akker, Dr Liang Liu and Mike O’Driscoll uniquely draws together three important concepts for the first time: namely student volunteering, critical thinking skills for nurses, and caring and compassionate nursing practice and shows how these relate to critical pedagogy in the nurse education. The programme of research has so far resulted in three conference papers, one peer-reviewed publication, a book and international collaboration with Dr Kwadwo Korsah at the University of Ghana School of Nursing in Accra and the establishment of academic networks in Canada, Australia, and Latvia.
The presentations were very well received and led to many interesting discussions around volunteering in health professional education and how critical pedagogy relates to compassionate care.
The presentation titled ‘The extent, variability and attitudes towards volunteering among nursing students: Implications for pedagogy in nurse education’ presented by Mike O’Driscoll at the AITNER conference in Athens can be downloaded here AITNER 2017 PRESENTATION.
Middlesex’s Prof Helen Allan collaborates on ground-breaking study revealing importance of delegation training for nurses
A new study carried out by researcher Helen Allan, Professor of Nursing at Middlesex, and colleagues at the University of Surrey, University of Salford and UCL Institute of Education sheds light on the practice of delegation in NHS nursing roles.
The research – which followed newly qualified nurses in four hospital trusts across England over a three year period – found increased educational and organisational support is needed to develop nurses’ delegation skills.
The team identified five styles of delegator among the nurses they followed. These ranged from the ‘do-it-all’ nurse who felt unable to delegate anything, to the ‘inspector’ who delegates but constantly checks the work of others for fear of being held accountable for mistakes.
Professor Allan’s work highlights an immediate concern as the most recent Nursing and Midwifery Council Code of Conduct states registered nurses should be accountable for their decisions to delegate tasks.
“Our research focuses on a little understood area of nursing – the delegation of key nursing tasks to untrained and unregistered care staff,” she says.
“Delegation falls into the category of essential nursing task which has for many years gone unacknowledged and unvalued.
“It is important because patients’ safety rests on effective delegation between nurses and care assistants. In fact, delegation is important across the whole health care team.”
The research findings will feed directly into Middlesex’s undergraduate nursing and midwifery courses to ensure students graduate with the necessary skills to delegate effectively.
“It’s important to act according to your Code of Conduct, which for the first time specifically stipulates that effective delegation is a key role for registered nurses,” explains Helen.
“Always feel confident that you know how to do what’s expected of you – and that anybody you ask to do something is competent too.”
Linda Collins our own Lecturer and PhD candidate was the speaker at our second seminar yesterday. Her research suggests that conventional ideas about testing urine for infections may need to change. She argued that what is often thought by testing labs to be ‘contamination’ of urine samples is in fact a sign of bladder infection, in the form of cells from the walls of an infected bladder. Here’s her abstract.
Abstract
A urinary tract infection (UTI) is a debilitating condition and is a leading reason for treatment in the primary healthcare sector. Women are more affected than men and it is estimated 50% of the UK female population would have experienced a UTI in their life time with subsequent recurrences.
Diagnosis of a UTI is reliant upon a positive urine test result when a specimen is sent for microbiological testing. However, it is often reported that a urine specimen is contaminated with cells and sediments which leads to inconclusive results and ultimately a missed diagnosis. Urine specimen collection and microbiological testing is the crucial initial stage of the diagnostic process.
An advanced cell staining technique (Uroplakin-3 staining) has proven that cells found in the urine are not contaminants, but are urothelial cells that have shed into the urine during the inflammatory stages of an infection, and reveal important pathology of a UTI.
The RCN Research Society leaps fearlessly into the world of social media with a Facebook page. We have 179 members of the page so it is clearly a good way to reach a lot of researchers in nursing in one fell swoop. Maybe to advertise research jobs or publicise a recent paper or book or to informally canvas opinions of nurse researchers. Its to be found here.
Professor Helen Allan has been invited to give a seminar at the Royal College of
General Practitioners on the topic of ‘Infertility’ at an RCGP Learning, One
Day Essential CPD for Primary Care Event on Men’s Health.
This is an important step forward for Professor Allan who hopes to recruit
GPs to work with her on a funded research project about early parenting in
infertile couples and the role of primary care professionals in identifying
the needs of parents following IVF.
For further information please contact Professor Allan: h.allan@mdx.ac.uk
Congratulations to Professor Helen Allan of the Centre for Critical Research in Nursing and Midwifery Education and colleagues who will investigate early parenthood experiences of infertile couples after successful fertility treatment as part of winning a development grant award.
The research group, which includes Professor of Health Psychology Olga van den Akker and Professor of Nursing Helen Allan, won the Society for Reproductive and Infant Psychology (SRIP) grant award to run a workshop to develop a collaborative team for investigating the implications on IVF/ICSI conception and delivery of a baby for couples’ lives in early parenthood.