The politics of midwifery education and training in New South Wales during the last decades of the 19th Century

This paper focuses on the introduction and development of midwifery education and training in Sydney during the last decades of the 19th century. The aim of the training, it is argued, was to displace the lay midwives by trained midwifery nurses who would work under medical control. The lay midwives were one of the largest occupational groups among women and two-thirds of births in NSW were being delivered by them in the late 19th century. It was a period of professionalisation of medicine and medical men laid claim to midwifery as a legitimate sphere of their practice and saw it as the gateway for establishing a family practice. The lay midwife stood in the way of their claim. The training programs were established purportedly to control maternal mortality. From the beginning in 1887 medical men were in control of midwifery nurse training. In addition to training at the Benevolent Society Asylum, three more women's hospitals were established in the 1890s in Sydney making it possible to train a stream of midwifery nurses. The midwifery nurses were charged exorbitant fees for their training; the fees contributed substantially towards running the new hospitals that delivered birth services to the poor and destitute women mostly in their homes. The midwifery nurses worked hard in miserable conditions under the guise of clinical experience required for training. When a critical mass of poorly trained midwifery nurses were in the offing, a Bill was introduced into the Parliament in 1895, restricting registration to midwifery nurses and this would have eliminated the lay midwife if passed. It took more than two decades to get a Registration Bill passed in the NSW Parliament.     

Re-inscribing Gender in New Modes of Medical Expertise: The Investigator-Coordinator Relationship in the Clinical Trials Industry

This article analyses the ways in which research coordinators forge professional identities in the highly gendered organizational context of the clinic. Drawing upon qualitative research on the organization of the clinical trials industry (that is, the private sector, for profit auxiliary companies that support pharmaceutical drug studies), this article explores the relationships between predominantly male physician-investigators and female research coordinators and the constitution of medical expertise in pharmaceutical drug development. One finding is that coordinators actively seek to establish relationships with investigators that mirror traditional doctor-nurse relationships, in which the feminized role is subordinated and devalued. Another finding is that the coordinators do, in fact, have profound research expertise that is frequently greater than that of the investigators. The coordinators develop expertise on pharmaceutical products and diseases through their observations of the patterns that occur in patient-participants' responses to investigational drugs. The article argues, however, that the nature of the relationships between coordinators and investigators renders invisible the coordinators' expertise. In this context, gender acts as a persistent social structure shaping both coordinators' and investigators' perceptions of who can be recognized as having authority and power in the workplace.     

Out of the wilderness and into the fold: the school nurse and child protection

This paper argues that there has been a major change since the mid‐1980s in the extent to which other workers involved in child protection recognize the value of the contribution of school nurses. Evidence for this is drawn from a longitudinal study in an English shire county using a vignette approach to explore workers' perceptions of the handling of child protection issues. While in part the greater recognition of the role of the school nurse can be attributed to the adoption of child protection procedures, this provides only a partial explanation. School nurses in the 1990s were better qualified and more experienced, while other workers such as school heads and social workers recognized the need to work with others, such as the school nurse, in order to meet their own objectives. The paper concludes that there is a case for more formal recognition of school nurses in child protection because, like health visitors, with whom they have a follow‐on colleague relationship, they are often the most significant health workers for children who may be neglected or abused. Copyright © 2000 John Wiley & Sons, Ltd.     

新型护患关系下优化护理实习的探讨

医学模式的转变,整体护理的推广,市场经济的运作,以及患者法律意识的增强,使护患关系呈现出新的特点。临床带教老师和护理实习生须充分认识和重视这一变化,并采取相应措施,强化角色意识,培养自控能力,提高综合素质,建立和谐的新型的护患关系,确保实习教学目标的实现,培养高质量、高素质的护理人才。     

浅析护士心理问题的表现形式、成因及对策

近年来护士心理问题已经受到越来越多的关注,阐述了护士容易出现心理问题的表现形式,分析了护士心理问题产生的原因,在此基础上提出了改善管理制度、创造沟通环境和支持系统、提高护士心理素质、提供心理咨询服务4个方面的对策。     

患儿入院初期的心理反应与对策

分析了不同年龄阶段的患儿在入院初期对陌生的医院环境和医务人员所产生的各种不同的心理反应,针对这些反应,给出了各种不同的护理措施,在临床工作中运用这些措施,达到了较好的效果。     

老年人烧伤的监护体会

目的鉴于老年烧伤患者病情的特殊性,探讨其监护特点。方法统计2001年～2002年我院不同程度烧伤老年患者25例,分析其监护特点及护理体会。结果 25例均得到较好的治愈。结论只有充分认识老年烧伤患者的特殊性,才能尽可能好的护理和治愈患者。     

The Care–tech Link: An Examination of Gender,Care and Technical Work in Healthcare Labour

Despite the dramatic increase of technology in the healthcare field, little is known of how care work and technical work are related. Examining substitute healthcare providers offers a useful illustration of the care–tech link because nursing (care) and medical (technical) models often merge. Forty‐two interviews with men and women (nurse practitioners, nurse anaesthetists and physician assistants) were conducted in the USA. The results showed that the gendered nature of care–tech boundaries has shifted in small but important ways and that the gendering of work influenced the shape of these boundaries. Men often encountered barriers when moving too far into the care realm and attempted to overcome this by ‘caring cautiously’ and emphasizing problem‐solving care. Women faced similar barriers from the ‘old boys network’ when they entered highly technical areas. There is also evidence that men and women challenged existing care–tech boundaries and moved beyond their traditional roles.     

Barriers preventing high-quality nursing care of people with disabilities within acute care settings: a thematic literature review

This literature review was conducted to identify obstacles in the provision of quality nursing care to people with disabilities within acute care settings. Research in 2006 by the Disability Rights Commission found that people with disabilities have healthcare needs that are not being adequately met with the quality of care expected or anticipated. Obstacles to the provision of high-quality nursing care are a matter of concern to nursing clinicians, educators and researchers involved with establishing and maintaining professional standards of care for nursing practice. Therefore, this review has identified three major themes illustrating barriers to provision of high-quality nursing care in the acute care setting to people with disabilities. Themes identified were: professional competence, professional attitudes and organisational management. Nurses have an obligation to take into account the concerns and needs of individual clients with a disability.     

The development of anti-cancer programs in Canada for the geriatric population: an integrated nursing and medical approach

Cancer control in Canada refers to the development of comprehensive programs utilising modern techniques, tools and approaches that actively prevent, cure or manage cancer. The scope of such programs is quite vast. They range from prevention, early detection and screening, comprehensive treatment both curative and palliative to comprehensive palliative care. Cancer is a disease associated with the aging population, and as the population ages the incidence of cancer would be expected to rise as well. This in itself poses a great challenge. In addition, the aging population demographics with the projected rise in the numbers of senior citizens, especially the over 80 group in the next decade, poses its own creative challenges to health planners. In Canada, health care is centrally administered, and controlled by the provincial governments of Canada, under the Canada Health Act. The challenge of developing comprehensive programs for the geriatric population requires changes in the care models and care pathways. The patient-centred models that have been adapted require a multidisciplinary approach to the clientele and their families that integrates cancer therapy and geriatric care and realities. This requires changes in the nursing and medical approach, as well as education in the subtleties of the two intersecting medical realities.