• Characteristics and Values of a British Military Nurse. International Implications of War Zone Qualitative Research

      Finnegan, Alan; Finnegan, Sara; McKenna, Hugh; McGhee, Stephen; Ricketts, Lynda; McCourt, Kath; Warren, Jeremy J.; Thomas, Mike; University of Chester; Heath Lane Medical Practice; University of Ulster; University of South Florida; British Army; University of Northumbria; University of Chester; UCLan (Elsevier, 2015-08-01)
      Background. Between 2001 and 2014, British military nurses served in Afghanistan caring for both Service personnel and local nationals of all ages. However, there have been few research studies assessing the effectiveness of the military nurses’ operational role and no papers naming the core values and characteristics. This paper is the only qualitative nursing study completed in this period where data was collected in the War Zone. Objective. To explore the characteristics and values that are intrinsic to military nurses in undertaking their operational role. Design. A Constructivist Grounded Theory was utilised. The first author designed the interview schedule, then following a pilot study, conducted and transcribed the discussions. Informed consent and UK Ministry of Defence Research Ethical Committee approval was obtained. Setting. Camp Bastion Hospital, Afghanistan, in 2013. Method. Semi-structured interviews were conducted with 18 British Armed Forces nurses. Results. A theoretical model was developed that identifies the intrinsic characteristics and values required to be a military nurse. Nursing care delivered within the operational environment was perceived as outstanding. Nurses consciously detached themselves from any legal processes and treated each casualty as a vulnerable patient, resulting in care, compassion and dignity being provided for all patients, irrespective of their background, beliefs or affiliations. Conclusion. The study findings provides military nurses with a framework for a realistic personal development plan that will allow them to build upon their strengths as well as to identify and ameliorate potential areas of weakness. Placing nurses first, with a model that focusses on the requirements of a good nurse has the potential to lead to better patient care, and improve the quality of the tour for defence nurses. These findings have international implications and have the potential for transferability to any level of military or civilian nursing practice.
    • Constructions of meaning and personal identity in the decision-making of community safety professionals

      Ellis, Roger; Hogard, Elaine; Wheeler, Timothy J.; Bendall, Mark; Warren, Jeremy J. (University of Chester, 2010-09)
      This thesis takes an interdisciplinary approach to the study of the impact that constructions of meaning and personal identity have upon the processes of professional decision-making, in the delivery of community safety services. The research draws upon the previous work undertaken in the fields of psychology, sociology, social anthropology, criminology and community safety. The research was composed of five separate studies. Study one was a Delphi exercise to determine consensus of meaning for different community terms in common usage for policy makers, practitioners and academics. The research was able to define consensual meanings for ten of the thirteen terms presented, including crime prevention, crime reduction and community safety. Consensus was not achieved for the terms community engagement, respect and quality of life and suggestions are made which may account for this result. Study two utilised repertory grids to investigate the ways that community safety professionals might construe the decisions that they have to make as part of their duties. Studies three and four utilised bespoke ISA/lpseus instruments, whose structures were informed by the results from Study Two. These instruments were used to further explore the construals and worldviews of a variety of community safety professionals through six process postulates. It was found that whilst an individual's initial job role or gender did not have significant impact upon their professional decision-making, the training that they had received in community safety and the time that they had spent working in the field did have a significant impact upon their professional decision-making. It was also found that the groups of community safety professionals differed in their attitudes towards those members of society who are the target of community safety activity. Study five involved the generation and piloting of a survey instrument whose various sections were designed to validate the findings generated from the previous studies, as well as providing further data on the decision-making processes of those working within community safety. The final chapter presents the Warren Person Process Priority (WaPPP) layered model of decision-making that was derived from the data collected to inform the current thesis. The outer Person layer is defined by the four-way typology derived from the Procedural / Free-form and Cautious / Adventurous bi-polar constructs of identity types that were identified from the ISA/lpseus studies. The middle layer of the model describes a number of different decision-making processes that professionals may follow when making a judgement or coming to a conclusion. The order of the processes was given by the results of the survey pilot. The central portion of the model presents a number of factors that may impact upon professional decision-making, determined from the ethnographic work that informed the ISA/lpseus studies. The order of these factors was determined from the preparatory data collection instrument that was used with the ISA/lpseus studies and confirmed by the results of the survey pilot. Suggestions are made for further research that may expand upon the results presented in this thesis. These include a larger version of the Delphi, with an international panel of experts; correlation of the ISA/lpseus instruments with other validated instruments for the measurement of personality, identity and decision-making and an expansion of the survey pilot.