Julienne Meyer - Academia.edu (original) (raw)

Papers by Julienne Meyer

Journal of Research in Nursing, Nov 23, 2009

Recently, the President of the Patients Association, Claire Raynor (a high-profile nurse), report... more Recently, the President of the Patients Association, Claire Raynor (a high-profile nurse), reported an increasing number of calls on their helpline from people wanting to talk about the 'dreadful, neglectful, demeaning, painful and sometimes downright cruel treatment their elderly relatives had experienced at the hands of NHS nurses.' (Patients Association, 2009, p. 1). She went on to suggest that she is: 'sickened by what has happened to some parts of my profession of which I was so proud. These bad, cruel nurses. .. should be identified and struck off the Register. If only the majority of good caring nurses. .. would stand up for their patients and their own profession, and blow whistles it would make a difference and bring back to them the sense of pride in the provision of good, safe care that used to be enjoyed by the whole population of this country' (Patients Association, 2009, p. 2

Journal of Research in Nursing, Aug 12, 2009

Abstract Greater standardisation of assessments of older people with complex care needs is a requ... more Abstract Greater standardisation of assessments of older people with complex care needs is a requirement of UK policy. This study explores the practicability and validity of two assessment tools, Minimum Data Set Resident Assessment Instrument (MDS-RAI) and ...

Journal of Clinical Nursing, Jan 22, 2013

To explore the facilitating factors that enabled staff on a rehabilitation ward for older people ... more To explore the facilitating factors that enabled staff on a rehabilitation ward for older people engage in change activities. The importance of facilitation in practice change is widely acknowledged; however, little nursing research has taken place in relation to its nature. Following identification in the early phases of an action research study that learned helplessness states and the use of socially structured defence techniques were preventing staff on a rehabilitation ward for older people from engaging in practice development, some change was achieved. What facilitated this to take place needed to be explored. An action research approach was used. Data gained from 13 in-depth interviews with staff and managers together with three years of researcher field notes were analysed using thematic analysis. The continuous presence and neutrality of the researcher who worked together with staff on their issues of concern using a flexible ward-based approach, combined with giving staff the opportunity to explore what it was like for them working in this area, were considered key in helping staff to engage with change. Analysis of findings suggests that the senses framework presents a theoretical approach to facilitation that can help staff move out of learned helplessness states and reduce the need for the use of socially structured defence techniques. This study identifies a facilitation approach that enabled staff to engage with practice change. Although carried out in the UK, its findings have wider relevance through the application of a theoretical perspective for practice change facilitation that has not before been considered in this literature, and which is likely to be of interest to those involved in practice change internationally.

Journal of Social Work Practice, Nov 1, 2006

There are studies about the emotional and social aspects of loss and grief in continuing care env... more There are studies about the emotional and social aspects of loss and grief in continuing care environments such as care homes and hospital wards, but researchers have tended to focus on either the cultural aspect of the organisation or the emotional response of individuals [Holman, C., Meyer, J. &amp;amp;amp;amp;amp;amp;amp; Cotter, A. (2004) ‘The complexity of loss in continuing care institutions

Journal of Advanced Nursing, Sep 1, 2007

Title. A concept analysis of renal supportive care: the changing world of nephrology Aim. This pa... more Title. A concept analysis of renal supportive care: the changing world of nephrology Aim. This paper is a report of a concept analysis of renal supportive care. Background. Approximately 1AE5 million people worldwide are kept alive by renal dialysis. As services are required to support patients who decide not to start or to withdraw from dialysis, the term renal supportive care is emerging. Being similar to the terms palliative care, end-of-life care, terminal care and conservative management, there is a need for conceptual clarity. Method. Rodgers' evolutionary method was used as the organizing framework for this concept analysis. Data were collected from a review of CINAHL, Medline, PsycINFO, British Nursing Index, International Bibliography of the Social Sciences and ASSIA (1806-2006) using, 'renal' and 'supportive care' as keywords. All articles with an abstract were considered. The World Wide Web was also searched in English utilizing the phrase 'renal supportive care'. Results. Five attributes of renal supportive care were identified: available from diagnosis to death with an emphasis on honesty regarding prognosis and impact of disease; interdisciplinary approach to care; restorative care; family and carer support and effective, lucid communication to ensure informed choice and clear lines of decision-making. Conclusion. Renal supportive care is a dynamic and emerging concept relevant, but not limited to, the end phase of life. It suggests a central philosophy underpinning renal service development that allows patients, carers and the multidisciplinary team time to work together to realize complex goals. It has relevance for the renal community and is likely to be integrated increasingly into everyday nephrology practice.

British Journal of Management, Dec 1, 2005

The NHS Plan (Department of Health, 2000) created Patient Advice and Liaison Services (PALS) to p... more The NHS Plan (Department of Health, 2000) created Patient Advice and Liaison Services (PALS) to provide information, solve problems and drive user-led change. Evidence is drawn from a study of PALS in London acute, primary care, mental health and specialist trusts, drawing on discussion forums, interviews with PALS officers and documentation. From context and role profiles, two conclusions are evident. First, organizational instability, boundary disputes, variable management support, resource limitations, financial insecurity and multi-site working characterize the context in which PALS operate, and the officer role is characterized by problem diversity, overlap with complaints systems, monitoring problems, relationship building and 'serial users'. Second, these context and role attributes restrict PALS to 'repair and maintenance', ensuring that established systems work correctly. While PALS sit on the bottom rung of a 'participation ladder', their contribution is more than tokenistic. However, a processual perspective demonstrates how a fluid, networked, and diversified context isolates PALS structures from management decision-making, constraining their power base, and inhibiting the promotion of substantive change agendas.

Journal of Advanced Nursing, Apr 24, 2012

The aim of this paper is to explore older people's approaches to living a life characterized by l... more The aim of this paper is to explore older people's approaches to living a life characterized by losses and "aloneness" and how this relates to loneliness. Background: Loneliness is closely related to social status and health condition. Older people are vulnerable to experiences of loneliness due to losses, which follow the ageing process. Method: A qualitative interpretative design was used. Older people, aged 65 and above, living at home, in retirement villages or long-term care settings in Australia, Norway and United Kingdom, participated. 78 persons were included. Data were collected through open-ended interviews during autumn of 2006 and spring of 2007. The interviews were audio taped, transcribed and analyzed applying a hermeneutic, interpretative process. Findings: Analyses revealed great differences in the way participants handled their life situation. Interviewees describing themselves as 'not lonely' viewed losses as normal, they participated in meaningful activities, connected to other people and thrived in their own company. Those describing themselves as 'lonely' on the other hand, strove to create meaning in their lives, were overwhelmed by losses, had problems finding meaningful activities and difficulty keeping up social relations. Conclusion: Loneliness was associated with overwhelming losses, inactivity, meaninglessness and social isolation. The contrasting findings between 'not lonely' and 'lonely' older people have implications for nursing in that nurses must seek to identify those who need help in managing their loneliness and provide guidance and support. More research is needed to develop interventions that is effective in reducing loneliness.

Health Expectations, Jun 1, 2005

Background Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and L... more Background Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. Objective To develop patient-centred criteria by which to assess PALS. Design Data were generated from qualitative interviews with 15 PALS service users and 15 members of local user/carer organizations, and from a workshop with representatives of 14 user/carer organizations (national and London-wide). Emergent findings were circulated to other user/carer organizations (n ¼ 32) for critique and comment. Results Findings suggest that users and their representatives want PALS to: be responsive to the needs and wishes of individuals; be accessible to all sections of the community, including older people, ethnic minorities and groups with special needs; offer clear, accurate and comprehensive information about local health and other services; work with their NHS organization to create a more patient-centred service; collaborate effectively with other organizations; be adequately resourced. Conclusions These criteria resemble the national standards for PALS compiled by the Department of Health, with the exception of the need for adequate resourcing. They also resemble previous work on usersÕ and carersÕ criteria for service delivery. Interestingly, PALSÕ lack of independence was not a major concern, though clients do need access to independent advocacy when ÔinsiderÕ troubleshooting fails. Although an alternative to the adversarial approach of complaints is welcome, PALS, like complaints procedures, may be under-used by marginalized or demoralized service users.

Innovation in Aging, Jun 30, 2017

Journal of Advanced Nursing, Oct 1, 2004

Repeat attendance by older people at accident and emergency departments Background. Older people ... more Repeat attendance by older people at accident and emergency departments Background. Older people are an increasing user group at accident and emergency departments and often have complex needs over and above the clinical cause of attendance. Few studies to date appear to have focused specifically on older people's re-attendance at such departments following direct discharge. However, these few studies conclude that incomplete staff assessment of older people's needs in this setting may play a part in reasons for re-attendance and recommend that further research is needed in this area. Aims. The aim of this paper is to describe a 6-month study exploring re-attendance, assessment and discharge issues for people aged over 75 years at an accident and emergency department. Methods. Documentary research was primarily used to collate data. Interviews with specialist health care professionals were also used to cross-check recorded documentary details of interest and to gain a wider perspective. In addition, illustrative cases were developed (incorporating a broader range of hospital documentation) to exemplify key issues raised relating to re-attendance by older people at the accident and emergency department concerned. Findings. Professional practice related to assessment of older people's social and functional needs was inconsistent in this accident and emergency department and some staff clearly underestimated the impact of illness or injury when considering their ability to cope on discharge. An illustrative case summary is included to highlight that such issues may be significant factors in re-attendance. Conclusion. Improving practice in relation to social and functional assessment and raising staff awareness concerning older people's potential needs seem important in accident and emergency departments. With little research identified to date into re-attendance, further research on this issue is recommended.

Age and Ageing, Sep 1, 2000

cipants throughout the study for validation and to inform What is it? decisions about the next st... more cipants throughout the study for validation and to inform What is it? decisions about the next stage of the study. In healthcare Action research is not easily defined, as it is an approach settings, this often involves a careful process of negotiation to research, rather than a specific method. The term is across traditional boundaries (for example, between health used widely and loosely throughout the scientific and and social care professionals or between hospital and professional literature. However, the following definition community care settings). This requires both excellent broadly captures its meaning. interpersonal skills as well as research ability. ''Action research is simply a form of self-reflective enquiry undertaken by participants in social situations Simultaneous contribution to social in order to improve the rationality and justice of their own practices, their understanding of those practices,

International Journal of Nursing Studies, Feb 1, 1997

This chapter draws from case study data obtained from research exploring the introduction of lay ... more This chapter draws from case study data obtained from research exploring the introduction of lay participation in care within the context of a hospital ward environment. Using illuminative evaluation strategies (Parlett and Hamilton, 1977) and an action research approach (Elliott, 1991), I worked together with a multidisciplinary team, on a general medical ward in a London teaching hospital, for a period of one year in an attempt to foster practice which would involve patients and their family/friends in care, with a view to better preparation for discharge. A multimethod approach to data collection was taken including in-depth interviews, questionnaires and participant observation recorded in daily field notes. I held weekly team meetings with participants to feedback findings and plan and evaluate action strategies. Whilst at the end of this period positive changes could be claimed, the process of innovation was extremely slow and various factors which hindered and facilitated developments will be discussed in this chapter. The slowness of organisational change in the health service has been described in other case studies by Stocking (1985) but this study specifically relates to initiatives to develop health promotion roles and describes the inertia in detail as health professionals were forced to challenge the status quo of traditional practice.

Journal of Research in Nursing, Jul 1, 2006

NT research, Sep 1, 2002

This paper reports ways of working and early findings from the Partnership with Care Homes Projec... more This paper reports ways of working and early findings from the Partnership with Care Homes Project (PCH). PCH is an extension to the ongoing CELEC Action Research Project: Care for Older People that is concerned with the development and evaluation of seven lead research and development nurses. These nurses have responsibility for improving care for older people in seven NHS trusts in North East London in line with the National Service Framework for Older People. Funded originally by CELEC (Central and East London Education Consortium), these nurses are using action research to blur the boundaries between education, practice and research. This innovative way of working has fostered closer working relationships, the cross-fertilisation of ideas and joint working between acute and primary care trusts; general and mental health services; users, carers and professionals; health and social care providers (NHS and voluntary sector), and commissioners and providers of education. The success of the action research project led to the North East London Workforce Development Confederation (CELEC's replacement), giving additional funding to extend the project into the private sector — the Partnership with Care Homes Project. This work is ongoing and currently 25 care homes (representing more than 1,500 beds) are participating in the project, with the emphasis very firmly on partnership working to meet their education, research and practice development needs. The lessons learned from the project may lead to a new model of commissioning for both education and service delivery which is able to respond more promptly to emergent need. The purpose of this paper is to share the experience of working in this way, explore the early findings and, more importantly, celebrate some of the outcomes that are already emerging from the work.

Journal of Applied Gerontology, Apr 28, 2017

This article reports on the analysis of the transformational My Home Life Leadership Support prog... more This article reports on the analysis of the transformational My Home Life Leadership Support programme for nursing home managers being implemented in Scotland. It analyses learning from a multi-method participatory descriptive study. Contribution Analysis theory informed the evaluation. Evidence-based Practice, Relationship centred Care, Appreciative Inquiry, and Caring Conversations informed the intervention to develop transformational leadership. Data generation methods included baseline and postintervention questionnaires to describe culture change within the study population, together with in-depth qualitative data generated from group discussions. Qualitative data analysis was an iterative collaborative process with participants to generate themes about the impact of the programme on themselves and their practice. Data showed positive changes in managers' perceptions of their self-awareness, leadership communication and relationship skills, and development of positive cultures. This model offers lessons for those interested in ways to approach the emotional, educational and cultural dynamics of change in other human service contexts.

Journal of Research in Nursing, Jul 1, 2009

Chair: Tony Butterworth, Emeritus Professor, Chair of the Academy for Nursing, Midwifery and Heal... more Chair: Tony Butterworth, Emeritus Professor, Chair of the Academy for Nursing, Midwifery and Health Visiting Research (UK) and Non-Executive Director, NHS Institute for Innovation and Improvement Proposer: Derek Sellman, Principal Lecturer, School of Health and Social Care, University of the West of England, Bristol, UK Seconder: Julienne Meyer, Professor of Adult Nursing, City University, London, UK Opposer: Veronica Bishop, Visiting Professor of Nursing, City University, Editor, Journal of Research in Nursing, UK Seconder: Dawn Freshwater, Professor and Dean, School of Health Care, University of Leeds, UK