Self-employed nurses as change agents in healthcare: strategies, consequences, and possibilities

2014 ◽  
Vol 28 (4) ◽  
pp. 511-531 ◽  
Author(s):  
Sarah Wall
Keyword(s):  
Healthcare System ◽  
Nursing Practice ◽  
Traditional Approach ◽  
Change Agents ◽  
Social Contexts ◽  
Alternative Conceptions ◽  
System Reform ◽  
Work Experiences ◽  
Content Type ◽  
Cultural Elements

Purpose – The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare. Design/methodology/approach – Focussed ethnography was used to explore self-employed nurses’ work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system. Findings – These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice. Originality/value – Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing ' s professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.

New NAFTA helps Canada’s Trudeau hurdle some problems

2018 ◽  
Keyword(s):  
Dispute Resolution ◽  
Healthcare System ◽  
Prime Minister ◽  
Market Competition ◽  
Supply Management ◽  
Public Healthcare ◽  
System Reform ◽  
Donald Trump ◽  
Content Type ◽  
Auto Parts

Significance Along with Mexico’s leader President Enrique Pena Nieto, whose term ends on December 1, the new US-Mexico-Canada Agreement (USMCA) will be signed by US President Donald Trump and Canadian Prime Minister Justin Trudeau in November, though it then needs ratifying in the three countries. Canada was the last holdout after US and Mexican negotiators reached a deal in August; Canada made concessions on dairy, copyright terms and auto parts rules to safeguard Ottawa’s priorities in the USMCA, notably independent dispute resolution on anti-dumping and countervailing duties. Impacts Canadian pharm firms face increased market competition from US firms newly protected by additional patent protections. Canada’s public healthcare system faces new costs from biological and other new medicines; system reform calls could grow. Canadian dairy will lose some market share to US products but survive (most of the Supply Management system remains). Canadian retailers will see some small revenue slumps as more Canadians use lower duties for US shopping.

Balancing Act: Identity and Otherness among Latin American Immigrants and their Food Practices

2016 ◽  
Vol 4 (2) ◽  
pp. 72-83
Author(s):  
Paulette Kershenovich Schuster
Keyword(s):  
Latin American ◽  
Cultural Production ◽  
Communication Systems ◽  
Social Contexts ◽  
Cultural Perceptions ◽  
Cultural Elements ◽  
Food Practices ◽  
Food Research ◽  
Private And Public ◽  
Latin American Immigrants

This article deals with the identity construction of Latin American immigrants in Israel through their food practices. Food is a basic symbolic element connecting cultural perceptions and experiences. For immigrants, food is also an important element in the maintenance of personal ties with their home countries and a cohesive factor in the construction of a new identity in Israel, their adopted homeland. Food practices encode tacit information and non-verbal cues that are integral parts of an individual’s relationship with different social groups. In this case, I recruited participants from an online group formed within social media platforms of Latin American women living in Israel. The basic assumption of this study posits that certain communication systems are set in motion around food events in various social contexts pertaining to different national or local cuisines and culinary customs. Their meaning, significance and modifications and how they are framed. This article focuses on the adaptation and acculturation processes because it is at that point that immigrants are faced with an interesting duality of reconstructing their unique cultural perceptions to either fit the existing national collective ethos or create a new reality. In this study, the main objective is to compare two different immigrant groups: Jewish and non-Jewish women from Latin America who came to Israel during the last ten years. The comparative nature of the research revealed marked differences between ethnic, religious and cultural elements that reflect coping strategies manifested in the cultural production of food and its representation in two distinct domains: private and public. In the former, it is illustrated within the family and home and how they connect or clash with the latter in the form of consumption in public. Combining cultural studies and discourse analysis, this article offers fresh insight into new models of food practices and reproductions. The article’s contribution to new food research lies in its ability to shed light on how inter-generational and inter-religious discourses are melded while food practices and traditions are embedded in a new Israeli identity.

A network of networks

2017 ◽  
Vol 31 (2) ◽  
pp. 223-236 ◽  
Author(s):  
Rick Iedema ◽  
Raj Verma ◽  
Sonia Wutzke ◽  
Nigel Lyons ◽  
Brian McCaughan
Keyword(s):  
Health Service ◽  
Health System ◽  
Network Governance ◽  
System Reform ◽  
System Transformation ◽  
Content Type ◽  
Multiple Networks ◽  
Network Of Networks

Purpose To further our insight into the role of networks in health system reform, the purpose of this paper is to investigate how one agency, the NSW Agency for Clinical Innovation (ACI), and the multiple networks and enabling resources that it encompasses, govern, manage and extend the potential of networks for healthcare practice improvement. Design/methodology/approach This is a case study investigation which took place over ten months through the first author’s participation in network activities and discussions with the agency’s staff about their main objectives, challenges and achievements, and with selected services around the state of New South Wales to understand the agency’s implementation and large system transformation activities. Findings The paper demonstrates that ACI accommodates multiple networks whose oversight structures, self-organisation and systems change approaches combined in dynamic ways, effectively yield a diversity of network governances. Further, ACI bears out a paradox of “centralised decentralisation”, co-locating agents of innovation with networks of implementation and evaluation expertise. This arrangement strengthens and legitimates the role of the strategic hybrid – the healthcare professional in pursuit of change and improvement, and enhances their influence and impact on the wider system. Research limitations/implications While focussing the case study on one agency only, this study is unique as it highlights inter-network connections. Contributing to the literature on network governance, this paper identifies ACI as a “network of networks” through which resources, expectations and stakeholder dynamics are dynamically and flexibly mediated and enhanced. Practical implications The co-location of and dynamic interaction among clinical networks may create synergies among networks, nurture “strategic hybrids”, and enhance the impact of network activities on health system reform. Social implications Network governance requires more from network members than participation in a single network, as it involves health service professionals and consumers in a multi-network dynamic. This dynamic requires deliberations and collaborations to be flexible, and it increasingly positions members as “strategic hybrids” – people who have moved on from singular taken-as-given stances and identities, towards hybrid positionings and flexible perspectives. Originality/value This paper is novel in that it identifies a critical feature of health service reform and large system transformation: network governance is empowered through the dynamic co-location of and collaboration among healthcare networks, particularly when complemented with “enabler” teams of people specialising in programme implementation and evaluation.

scholarly journals Chinese students’ participation: the effect of cultural factors

2014 ◽  
Vol 56 (5) ◽  
pp. 430-446 ◽  
Author(s):  
Chris S. Hodkinson ◽  
Arthur E. Poropat
Keyword(s):  
Teaching Effectiveness ◽  
Educational Achievement ◽  
Chinese Students ◽  
Educational Practice ◽  
Chinese Student ◽  
Future Research ◽  
Electronic Interaction ◽  
Content Type ◽  
Cultural Elements ◽  
The Impact

Purpose – The purpose of this paper is to provide for Western educators of international Chinese and Confucian Heritage Culture (CHC) students the first integrated review of kiasu, the “fear of missing out”, and its consequences for learning, teaching, and future research. Design/methodology/approach – A review of the economic importance of international Chinese students is provided, followed by consideration of the pedagogical consequences of restricted participation in educational activities by the so-called “silent Chinese student”. Examination of research on international Chinese students and their source cultures established significant gaps and misunderstandings in the generally accepted understandings of CHCs, especially with respect to the actual practices used in Western and Chinese teaching. More importantly, the participation-related implications of kiasu within the context of broader cultural characteristics are described and implications drawn for teaching practices and research. Findings – While many Western university teachers are aware of the “silent Chinese student” phenomenon, few understand its underlying reasons, especially the kiasu mindset and its relationship to other cultural elements. Kiasu actively impedes the interaction of international Chinese students with their teachers and restricts collaboration with peers, thereby limiting educational achievement. Specific tactics for amelioration are reviewed and recommendations are provided, while an agenda for future research is outlined. Practical implications – Western teachers need to normalise and encourage Chinese student participation in class activities using tactics that have been demonstrated to improve outcomes for Chinese students, but that also assist students generally. These include both within-class and electronic interaction tools. Social implications – More culturally sensitive understanding of the impact of cultural differences on teaching effectiveness. While some effective responses to these already exist, further research is needed to expand the skill-set of Western teachers who work with international Chinese students. Originality/value – This paper provides the first systematic integration of the kiasu phenomenon with educational practice and research.

Forensic learning disability nursing: what's it really like?

2014 ◽  
Vol 5 (4) ◽  
pp. 167-177
Author(s):  
Mark F Dalgarno ◽  
Sharon A Riordan
Keyword(s):  
Learning Disability ◽  
Design Methodology ◽  
Nursing Practice ◽  
Structured Interview ◽  
Phenomenological Analysis ◽  
Forensic Nursing ◽  
Content Type ◽  
Emotional Challenge ◽  
Areas Of Interest

Purpose – The purpose of this paper is to explore the lived experiences of learning disability nurses working within forensic services, and their views on their practice as a speciality. Design/methodology/approach – A qualitative, semi-structured interview-based design was used and participant's voices were examined through interpretive phenomenological analysis. Findings – Nurses explored a range of topics related to their practice and overall, five superordinate themes were developed. Forensic nursing as being both the same and different to generic nursing, the journey, and the emotional challenge of forensic nursing, the balancing act of everyday practice and the role of language within forensic nursing practice. Originality/value – Very little research has examined the views of learning disability nurses within the forensic field. This study gives both a voice to these nurses and suggests areas of interest both for research and for clinicians to consider in their practice.

A turnaround fuelled by transformational leadership

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mayuree Sengupta
Keyword(s):  
Decision Making ◽  
Transformational Leadership ◽  
Organizational Performance ◽  
Secondary Data ◽  
Management Style ◽  
Early Years ◽  
Annual Reports ◽  
Work Experiences ◽  
Content Type ◽  
The Rich

PurposeThe purpose of this paper is to understand how Chairman and Managing Director (CMD) of the National Research Development Corporation, India, Hanumanthu Purushotham had facilitated a turnaround of the organization and ensured profitability during his tenure there. This is one of the series of interview-based studies that focuses on a South Asian CEO, with the goal of ascertaining his leadership and management style in a volatile situation. This brief paper expounds how leader traits and transformational leadership can positively impact an organizational turnaround and fuel growth.Design/methodology/approachThis paper uses primary interviews and complements the findings with secondary data sources such as annual reports and management literature on leadership trait, transformational leadership and organizational turnaround.FindingsThe study found that socioeconomic factors have a bearing on leadership attributes. In this instance, the CMD's early years, diverse work experiences, bright traits and transformational leadership positively impacted organizational performance. Therefore, not only the qualifications but also the qualities of a leader are pivotal in shaping success of an organization.Originality/valueThe narrative provides an instance of how decision-making driven by strategic leadership can change firm performance. The rich experiences of the India-educated CMD, a government job holder all-through, provides a veteran's view to decision-making in a state-controlled firm and helps us understand how an organization can be transformed in a limited time and with scarce resources.

Social marketing hackers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maria M. Raciti
Keyword(s):  
Social Marketing ◽  
Change Agents ◽  
Content Type ◽  
Marketing Professional ◽  
The Social ◽  
Greater Good ◽  
The Many ◽  
Behaviour Changes ◽  
Social Causes ◽  
Blind Spots

Purpose Social marketing has come of age. Today, the study is a legitimate discipline with a wealth of empirical evidence that manifestly demonstrates the ability to bring about behaviour changes for the greater good. As social marketers, the study is rapidly expanding the horizons, with a growing interest in the labyrinth of systems that influence the chosen social causes. The study has become brave and bold, but is the study now running the risk of romanticising the work and ourselves? It is time to recalibrate, to take stock and to address the elephants in the social marketing room. Design/methodology/approach Expanding on my Change 2020 Driving Systems Change panel presentation, this study is a provocation, a think piece, centred around two observed phenomena. Findings The first phenomenon observed is the many identities of the contemporary social marketer – hackers, change agents, heroes, political power brokers and master puppeteers. The second phenomenon observed is the accelerated interest in systems thinking for which the author propose three preconditions are needed – an awareness of the system(s); an acknowledgement that this study is a part of the system(s) and the need to decolonise social marketing. Originality/value This paper poses challenging questions but offers no solutions as to how social marketers should, could or do square up the blind spots, make peace with the paradoxes or unblinking the views. Not only would it be naïve to proffer solutions but it would also stifle the growth of you, the reader, in your journey to becoming an integrated person and woke social marketing professional.

Who is a “Senior”? Looking for a definition in the healthcare system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Monica Consolandi
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Design Methodology ◽  
Social Role ◽  
Content Type ◽  
The Core ◽  
Starting Point

Purpose Seniors are nowadays at the core of important reflections to understand both how to ensure them a proper quality of life and better recognize their social role, providing them services and proper health care to value them as persons and resources. This paper aims to find a through definition about who is a senior, in the author’s opinion the starting point to help them flourishing. Design/methodology/approach As an example of definitions, an online dictionary and two geriatric text-books are quoted, highlighting qualities and rights referred to seniors especially in the delicate context of the health-care system. Findings The lack of a commonly shared perspective on this delicate kind of patient entails the difficulty to reach a coherent and satisfying definition about who a senior is. Originality/value The lack of a commonly shared definition leads to inevitable misunderstandings and could explain the arduousness of considering seniors in all their aspects. Further investigations are suggested.

Recovery college features and context: advancing a recovery and well-being policy agenda

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amadene Woolsey ◽  
Gillian Mulvale
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health System ◽  
Mental Health System ◽  
Well Being ◽  
System Reform ◽  
Educational Approach ◽  
Content Type ◽  
Policy Objectives ◽  
Mental Health Association

Purpose Internationally, there has been a move towards more recovery-oriented mental health policies for people living with mental illness, and some countries have included well-being as a population-level objective. In practice, these policy objectives can be difficult to achieve because of deeply rooted policy legacies, including a biomedical approach to care and the stigma associated with mental illness. The purpose of this paper is to investigate how interventions that operate outside the formal mental health system, such as recovery colleges (RCs), may advance these policy objectives more easily than efforts at broader system reform. Design/methodology/approach This study conducted a scoping review to explore the features and context of RCs that make the model an attractive and feasible opportunity to advance a recovery and well-being agenda. Our research is motivated by the initial and growing adoption of RCs by the Canadian Mental Health Association. This paper applies the consolidated framework for implementation research to analyse features of the model and the context of its implementation in Canada. Findings The RC’s educational approach, adaptability, coproduced nature and positioning outside the formal mental health system are key features that facilitate implementation without disrupting deeply entrenched policy legacies. Other facilitators in the Canadian context include the implementing organisation’s independence from government, its federated structure and the model’s alignment with national policy objectives. Originality/value This paper highlights how interventions outside the formal mental healthcare system can promote stated recovery and well-being policy goals.

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