Chapter
Role modelling clinical decision making
pp.：
27 – 30
The journey to expertise: the learning transitions model
pp.：
30 – 33
Chapter overview
pp.：
33 – 35
Introduction
pp.：
37 – 37
2 Critical to care: towards a model of caring excellence
pp.：
37 – 37
The dose of nursing
pp.：
37 – 40
Scenario 2.1: Self before service
pp.：
40 – 40
Scenario 2.2: The impact of a cast-away comment
pp.：
40 – 41
Scenario 2.3: Contrasting absence and presence
pp.：
41 – 42
Scenario 2.4: A model of excellence
pp.：
42 – 42
Self in therapeutic service
pp.：
42 – 43
Scenario 2.5: Cure and care
pp.：
43 – 44
Scenario 2.6: Caring as common sense
pp.：
44 – 46
Factors that impede caring excellence
pp.：
46 – 46
Factors that impede the transmission of expertise
pp.：
47 – 48
Nurses who are uninterested in nursing
pp.：
48 – 50
Managerialism and marketisation
pp.：
50 – 51
Introduction
pp.：
55 – 55
3 The dynamic context of critical care provision Caroline Williams
pp.：
55 – 55
The NHS and the modernisation agenda
pp.：
55 – 57
Defining critical care
pp.：
57 – 58
Modernising critical care services
pp.：
58 – 59
Developments in critical care outreach
pp.：
59 – 61
Critical care networks
pp.：
59 – 59
The Discovery Interview Process
pp.：
61 – 62
Critical care follow-up
pp.：
61 – 61
Challenges for specialist services within critical
pp.：
62 – 62
Challenges for paediatric nursing in critical care
pp.：
62 – 63
Care bundles for critical care
pp.：
62 – 62
Reforms in emergency care services
pp.：
63 – 64
Critical care or coronary care?
pp.：
64 – 65
Supporting and retaining the critical care workforce
pp.：
65 – 67
Education for developing practice
pp.：
67 – 68
Part 2 Facilitating learning transitions towards expertise in critical care nursing
pp.：
73 – 75
4 Role transition
pp.：
75 – 75
Theoretical perspective
pp.：
75 – 76
Introduction
pp.：
75 – 75
Role transition and nursing
pp.：
76 – 77
The process of role transition
pp.：
77 – 78
Antecedent conditions
pp.：
78 – 79
Scenario 4.1: Factors that trigger a role transition into an outreach service
pp.：
79 – 80
Expectations
pp.：
80 – 83
Role adjustment and role adaptation
pp.：
83 – 84
Consequences
pp.：
86 – 87
Career transitions: the impact on professional and personal identity
pp.：
87 – 88
Re-writing the self
pp.：
88 – 89
Typologies of transition
pp.：
89 – 90
The vicarious transitioner
pp.：
90 – 91
Facilitating learning transitions in the induction period
pp.：
91 – 93
5 Learning and transitions
pp.：
96 – 96
Pre-registration exposure to critical care nursing
pp.：
96 – 97
Introduction
pp.：
96 – 96
Making a difference? Student placements in critical care
pp.：
97 – 99
Outreach: learning critical care skills in the acute care environment
pp.：
99 – 101
Learning the science to inform critical care skills
pp.：
101 – 103
Facilitating the student through the preparation and encounter phase of their allocation to critical care
pp.：
103 – 105
Socialisation and learning
pp.：
105 – 105
Expectations of the experience
pp.：
105 – 106
Initial behaviours on the A&E placement
pp.：
106 – 108
‘Fitting in’
pp.：
108 – 110
Post-registration education in critical care
pp.：
110 – 111
Socialisation in education: the case in post-registration programmes
pp.：
111 – 116
Standardising educational competencies for critical care
pp.：
116 – 118
Implications for future provision of critical care education
pp.：
118 – 120
Factors to consider when facilitating learning transitions in colleagues
pp.：
120 – 121
References
pp.：
121 – 125
Facilitating transitions for registered nurses
pp.：
125 – 126
Introduction
pp.：
125 – 125
6 Effecting transitions: transforming knowledge and practice
pp.：
125 – 125
Newcomers and novices to critical care
pp.：
126 – 127
The practitioner returning to nursing
pp.：
127 – 128
Factors to consider when facilitating a newcomer, novice and return-to-nursing practitioner
pp.：
128 – 129
Scenario 6.1
pp.：
129 – 130
Silent transitions: acting up
pp.：
130 – 131
Facilitating horizontal transitions
pp.：
131 – 133
Facilitating transitions into senior posts
pp.：
133 – 134
Reflection
pp.：
134 – 135
Strategies for facilitating interactive reflection
pp.：
135 – 140
Conclusion
pp.：
140 – 141
References
pp.：
141 – 145
Introduction
pp.：
145 – 146
7 Assessment as learning
pp.：
145 – 145
Procedural issues
pp.：
146 – 148
Failing to fail
pp.：
146 – 146
Scenario 7.1a: Warning signs – ‘attitude problem’
pp.：
148 – 150
Scenario 7.1b: The consequences of inaction
pp.：
150 – 150
Differing agendas
pp.：
150 – 151
The students’ perspective
pp.：
151 – 152
Scenario 7.2: Red Flag – ‘high support’
pp.：
152 – 155
Scenario 7.3: The OSCE assessment
pp.：
155 – 157
The validity and reliability of the practice assessment documentation
pp.：
155 – 155
Questioning
pp.：
157 – 158
Scenario 7.4: Questioning to identify competence
pp.：
158 – 161
The practice educators
pp.：
161 – 162
Assessment of post-registered students
pp.：
162 – 163
Step 1: Recognition of one’s limitations
pp.：
163 – 166
Transforming the practice of demotivated colleagues
pp.：
163 – 163
Step 2: Confronting contradiction creating high intellectual interference
pp.：
166 – 168
Step 3: Critical reflection and self-evaluation
pp.：
168 – 171
References
pp.：
171 – 175
Conclusion
pp.：
171 – 171
Part 3 New ways of working: the contemporary context for developing expertise
pp.：
175 – 177
8 Competence: the building blocks of professional practice
pp.：
177 – 177
Introduction
pp.：
177 – 178
Applying core skills and advancing clinical competence in critical care
pp.：
178 – 179
Competence
pp.：
179 – 180
Debate about competence-based approaches
pp.：
180 – 182
The NHS Knowledge and Skills Framework
pp.：
182 – 183
Skills for Health Framework
pp.：
183 – 184
Faculty of Emergency Nursing Framework
pp.：
184 – 185
Competence deflation and up-skilling
pp.：
185 – 187
The role of the support worker in critical care
pp.：
187 – 188
Factors inhibiting delegation to support workers
pp.：
188 – 190
The transition from professor to HCA
pp.：
190 – 191
Scenario 8.1: Reflecting on delegating fundamental care
pp.：
191 – 192
Scenario 8.2: Reflecting on implicit criticism?
pp.：
192 – 192
Scenario 8.3: Delegating observational tasks to the HCAs
pp.：
192 – 194
Conclusion
pp.：
194 – 196
References
pp.：
196 – 199
New roles: the early background
pp.：
199 – 200
Introduction
pp.：
199 – 199
9 New roles in critical care practice John W. Albarran
pp.：
199 – 199
The impact of health service reforms
pp.：
200 – 201
The context of new roles – extension, expansion and development
pp.：
200 – 200
The impact of government initiatives
pp.：
201 – 203
Scenario 9.1
pp.：
203 – 204
Scenario 9.2
pp.：
204 – 205
Changes in the delivery of services
pp.：
205 – 207
Professional expectations
pp.：
207 – 208
Blurring and blending of roles
pp.：
208 – 209
The nature and scope of nursing roles
pp.：
209 – 211
Substitution of tasks
pp.：
211 – 211
Intermediate and narrow-focus substitution
pp.：
211 – 213
Scenario 9.3
pp.：
213 – 214
Blended and bounded roles
pp.：
214 – 216
Examples of autonomous practice
pp.：
216 – 217
Loss of experiential wisdom
pp.：
217 – 218
Consequences of new nursing roles
pp.：
217 – 217
Educational preparation and advanced roles
pp.：
218 – 219
Moving role transition forwards – facilitators and barriers
pp.：
219 – 220
Conclusion
pp.：
220 – 221
Acknowledgement
pp.：
221 – 221
References
pp.：
221 – 227
Introduction
pp.：
227 – 227
Leadership for the future
pp.：
227 – 228
10 Future gazing: the place for expert nursing?
pp.：
227 – 227
Advances in biotechnology
pp.：
228 – 229
Moral and ethical health care and economics of provision
pp.：
229 – 229
Hospitals as intensive care units
pp.：
229 – 230
The emergence of new professions
pp.：
230 – 231
Information technology and the place of nursing in future critical care provision
pp.：
231 – 233
The rise of fundamentalism and conservatism
pp.：
233 – 233
Future predictions on trends and drivers for critical care provision
pp.：
233 – 233
Funding for science and technology moves into the private sector
pp.：
233 – 234
Public involvement
pp.：
234 – 235
The restoration of public trust in the new professions
pp.：
235 – 236
The (re)emergence of revered intellectuals and professionals
pp.：
235 – 235
Global risks
pp.：
236 – 237
Accountability for waste production and disposal
pp.：
236 – 236
Conclusion
pp.：
237 – 239
References
pp.：
239 – 242
Developing Expertise in Critical Care Nursing
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