Abstract: This thesis presents the job of psychiatric nursing from the nurse's point of view, as derived from the author's personal experience and from interviews with thirty five other staff within a particular psychiatric institution.The first part of the thesis is reconstructed narrative account of an afternoon and a day shift in an acute admission ward. In the second part, the basic situation on the ward and some of the exigencies of nurse-patient and nurse-staff relations are discussed from structuralist and strategic conduct perspectives.The discussion that follows Anthony Giddens' (1976, 1979, 1984) conceptual framework of power, legitimation and signification, with particular attention to the strategic implications of ward routines, nursing practices, and interpersonal relations, as well as the duality of clinical and moralistic interpretive themes. The third part of the thesis 'the nurse's progress' over time. Characteristic changes in understanding and awareness take place with the movement from the 'backwards' to the 'acute' area and from the student to staff nurse. This is portrayed as a 'moral career' analogous to that suggested by Goffman (1968) for psychiatric patients; marked by 'happenings' that generate revised conceptions of self and others, and including those experiences of duality and contradiction discussed in part Two. While acknowledging the diversity of nurses' attitudes and approaches, with variations according to individual temperament, past experiences and the current setting, the suggestion is made of a common and distinctive 'meta-awareness' that develops with the fob

Abstract: Patients with myisthenia gravis (MG) face major pulmary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced total capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8.00 a.m. to 8.00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholnesterase medication, and some subjects received additional treatment modalities. Most of the subjects were non-smokers or previous smokers, but two subjects continued to smoke. Ninety-three recent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p=.0000) than those predicted for normal subjects. The inspiratory force for the sample was low sat 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in total volume to normal values derived from random tables and predicted equations ws not significant. Th major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when the muscles are strongest

Abstract: This is a report of a study into the night-time experience of elderly hospitilised adults and the nurses who care for them. A grounded theory approach was used for the analysis of data and subsequent generation of a theoretical description an partial explanation of patient experiences, nursing actions and nurse-patient interactions.Data were gathered through observation, interview, document audit and literature review; tow general medical wards in a large regional hospital were the focus of field methods of data collection.It is argued that the night-time experiences of elderly hospitalized adults are to a large degree dependent on the individual patterns of sleep and waking behaviour of these people in their normal environments. If individualised care is given, nurses must be aware of people's usual patterns of behaviour.Nurses working at night engage in a series of complex decision sin the course of their interaction with patients. They work under constraints not present during the daytime, and are highly dependent on co-operation from colleagues on other shifts for information which would enable them to deliver optimum care at night. At the same time, night nurses have access to information from and about patients which would be invaluable to a total assessment of any patient's health state.Considerations of sleep and sleep are relevant to nurses working all shifts. The findings of the study have implications in terms of nurses' knowledge of all aspects of sleep; assessment practices; nurse-patient and nurse-nurse communication; nurse-patient relationships at night; wars management; and the independence of nurses