Abstract: A telephone survey was conducted with 61 randomly selected patients who had been admitted to the cardiology service with an Myocardial infarction but did not attend the cardiac rehabilitation programme. Findings show that many patients who would benefit from cardiac rehabilitation are denied access because it is only open to patients who have Myocardial Infarctions. Only a small percentage of MI admissions attend rehabilitation the main reason being patients are not informed the service is available. Women are under represented among rehabilitation participants and lack of transport is a major factor inhibiting women from attending. Improvements in referral systems and follow up are recommended

Abstract: The move to nursing degrees has encouraged educators to use student centredteaching methods which develop problem solving skills, critical thinking andreflection. Kola's Experiential learning cycle is proposed as one method to developsome of these skills. The study compared the effectiveness of three differentmethods of teaching the instillation of eye drops and application of an eye pad. Asample of 73 volunteers from a Diploma of Nursing programme were systematicallyassigned to one of three groups. The modified experimental design consisted of acontrol group (tutor demonstration and student practice), Kolb's group (teachingusing the experiential cycle) and the SDL group (self directed learning using writteninformation with no tutor instruction or feedback). Participants rated their confidence,competence and the amount of thinking, analysis, guidance and problem solvingbefore and after each method.Results for instilling eye drops indicated that there were no significant differences onthe pre-test ratings and a marginally significant difference (p=0.06) on the post testratings across the teaching methods. Results for the eye pad showed no significantdifferences on pre-test or post-test ratings across the methods. Students learnt by allmethods and the differences, if there were any, were not large enough to bedetected in this study. There was a significant difference in problem solving and tutorguidance across the methods due to the low ratings of the SDL group. There was nosignificant difference in thinking, analysis or partner guidance across the methods

Abstract: We are about to implement a nurse-based critical care follow-up service and used a follow-up study of tracheostomy to determine the feasibility of such a service. Nine to 27 months median 14 after intensive care admission we attempted to follow-up 116 of our most severely ill survivors. Twenty six could not be found, 11 declined follow-up. A questionnaire, interview and limited examination were used to determine health status. Ten patients unable to come to a clinic were seen at home. Interview time varied between patients but 79 patients took 100 nurse-hours. Ninety percent of patients co-operated with respiratory function testing. Pulse oximetry identified one with severe chronic respiratory failure. In this highly selected group of patients with on going problems (perceived poor health, dependency, disability, changes in appearance, deterioration in personal relationships, poor sleep, pain, altered diet, unaddressed chronic health problems, poor access to health services, and continuing prescription medication) were common, and addressed to some extent by appropriate referral. Approximately 20% of patients reported improvement in their health and personal relationships after critical illness and half of the smokers had given up. Factors contributing to follow-up difficulty included distance, delay in initial contact, change of address (255 of this group), disability and poverty. A nurse-run critical care follow-up clinic is feasible, time consuming but productive. A register of current addresses and phone numbers is recommended. The optimal time for follow-up will vary with patients conditions but early follow-up with protocol- based lines of referral is recommended to reduce persistent health problems

Abstract: This thesis presents a study of a nursing 'practicum' from the perspectives of nursing students and staff 'buddies'. A grounded theory approach was used to interview six nursing students during their transition placement, the final practicum of their Diploma in Nursing programme. Five staff nurse buddies selected by the students were also interviewed. An informal, conversational interview was used and data was analysed from an experiential learning perspective.This study differs from others because it focuses on the clinical experience component of nursing education, 'practicum', and includess practitioners viewpoints. At present there is a re-evaluing of experience within nursing education with a new emphasis on practice-based learning. Experience-based learning is becoming increasingly acceptable within academia as a 'seamless' education system evolves.I identified three learning stages which students' experience during practicum – initiation, exploration and consolidation. The key stage for learning through experience was exploration. Learning during this stage was predominantly buddy-directed which contradicted the self-directed curriculum design. Students and staff nurses however agreed that communication between them during this stage enabled the development of 'competence'.The learning /teaching approach used by the students and staff nurses made it difficult for students to translate their 'all-round' competencies during practicum. It is argued that it is the useof such competencies during practicum which enable nursing students to become autonomous in the attitudinal and epistemological sense. The predominantly 'technical training' approach adopted was understood by students and staff nurses to be reinforced by 'silence' from tutors.Restructuring gives the opportunity for nursing to develop an ';investigative', enquiry-based approach in practice. There will increasingly be an emphasis on practice-based research as a result of the implementation of degree and post-graduate programmes in nursing. This study highlights some aspects of nursing education and it's relationship with practice which can assist the development of such an approach