Trophicognosis. Is this sufficient?

SELF - individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group - POPULATION

	trophicognosis

trophicognosis

 [trof″ĭ-kog-no´sis]

the scientific approach to determination of an individual patient's nursing care needs; suggested as an alternative to the term nursing diagnosis.

trophicognosis. (n.d.) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved April 4 2019 from
https://medical-dictionary.thefreedictionary.com/trophicognosis

Threshold Concepts, Professionalism & Scope of Practice

Amongst the chaos of self-directed study, vapourware, writing and starting a PhD program one writing project still in draft form concerns Hodges' model and what is termed the 'scope of practice'. As a generic and multidisciplinary conceptual framework Hodges' model can, I believe, assist in demarcating and differentiating the following:

• knowledge - in all its forms;
• a curriculum;
• interprofessional working;
• activity, tasks, actions;
• responsibilities;
• expected competences;
• procedures;
• assistant, associate, general registered, specialist - advanced practice;
• existing policies, law, rules and standards;
• records

Another draft paper (closer to completion I think) and which I've referred to before (see - chaos is the word!) relates Hodges' model to threshold concepts and definitely bears revisiting.

Scope of practice is different from professionalism but invites comparison. For example, the professionalism that is hopefully exercised when a practitioner recognises that their scope of practice is being called into question.

Searching the literature once again below is a new paper that combines professionalism and threshold concepts. I will see if I can add another paper of note and extend this post later in the week.

Hilary Neve, Helen Lloyd & Tracey Collett (2017) Understanding students’ experiences of professionalism learning: a ‘threshold’ approach, Teaching in Higher Education, 22:1, 92-108,
DOI: 10.1080/13562517.2016.1221810

To link to this article: http://dx.doi.org/10.1080/13562517.2016.1221810

The Scope of Nursing::And other things

individual
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INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
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"Scope Resolution Operator (::) 

The Scope Resolution Operator (also called Paamayim Nekudotayim) or in simpler terms, the double colon, is a token that allows access to static, constant, and overridden properties or methods of a class.

When referencing these items from outside the class definition, use the name of the class.

As of PHP 5.3.0, it's possible to reference the class using a variable. The variable's value can not be a keyword (e.g. self, parent and static). 

Paamayim Nekudotayim would, at first, seem like a strange choice for naming a double-colon. However, while writing the Zend Engine 0.5 (which powers PHP 3), that's what the Zend team decided to call it. It actually does mean double-colon - in Hebrew!"

Source: http://php.net/manual/en/language.oop5.paamayim-nekudotayim.php 

Scope of Nursing: (Interpersonal, Sciences, Sociology, Political & Spiritual)  actions, procedures, responsibility, accountability, governance, whistle-blowing, transparency, competency, candour, quality, safety....

Self-care?

Spot image: http://iridia.ulb.ac.be/~cpinciroli/extra/h-414/one_spot.png

Thinking checks and balances [I]

Following on from last month's -

Newton and Einstein had it right - Reflection in H2CM

- this is the first of several posts on learners, their career (and yours as a lifelong learner), reflection, thinking and researching Hodges' model.

In several papers on Hodges’ model and in numerous blog posts I’ve made many claims about the scope, versatility, potential utility and power of the model as a tool for reflection, assuring reflective practice, bridging the theory-practice gap, and supporting person centred and integrated care.

This is quite a claim, especially using words like scope, versatility, potential utility and power. Without evidence these words are not so much virtual as vapour – nebulous in terms of what they really mean.

What (I believe) Hodges’ model does provide simultaneously through its combined structure and care (knowledge) domains is ready cognitive access to three forms of thought:

1. Dualist
2. Multiplistic
3. and Relativistic Thinking

Johnson and the sources cited describe a developmental pathway for learners through 1-3.

If I or other interested parties could demonstrate that Hodges’ model does encompass all three that would be progress.

As many previous posts reveal this trinity isn't the only idea to support the model. Amid the many ongoing questions is balance and clearly the conventional view of balance is not sufficient for learners in the 21st century.

Tomorrow some thoughts about dualistic thinking and Hodges' model.

Johnson, D.D. (1994) Dualistic, Multiplistic, and Relativistic Thinking as it Relates to a Psychology Major. Honors Theses. Paper 202. http://opensiuc.lib.siu.edu/uhp_theses/202/

The Willis Report on Nursing Education [ III ]

See also:
The Willis Commission on Nursing Education [i]
The Willis Commission on Nursing Education [ii]

Having related (in part ii) some of the skill sets within the technical papers to Hodges' model what next? Well, instead of the 2x2 table, below I've included a screen capture of the quads page [no longer available]. This indicates the potential conceptual scope of the four care domains of Hodges' model. If the skill set listing by Watts and Gordon (2012) is succinct, the quads page is anything but. It might however drive home, the need for the Willis report and the educational challenges for nursing and other healthcare disciplines. Another common element here with Willis' findings are some of the original purposes that Hodges' model can address:

• the theory - practice gap (Watts and Gordon, 2012, p.7)
• curriculum development 

Just for the moment imagine picking up the curriculum? Yes, picking it up; all of it.
Can you feel it? Can you? OK well, try this (odd - Find Wally-like?) exercise:

1. Visit the quads page.
2. Print the page (in black and white).
3. Make a cup of your preferred beverage.
4. Cross out what in your opinion is NOT part of the nurse curriculum.
• Most of these items are learned through our being socialised and during formative education (when available)?
5. Outcomes are certainly in vogue, so what are yours in completing steps 1-4? Any surprises, frustrations; did you find the plumbing - kitchen sink and all...?
6. If you feel there is something - important - missing please let me know.

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Former web page - Indicative content of Hodges' model

You have to hand it to educationalists and policy makers who wrestle with curricula. The very word could almost be some disorder of the posture, such are the contortions the curriculum demands. What to include, what as a consequence to remove. One thing not included in quads.htm is the hidden curriculum. Additional complications are no doubt many; I'll add just one. Such are the recruitment challenges that a Trust setting out to train their own student nurses, that is through non-Health Education England places (Hazell, 2015).

The word 'innovation' is all over the media, the HSJ, and this blog. As I read the recommendations of Willis (see emphasis in first post), the technical papers and Hodges' model I can't help but wonder about history and the potential here - and now. Especially in terms of supporting learners in their acquisition, practice and delivery of compassionate care or caring behaviour.

View the full report here (1,105kb)


Hazell, W. (2015) Lancashire trust to train its own nurses, Health Service Journal, 16 January. 125:6430, p.15.

Hazell, W. (2015) First self-funded nursing course launched to tackle shortage in NW, Nursing Times, 7 January.

Interested in writing? [ II ] Hodges' Health Career - Care Domains - Model

In the side bar beneath the bibliography (on a desktop) I've listed a few topics worthy of critical attention. The real need is to link practical application of Hodges' model and further some theoretical underpinnings for the model. This is now happening and it's quite a challenge as I chase questionnaires and write up a draft report for next week. This report is set out as a paper using an author's template from a nursing journal.

Trying to get the message out on writing about this free, holistic bandwidth defining, holistic wrangling, (self-) caring info-portal I blogged an appeal of sorts in 2010. Here we are again. The existing topics in that list relate to the original purposes of the model, plus a few 'extras':

• reflection;
• curriculum development;
• case formulation;
• holistic care;
• conceptual spaces

I'll revise the above as a result of this post and ongoing studies at Lancaster University. I will also add the journal to the most recent recovery paper. Expanding on the above for the benefit of anyone interested in using Hodges' model, reflection (as in 2010) is for me the primary purpose of the model.

Reflection: I'm sure that Hodges' model can complement existing and established approaches to reflection. It would be interesting to compare the use of Hodges' model with a control in clinical reflection, reflective practice with a patient/client, and in clinical or managerial supervision. (You see why this is a challenge, and I appreciate it is easy to generate suggestions!)

Curriculum development: If you need a map that incorporates an academic compass (sat-nav even) look no further. Where are the curricula hot-spots and how are they distributed?

Case formulation: There is an existing draft that needs to be revisited at some point, but the scope here is huge in terms of disciplines and applications. As mentioned above it is coming up with questions and research methods.

Holistic care: Is it time to revisit this phrase? Break it apart and put it back together if it still fits?

Is it a case of damaged goods?

Is this a broken currency as it originally did not include the patient as an active participant? Is it one of several linguistic tropes, said in earnest yet what does it mean? How do we measure it? Could there be a role for Hodges' model in defining or measuring it in theory (through the health record) in practice through outcomes that are demonstrably holistic? Does this make sense...? What is this holistic bandwidth that PJ witters on about? Is an informatics metaphor too far, or this a means to a definition?

To conceptual spaces I need to add threshold concepts and there is a literature here for health and social care, something to build upon and post here....

Interested in writing?

Two items can be readily brought together here: 

----- Forwarded Message -----
From: JS Drummond
To: NURSE-PHILOSOPHY AT JISCMAIL.AC.UK
Sent: Tuesday, 22 April 2014, 18:00
Nursing Philosophy (Post)-Graduate Student Essay Prize

Hi Folks,

To interested parties, there is still time to submit an entry for the (Post)-Graduate Student Essay Prize to the Journal, Nursing Philosophy.

Details are on the IPONS website. http://www.ipons.co.uk

Best Wishes,
John Drummond (IPONS)
Sent on behalf of Derek Sellman, Editor, Nursing Philosophy

The latest paper on Hodges' model -

Exploring the Dimensions of Recovery and User Experience

- has progressed to the point were I am awaiting contact from the production office of the International Journal of Person Centered Medicine.

In addition to the (Post)-Graduate appeal with IPONS there may be an opportunity through h2cm. If there are any student nurses and other health care learners interested in models of care and the future, I would be pleased to offer some support on a paper. Perhaps there are personal tutors out there who could also engage? I can't offer a prize, but there is surely a prospect with the journal Advances in Nursing Sciences:

Models of Care for the Future
Vol 38:1 - June 2015
Manuscript Due Date: October 15, 2014
As nations worldwide seek to establish models of care that provide quality and efficiency, nurse leaders are emerging to play a significant role in the development of these models. For this issue of ANS we are seeking manuscripts that provide theoretical underpinnings of creative models of care, as well as evidence that supports their implementation. Manuscripts should be clearly grounded in a nursing perspective; the content can include philosophic, theoretic, empirical or ethical aspects related to the model.

I do have form here - two submissions without success - but the very helpful feedback did result in a publication elsewhere.

With studies of my own I can't write another paper alone, but perhaps I can help others. It's time for me to not just think about the model, but do something with it too. It feels strange finally having questions out there in the field - a small study.

Earlier this week a colleague referred to the model's elegant parsimony. This is definitely a quality of Hodges' model and one that merits exploration with new explorers.

Papers, case formulation and hyperbole

I am enjoying a three night break in Keswick where it is dry, windy and chilly. Invigorating for all that.

In between taking in the hills and the atmospherics of the skies I am working on completing the revision to the - scope of nursing - paper. There is still a paragraph to lose to reduce the length for the target journal.

The case formulation and h2cm paper is taking shape too - 5,000 words. I am sure the ongoing advice and thoughts of my co-author on the scope effort is making a difference. As a result the case formulation paper will be in final draft form soon. Then I'll seek some feedback from a CBT therapist before trying to locate a journalistic home. Here's a snippet from the draft:

... If the talking therapies are specialised forms of conversation then we should also be able see case formulation as being on a continuum, derived from narratives that can include extreme case formulation, and hyperbole (Norrick, 2004). The specific therapies discussed here [cognitive behavioural therapy and cognitive analytical therapy] are concerned with overstatement and exaggeration in thought not just speech. Things may be said in everyday speech that are rhetorical and not necessarily indicative of deeply held core, dysfunctional beliefs. ...

Norrick, N.R. (2004). Hyperbole, extreme case formulation. Journal of Pragmatics 36. 1727–1739.

I receive regular reminders about a part time PhD application that remains incomplete. So I will address this too (and check other opportunities) over the next few days.

Post on a new laptop and a socio-technical-existential addiction to follow ....

Update on new papers: 1. Case formulation & 2. Scope of Nursing

At present, with the support of a co-author, I am editing a paper on Hodges' model and the scope of nursing. The text some 6000 words was submitted to a journal last April and rejected, but as ever feedback is golden and the comments are being used to revise. The referees have set a challenge as amongst several points I tease out where the inherent theoretical perspectives lie in Hodges' model and how their identification within h2cm helps to define the scope of nursing.

Another paper in final draft - 4400 words - concerns the model and case formulation. At last I've arrived at this topic. Hodges' model is basically a simple drawing with care concepts superimposed. Cognitive behavioural therapy [CBT] and cognitive analytical therapy [CAT] make use of case formulation and CAT utilizes what are called sequential diagrammatic formulations.

The old website pages were written rather on the fly. They almost comprise a 'to-do-list' of thoughts and findings to revisit and check. Of two old pages one dealt with possible ideas and sources that might inform the structure of Hodges' model; the other page theory.

On the latter page I learned of SDRs - the sequential diagrammatic reformulations used in CAT and related this to the care domains of h2cm -

It feels good to be able to address this theme at long last.

In just over a week I'm looking f/w to a three day break in the Lakes. Weather permitting some  walking and a few runs, a bike ride, writing and Drupal - which I have put down of late...

[HIFA2015] International Nurses Day, May 12 "Closing the gap: From evidence to action"

Dear Colleagues / collaborators,

Nurses worldwide under the umbrella of the International Council of Nurses celebrates the International Nurses Day yearly on May 12. This is to pay tribute to the millions of men and women who put their lives to the service of humanity, in accordance with convention 149 of the ILO (Nursing Personnel Convention) passed in 1997. This celebration however has not yet gained the recognition it should, for how can one explain the fact that this day may even go by unnoticed in some countries, or are we therefore saying it is not worth it and why is this day not even a public holiday like for other professional groups.

I find it hard to believe that until now on this forum no one could think of it, when the celebration is due in barely 36 hours. I understand the delicate nature of health jobs, but this should not be an excuse for not paying tribute where is it due. I know this day should be meant for reflection among nurses and seeking for ways to improve nursing services. This will not happen in isolation, for nurses need the political will and inter sectoral collaboration to do their job effectively, shape a better future for the next generation of nurses consonant with current stakes.

This year, nurses are deliberating on the theme 'closing the gap: From evidence to action'. This topic is quite elaborate and needs lots of considerations both within and without the influence of nurses. Understanding evidence-based practice, seeking for sources of evidence, making the appropriate case for change and moving from evidence to action is the cycle in which nurses hope to reflect as they celebrate this year. Nurses will need new skills and expertise to deal with their clients in today's changing and challenging health environment. This is why this forum is of vital importance and I will continue to thank the team behind it. Nursing training programs may be subject to revision, expanding the legal and professional limits of practice while maintaining strict regulatory sanctions. This increased autonomy will enable nurses take up new functions within the confines of their practice and help in meeting the health needs of our population and not acting as physician substitutes or mini-doctors.

Therefore, I wish all nurses a happy celebration, calling on them to use the very rich celebration kit from the ICN, easily downloadable from their website, www.icn.ch, and share among themselves in all settings where nurses live and work. It is our day and we should be happy and honoured for the services we offer to the six billion people on earth, since nurses form the bulk of health care providers and work in remote areas in all countries.

In Cameroon, thousands of nurses from all the ten regions, shall be meeting in the economic capital Douala between June 14 to 16, to brainstorm on the activities. This event is usually opened by the Minister of Public health or his representative, various scientific presentations, round table conferences and other important activities grace the event and concluded by a closing ceremony during which important decisions taken are communicated to participants.

Tita Pale Isa Ndognjem, BSc, RN
Public Relation officer, Cameroon Nurses Association
2012 Fellow, Commonwealth Nurses Federation
paleisa AT yahoo.com 

Additional link:

C149 Nursing Personnel Convention, 1977
Convention concerning Employment and Conditions of Work and Life of Nursing Personnel (Note: Date of coming into force: 11:07:1979.) 
 
My source: HIFA2015