Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Kicking Eeyore into Touch: 'Living-Strong', 'Nursing-Strong' and Being Appreciative and Solution-Focused

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Kicking Eeyore into Touch: 'Living-Strong', 'Nursing-Strong' and Being Appreciative and Solution-Focused

Article excerpt

INTRODUCTION: NURSING BEYOND EEYORE1

Most of us have a touch of Eeyore in us. Some days, Eeyore wins out and we see the world in a rather gloomy, pessimistic and slightly melancholy way. We think of the things that we would like to do but which we cannot because we have not got the time, resources or facilities. We negatively problematise the world, our practice and, by default, the children and families we care with and for. Yet, despite our occasional forays into Eeyorishness, I firmly believe - with absolutely no empirical evidence upon which to support this belief - that most children's nurses have more Piglet and Kanga in them than Eeyore.

It's quite easy for children's nurses, regardless of their role - practitioner, manager, or academic - to get complacent about the philosophical underpinnings of children's nursing. It sometimes takes a moment of dysjunction to propel us, either as individuals or as a group, into adopting a new mindset about our practice. What I'm advocating in this paper are the potential benefits of moving towards a solution-focused, appreciative way of working with children and their families. This does not mean that there would be a wholesale revolution resulting in the overthrow of philosophical frameworks, such as 'child/family-centred' care, that most of us hold dear to our hearts but for which there is conflicting evidence (Shields, Pratt & Hunter 2006). However, it would require a significant readjustment about how we work within these frameworks. In the United Kingdom, children's nurses have embraced many changes. These include the shifts to community based care (British Association for Community Child Health (BACCH) 2005), more active approaches to partnership and collaboration (Kirby et al. 2003), the notion of the expert patient (DoH 2006; Hawley 2005a; Hawley 2005b) and the shift in perceptions of children having their own active social agency (Hill et al. 2004; Mayall 2006; Roberts & Petticrew 2006).

Whilst all of these changes have been laudable and necessary we still have a tendency to work in a problem-oriented way. We assess needs and problems and consider interventions to provide support and care. Whilst these are, arguably, fundamental to our role we less frequently frame our practice with children in relation to what they are achieving, their successes, what they can do or what they actually want (Bricher & Derbyshire 2004). Being oriented to problems and needs is not, in itself, wrong. However, it is constraining both for ourselves as practitioners and also for the children and their families. To a greater or lesser extent it takes some of the joy out of our relationships with children and their families. Children's nursing has the potential to be celebratory; a sharing of expertise; a way of being-with children who are ill or require nursing. We should recognise this and try and ensure that our practice is more joyous, more generous, and more affirmative (Carter 2006a).

To some extent this paper represents a set of personal thoughts in progress. Where references exist and where I think they add to the argument I am developing I have used them; elsewhere the text is free from references. It is a paradox to try and reference something which is a new idea - the evidence base does not fully exist. This paper aims to add to the literature exploring the potential of solution focused children's nursing and the need to shift to a new paradigm. I anticipate that this paper may challenge some people, be dismissed by some but intrigue others; I would be delighted with all and any of these responses.

SHIFT TO A NEW PARADIGM: OUT OF THE COMFORT ZONE?

There are many pitfalls and pratfalls associated with proposing change, especially when it comes to suggesting a shift in the way we think about children's nursing. Yet, I do think it is time for a paradigm shift. The paradigm we are working in is comfortable; we share a general understanding of what philosophically underpins children's nursing. …

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