Suchergebnisse

AbstractInvasive non‐sedated clinical procedures such as gynaecological examinations are normalised; however, there is limited research highlighting the relational and technical skills required for clinicians to ensure patients' continued consent. A considerable body of research emphasises that women dislike examinations, leading to their non‐compliance or a delayed follow up for gynaecological and sexual health problems. However, medical research focuses on 'problem' women; the role of clinicians receives limited appraisal. This article draws on interviews with sexual health clinicians in New Zealand, from metropolitan and provincial locations. The gynaecological care of women in New Zealand attained international notoriety with the 1988 publication of Judge Cartwright's inquiry into ethical shortcomings in cervical cancer research at the National Women's Hospital. Judge Cartwright's recommendations included patient‐centred care in order to ensure informed consent had been received for clinical procedures and research participation. This article's critical analysis is that, although clinicians' language draws on humanistic notions of patient‐centredness, Foucault's notion of secularised pastoral power enables a more nuanced appreciation of the ethical work undertaken by clinicians when carrying out speculum examinations. The analysis highlights both the web of power relations present during examination practices and the strategies clinicians use to negotiate women's continued consent; which is significant because consent is usually conceptualised as an event, rather than an unfolding, unstable process.

The drive to both maintain competitiveness and to meet marketplace expectations using the strategic management of communication is a feature of the international workplace. In the complex and dynamic commercial environment of the new millennium, this drive includes the imperatives to employ competent communication professionals. Whether organizations are intent on acquiring or developing proficient practitioners, the ability to achieve these aims rests on the identification of relevant competencies and attributes. This study uses the Critical Incident Technique to explore the practice of Communication Management in a sample of practitioners in New Zealand and Finland—two geographically disperse countries. The identified critical incidents mostly related to managing crisis communication across both countries. To manage the incidents, communication practitioners predominantly used two competencies: stakeholder relationship management and external interface management. In addition, the personal attribute of adaptability was most commonly employed in both countries. Despite the similarity of incidents and the competencies and attributes required to manage them, also variability in practitioners' strategic and personal responses was evident.

The United Arab Emirates (UAE) has a very small population of national citizens, so it relies on foreign workers who bring a range of cultures with them, resulting in a unique multi-cultural context. Unlike Western countries, such as the UK, Canada and Australia, workers are unable to permanently migrate to the UAE, so instead they hold temporary, expatriate status. This exploratory study focuses on the experiences of internationally qualified, expatriate nurses in hospitals in Al Ain, gathered by qualitative interviews. Twenty-one registered nurses participated in this study. The nurses faced challenges associated with language requirements and differing cultural expectations, and displayed limited acculturation, which compromised their ability to provide appropriate care for patients. The temporary nature of the work, cultural expectations, language difficulties and potential improvements are discussed. The findings have important implications for organizations that employ large groups of staff from overseas in all sectors. This article contributes to knowledge of expatriates' challenges in the UAE and highlights the difficulties of working in a diverse environment, leading to a range of actions being recommended for managers.