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Practitioner perspectives on best practice in non-treatment factors that support the delivery of repetitive transcranial magnetic stimulation (rTMS) for depression.

Accessible SummaryWhat is known about the subject? The practices of mental health nurses in the administration of repetitive transcranial magnetic stimulation (rTMS) treatments for depression in outpatient clinic are crucial for patient outcomesTo date, most research has focused directly on procedural aspects of treatment delivery with limited focus on the delivery of holistic care and treatment.There is a lack of best practice guidance based on the experiences of those involved in clinical delivery to inform and improve rTMS practices What this paper adds to existing knowledge? This study provides unique insights into service and personalized non‐treatment factors associated with rTMS delivery that may reduce stress and improve the experiences of rTMS patientsIt reviews and updates understanding of the factors that contribute to the delivery of effective rTMS. What are the implications for practice? The need to apply findings for the development of best practice guidanceFactors to improve practice include (a) rTMS machine demonstrations; (b) constructive, individualized, friendly, and therapeutic conversations; (c) a relaxing, comfortable, 'homely' physical environment; (d) long term supportive management; and (e) careful engagement of nursing and support staff.

Corona XL – listen

Corona XL – listen

How to be an Agnostic

[Excerpt]In a famous trial in Dublin in 1937, Samuel Beckett took the stand in a libel case, not directed at him but rather at a local author, Oliver St. John Gogarty, for an antisemitic caricature he had recently made of Beckett’s Jewish relations. Gogarty’s barrister put the following question to Beckett: “Do you call yourself a Christian, Jew, or Atheist?” From the dock, Beckett replied: “None of the three.” To this extent, Beckett may be grouped with the ever-increasing number of today’s ‘nones’, those who regard themselves as ‘non-religious’, who are not affiliated with any religious tradition or community. It is primarily these nones to whom Schellenberg addresses his book. But what he seems to overlook is the distinctive, albeit unusual, way in which Beckett and many like him identify as religious ‘nones’. Beckett’s perspective on religion is notoriously difficult to categorise. And he is not unique in this respect: the world’s great writers tend to resist pigeonholes, especially with regard to religious belief. To ask, for example, whether Kafka was a theist is almost as illogical as many of the scenes depicted in his novels and short stories. Consider also Camus’ reaction to the frequent attempts made to label him an atheist: “I hear people speak of my atheism. Yet the words say nothing to me: for me they have no meaning. I do not believe in God and I am not an atheist.” Even those who profess a fixed religious identity are often betrayed by their own writings. A good, albeit contested, example of this is Dostoevsky, whose affiliation with a quite conservative form of Christianity is well known, but who, at the same time, arguably undermined this very affiliation by putting forward some of the most powerful criticisms ever made against belief in God (for example, in the rebellious character of Ivan in The Brothers Karamazov).

Guest Editorial: That Was Then, This Is Now

This is not my first JPT editorial. In fact, it is more than 16 years since that was published - sufficiently long ago that I initially put my invitation to write this piece down to an error. When it became clear that was not the case, I wondered what I should use this opportunity to say. I had entirely forgotten what I had written about in February 2004. Reading that editorial again was slightly uncomfortable, and I found myself wincing at parts. Setting that discomfort aside, when I thought about when the piece was written, as much as what I had said, I was struck by the parallels and contrasts with the world that we live in today. That insight led me to test what I believe to be important for the oil and gas industry of tomorrow. Facewhat? Compared to 2004 I am, broadly speaking, much the same; perhaps a little wiser. I still have a keen interest in (my words), or pointless obsession with (other people’s words), fonts, text editors, pre-1980s programming languages, and units of weights and measures. I could add more to this list, but I don’t want to come across as too nerdy. While I have remained constant, at least in spirit, some things were profoundly different at the start of 2004. US Oil Production Had Been in a Long Period of Decline. During 2003 the US produced around 5.6 million B/D of crude oil, including lease condensates. Production had been declining steadily from its peak in the mid-1980s. In my editorial I wrung my hands at the slow pace of uptake of methods to improve well productivity and drive down well costs. As far as the US was concerned, I needn’t have worried: a productivity revolution was underway that would profoundly affect not only the shape of the US oil industry, but the supply/demand balance of the entire world. The factory drilling of highly stimulated horizontal wells took US crude production from 5 million B/D in 2008 to more than 12 million B/D by the end of last year. Facebook Did Not Exist. Facebook was launched in February 2004. Gmail was announced in April the same year. Twitter was not “a thing” until 2006. In a world where something has become so pervasive, it is hard to imagine that the term “social media” had no meaning for most people in 2004. Today, social media is deeply entrenched in our working practices: it is central to the way that companies communicate with their employees and with the public; it provides the means by which we advertise and apply for jobs; people use WhatsApp groups to collaborate on projects because it is better than the tools provided by their employers. The impact upon our personal lives is perhaps even more dramatic. Although the positive influences of being hyperconnected should not be underestimated - a point I’ll come back to later - cyber-bullying was no real cause for concern in 2004, nor was the impact of social media on major political events. SARS-CoV Did Not Have a Number. By the end of 2003, the SARS epidemic had been reduced to a few sporadic outbreaks. The coronavirus genome that caused the disease had earlier been classified as SARS-CoV. Today it is known as SARS-CoV-1 and its baby brother, CoV-2, is currently wreaking havoc across the world. At a time when the oil and gas industry was already wrestling with oversupply, COVID-19 has managed to destroy demand by an unprecedented level, and the oil and gas industry has been plunged into another downturn. I hear people using phrases like “the coronavirus fog is lifting,” but I’m not so sure - I think we have just adapted rather quickly to working in the fog.

Can Self-Reported Personal Audio System Volume Predict Actual Listening Levels in Young Adults?

Most young adults report using personal audio systems (PAS) with earphones as part of their daily activities. PAS exposure is intermittent and research examining the levels these young adults are listening to is increasing. On average, preferred listening levels are below what would be considered at risk in an occupational setting. The purpose of this study was to evaluate how two questions predicted preferred listening level in young adults with normal hearing; specifically, whether these young adults could identify if they listen at a high level or not. One hundred and sixty young adults (111 women, 49 men) with normal hearing completed a questionnaire that had questions about PAS listening habits and then had preferred listening level assessed using a probe microphone system while listening to 1 hour of music through earphones. Otoscopy, tympanometry, and pure-tone thresholds were completed in a randomly determined test ear. As part of the Risk Factors Survey, two closed-set questions were completed. First, "For a typical day, what is the most common volume used during this day?" with the following response options "Low," "Medium/Comfortable," "Loud," or "Very Loud." And second, "Do you listen to your personal music system at a volume where you…" with the following response options "Easily hear people," "Have a little trouble hearing people," "Have a lot of trouble hearing people," or "Cannot hear people." Using a probe microphone, chosen listening level (A-weighted, diffuse-field correction and a conversion to free-field equivalent [LDFeq]) was calculated over 1 hour while the participant listened to music with earphones. Sensitivity and specificity were determined to see how well young adults could identify themselves as listening at a high level (>85 dBA) or not. Linear regression analyses were performed to determine the amount of variance explained by the two survey questions as predictors of measured LDFeq. Almost half of the participants reported a longest single use of a PAS as <1 hour daily and more than half reported listening at a medium/comfortable volume and had a little trouble hearing people. Mean LDFeq was 72.5 dBA, with young adult men having a significantly higher mean LDFeq (76.5 dBA) compared with young adult women (70.8 dBA). Sensitivity was 88.9% and specificity was 70.6% for the question asking about volume on a typical day. For the question asking about being able to hear other people while listening to music sensitivity was 83.3% and specificity was 82.5%. Two variables, listening volume on a typical day and sex, accounted for 28.4% of the variability associated with LDFeq; the answer to the question asking about being able to hear others and sex accounted for 22.8% of the variability associated with LDFeq. About 11% of young adults in the present study listen to a PAS with earphones at a high level (>85 dBA) while in a quiet background. The participants who do report listening at a high level, however, do well at self-reporting this risk behavior in survey questions.

Critical Contextualization: Case Studies from Cambodia

"Those of us involved in world mission must be at the forefront to encourage local people to develop local expressions of their faith. When I hear people rejoice about the fact that regardless of where they travel in the world the Sabbath school and church service order of worship, the songs sung, and the way of doing church is the same, I do not rejoice, I groan. For that means that the foreign visitor is comfortable, but how about the local people? Are they comfortable with the often foreignness of Adventist worship? We can and must do better to allow local cultural expressions of biblical faith and practice."

Raising Awareness of the Value of Orthotic and Prosthetic Care.

It is no secret that government-funded health care programs face deficits. Dealing with these deficits has created a zeal for reformation of the payment system. Within the midst of this unprecedented revolution in health care, payers, health insurers, and government agencies are in the driver’s seat. The changes they are unleashing are disrupting the business and clinical service delivery models that have been the norm. All payers are driving toward outcomes-focused metrics. Although this emphasis in outcomes is positive, their heightened, and often misguided scrutiny of coverage decisions and their lack of appreciation of the value and cost of prosthetic and orthotic interventions have negative consequences. This unwarranted oversight impacts not only what care orthotists and prosthetists provide, but also what they are reimbursed for their services. This pressure is negatively impacting the quality of life for the people who receive orthotic and prosthetic care. The ongoing development, establishment, and dissemination of our evidence base is of critical importance if the orthotic and prosthetic profession is to stand any chance of defending itself and our patients from those who attack and undermine the value of our services. There is clearly increasing pressure in both the military and civilian medical sectors to identify and produce objective evidence about treatment protocols and practices that work. I hear people continually say that orthotics and prosthetics has a low, or at best, an immature scientific base; however, this is neither unique nor entirely negative, but rather an exciting opportunity. The development of a scientific or evidence base within orthotics and prosthetics is a process not an event, and we are making progress. Although the manuscripts in this supplement deal primarily with Medicare and the private sector, the concerns expressed and the guidelines suggested in these efforts should also apply to military medicine. Team management, documentation, provision of care by qualified providers and cost-effective services are as important in military medicine as they are in the civilian sector.

Inspiring innovation

Inspiring innovation

Melancholia of Freedom: social life in an Indian township in South Africa by Thomas Blom Hansen, and: Chatsworth: the making of a South African township eds. by Ashwin Desai and Goolam Vahed (review)

Reviewed by: Melancholia of Freedom: social life in an Indian township in South Africa by Thomas Blom Hansen, and: Chatsworth: the making of a South African township eds. by Ashwin Desai and Goolam Vahed Bill Freund (bio) Thomas Blom Hansen (2013) Melancholia of Freedom: social life in an Indian township in South Africa. Johannesburg: Wits University Press Ashwin Desai and Goolam Vahed (eds) (2013) Chatsworth: the making of a South African township. Pietermaritzburg: UKZN Press, and Princeton: Princeton University Press It has become a standard cliché in South Africa today that people respond to behaviour that they cannot otherwise justify or explain by announcing that they do things according to their ‘culture’. This is intended to silence any criticism: the idea that one’s culture might be confining or tedious is not part of the discourse. As under apartheid, escaping one’s culture is hardly a good thing today in this way of thinking. You rarely if ever hear white people now, however, use the word in this way; this assumption that there is something, whether liberating or immutable, about one’s ‘culture’ is not theirs. This notion of cultures as silos can be adapted to fit the Tutuesque idea of a rainbow nation stitched together but it also fits well into the way apartheid ideologues saw the world. At the same time, it is striking that one social science discipline, anthropology, especially in its American garb, is also hooked on ‘culture’. The positive thing about anthropology is that it has become a home for those justifiably repelled by the economistic and positivist trends that are so powerful in most other social sciences professionally. The negative thing is [End Page 110] that, amongst many anthropologists, reifying a ‘culture’ as the key explanatory factor becomes equally problematic. As Bourdieu wrote, people respond to life in terms of a habitus but habitus can be contradictory and complex and it does not prevent change, even drastic change, in a capitalist world where everything solid melts into air, to take Marx’s phrase. The two books under review are both recent substantial studies of the former Indian township of Chatsworth, the first major new creation of the Group Areas Act in Durban and the most populous Indian group area in the country. Does Chatsworth have a distinct culture in these respects or perhaps a culture emblematic of a broader Indian culture in South Africa? This issue is handled differently in these two projects. The Desai and Vahed volume is open-ended and diverse. It is edited by Goolam Vahed, the noted Durban historian, and Ashwin Desai, sociologist-journalist who sometimes writes (enjoyably) as though he wants to hark back to the Damon Runyon school of hard-boiled sagas of American guys and dolls. This volume is a mix of human interest stories of hardship and triumph against the odds by plucky individuals constructed from rich sociological and historical material. Many of the interviewed live or lived in ‘the flats’ where life has always been hard; respectable success stories in the bungalows are also showcased in a different category of narratives about achievement. Some of the personal testimonies are less nostalgic, don’t fit the stereotypes and there is much that is revealing and three-dimensional. Initially the early settlers of Chatsworth were often plucked with abandon by the local state from non-descript housing, typically on the urban periphery, where they could practice a complex kind of mixed livelihood in a large family setting. Individuals would be involved in fishing, market gardening, petty commerce and wage employment, pooled together in families that emerged out of the indentured immigrant population. The location of these homes was often convenient, and a series of temples, mosques and other institutions, solidly constructed, dotted these areas, which benefited from interaction with black and white Natalians. However, home conditions were often squalid and insanitary and many of the forcibly removed were not sad to say farewell to exploitative landlords, usually Indian as well. As one poor Zanzibari told Vahed: ‘I should have been…five or six. I remember when they just load [sic] us into trucks and they brought us to these big houses. They were empty but the lights...

Using musical film Les Miserables in English education

In this paper, the researcher is going to talk about the benefits of using musical films in the EFL classroom. Musical films are different from the other feature films since the content is transmitted through songs. Students tend to have fragmented knowledge these days. They need to read more valuable books in depth to learn the lessons about life. Musical films based on the literature can help students to grow as a person. By singing and studying the libretto, students can understand the content in general and also they can have empathy about the characters through the main characters` obstacles and hardships. Musical films can play important roles for students` listening skills in English. In the age of digital revolution, Les Miserables written by Hugo will be beneficial to students` affective aspects. There are well known songs such as “Do you hear people sing?” “One Day More” or “I dreamed a dream” in this musical film Les Miserables. Using musical films has various benefits since students will look at the world with more critical point of view. Most of all, musical films will contribute to improve students` listening skill in English and grammar. Smartphones can be used as an important tool to create more interactive ways such as writing short comment in English or posting audio file about the certain questions. In the further research, detailed lesson plans should be created.

I am shocked when I hear people complain that nursing is no longer recruiting the right sort of people

How can the new generation of nurses be seen in such a negative light?

Technology and Gerontology:Is This in Your Nursing Curriculum?

WE ALL HAVE OUR NOTIONS OF WHO DOES OR DOES NOT USE TECHNOLOGY, AND FOR MANY, THE ELDERLY ARE VIEWED AS LUDDITES. technology and the elderly do mix. i hear people say, My grandmother would never use a computer, she would never enter data in a personal health record, and, for sure, she would never go on the At the university of Colorado College of nursing, we offer a graduate core course called Human technology interface, which explores the positive, negative, and unintended consequences of technologies. We broadly define technologies to include information technology, biotechnology, nanotechnology, and emerging technologies, such as mobile and smart technologies. When we first offered the course in 1997, the discussions around the use of computers, internet, email, and smart homes, especially for older adults, were stereotypical. older adults did use technology and, through the eyes of young adults, the elderly would never want their privacy invaded with smart tools in their homes. typically did cross the mind of students that if the choice was to live independently at home, with some smart devices, or live in a long-term care facility, many would sacrifice some privacy to stay in their homes. There is evidence to support this notion. Elinor Ginzler, senior vice president for livable communities at aarp, said, it would be incorrect to assume that older residents would reject the electronic monitoring devices because of a loss of privacy. in an aarp 2011 Survey, they found that nearly nine in 10 seniors said they would be willing to give up some privacy if they could remain in their homes longer (abrahms, 2012; iHealthBeat, 2011). The world has changed since we started this course, and are now more reasons to ensure that our students understand that technologies are important assets in health care, especially for the elderly and boomer generation, now turning 65. this column highlights some statistics and shows how certain technologies are being used now. is hoped that you will begin to incorporate this information in your gerontology curriculum. Let's start with recent pew internet and american Life reports. Since 2000, the pew internet project has collected data on who and uses the internet and why. Zickuhr and Smith (2012) noted that, in comparisons between 2011 and 2000 studies, there were stark differences between those who were using the internet and those who were not (p. 2). Here are some major findings: * Seventy-eight percent of adults (over age 18) use the internet, in comparison with 14 percent in 1995 and 50 percent in 2000. recent trend data from February 2012 (www.pewinternet.org/Static-pages/trend-data/Whos-online.aspx) show an increase to 80 percent. * Sixty-two percent access the internet through broadband access. Having a negatively correlates with internet access when controlling for the demographic variables of age, income, and educational level. only 54% of those with a access the internet in comparison to 81% of those without a disability (Zickuhr & Smith, 2012, p. 11). * For the demographic differences studied by Zickuhr and Smith (2012), age, education, and household income are the strongest positive predictors of internet use. Let's drill down on age and compare the 2000 and 2011 results. For young adults, internet use increased from 61 percent to 94 percent; for those 30 to 49 years old, usage increased from 57 percent to 87 percent. now look at the boomer generation (ages 50-64) and those over 65. For boomers, usage went from 41 percent to 74 percent; for those over 65 went from 12 percent to 41 percent. So, when preparing your students for the next generation of care, is important to understand that right now, 4 out of 10 seniors over the age of 65 and 7 out of 10 in the boomer generation use the internet. think what the data will look like in another 5 to 10 years when a large portion of our nursing faculty reach the age of 65. …

Dinosaurs and other extinct saurians: a historical perspective by Richard T. J.Moody, EricBuffetaut, DarrenNaish &amp; Dave M.Martill (editors). Geological Society, Special Publication343, London, 2010. No. of pages: vi+394. List price: UK£ 95‐00. ISBN 978‐1‐86239‐311‐0 (hardback).

‘Yet another book on dinosaurs?’, do I hear people say? Well, my thoughts exactly when I was sent this book for review. But, notwithstanding the fact that there is a lot on dinosaurs, this volume does do the ‘other extinct saurians’ pride and is, in fact, a bit of a mixed bag. The whole tome is full of mouth-watering details and forgotten stories, and makes for a very good read. Some chapters comprise a few pages only, others are much longer (up to almost 30 pages) and lavishly illustrated. As said, non-avian dinosaurs do figure prominently, but even in those chapters there is lots of information to be found for which you would be looking in vain in other works. Avian dinosaurs (birds, for short), pterosaurs, plesiosaurs and other marine reptiles are allowed to put an oar in as well. The main appeal, at least in my opinion, lies in the fact that every chapter is crammed full of detail. Data on the specimens themselves, often illustrated as well, but also on the people that studied, prepared and described them – some very famous, others long forgotten. I must admit that I had never heard of quite a number of those collectors and scholars of extinct saurians of many kinds. What about William Perceval Hunter (mainly Wealden dinosaurs, but he did a fair amount of travelling, too), Giovanni Capellini and Guillermo Schulz, who were instrumental in promoting vertebrate palaeontology in Italy and Spain? Of course, I cannot do justice to all contributions here, which is why I wish to list those that I enjoyed most. The chapter on Alan J. Charig is a prime example of tribute paid by former colleagues and friends, and includes a range of fieldwork snapshots, group pictures and a full list of his scientific papers. Comparable is an extensive paper on the so-called Leeds Collection of marine and terrestrial reptiles from the Oxford Clay Formation; part of the title, ‘Old bones, dry subject’, is particularly aptly chosen. There are numerous, good quality, black and white pictures of bones, with original sketches alongside, and pertinent archive material is also enumerated: it is a genuine treasure trove. The chapter on ‘forgotten women’ heads off with Mary Anning (who else?), but also provides details of the lives of many other women in vertebrate palaeontology, either directly or indirectly (by marriage), including famous modern-day workers such as Joan Wiffen, Betsy Nicholls and Halszka Osmólska, who all sadly died in recent years. As the editors point out in the introductory chapter, British material (e.g., Wealden Group taxa, Yorkshire dinosaur footprints) is central in this tome, but it is good to see that dinosaurs from India (featuring Charles A. Matley) and North Africa are not forgotten. The tale on spinosaurids avant la lettre nicely illustrates how wide ranging the former interpretations of isolated bones actually were. The remaining chapters offer a wide range of subjects, all historical in nature (of course), going from birds (Archaeopteryx; the reptile/bird transition and Thomas Huxley's stance on this), pterosaurs and the iconography of dinosaurs (films, comics and their impact on the public's perception), and back to the theme of sauropod dinosaurs. Five stages have been recognised in the research activities of these colossal animals; a very neat overview indeed, strongly recommended for usage in classroom and lecture theatre alike. In all, printing quality is good, with tight editorial control, but some of the diagrams are simply too small (e.g., fig. 1 on p. 230), while other illustrations (e.g., maps) lose their clarity in black/white (e.g., fig. 1 on p. 190), are too fuzzy or lack focus. But, such are the exceptions and I strongly advise anyone interested in those early days of vertebrate (reptilian) palaeontology to make sure to obtain a copy for themselves. I, for one, was pleased to see that the rendition of the looting of the second mosasaur skull from Maastricht by the French revolutionary armies in 1794 (not 1795) was based on the most recent accounts of this fact.

NASA focusing beyond space shuttle era

Although the NASA space shuttle Atlantis is set to close out the space shuttle era in July with the STS‐135 mission, this final shuttle mission will not mark the end of America's leadership in human spaceflight, NASA administrator Charles Bolden said in a 1 July speech at the National Press Club in Washington, D. C. “When I hear people say, or listen to media reports [that indicate], that the final shuttle flight marks the end of U.S. human spaceflight, I have to say, ‘these folks must be living on another planet.’ We are not ending human spaceflight; we are recommitting ourselves to it and taking the necessary and difficult steps today to ensure America's preeminence in human space exploration for years to come.”

Congress Learns about 21st Century Biology

L ast year, the National Research Council (NRC) issued A New Biology for the 21st Century: Ensuring the United States Leads the Coming Biology Revolution. Described by some scientists as biology’s “moon shot,” the 112-page report makes a case for new research and funding models that can stimulate fundamental discovery and solve complex problems in the areas of environment, energy, agriculture, and health. Policymakers have since begun to consider the report’s recommendations. In June, shortly after the House of Representatives passed its version of the America COMPETES Reauthorization Act of 2010—legislation to reauthorize the National Science Foundation (NSF) and several other federal science programs—the chamber’s Subcommittee on Research and Science Education convened a hearing to examine the future of the biological sciences. Spurred in part by the NRC report, the hearing considered how potential scientific advances can be translated into technologies that benefit society, and how to prepare researchers to thrive in areas of research that do not fit easily into a single academic department. In his opening remarks, Subcommittee Chairman Daniel Lipinski (D–IL) shared an amusing and informative recollection: “Biology was not my favorite subject in high school— although that may be because it was first semester freshman year and we had to dissect the fetal pig—the new, 21st century biology has me much more interested. I was trained as a mechanical engineer, and when I hear people talking about cells as a systems design problem, I understand the important role of engineers and physicists working in biology.” Testifying before the panel, James P. Collins suggested that biology “will flourish in the 21st century by sustainranking Republican, said he is still getting his head around the report’s recommendations. He told a story about a friend who, after receiving the Nobel Prize in Physics, decided that the important problems are in the biological sciences. Unfortunately, Ehlers noted, his friend has had less impact in biology than his friend anticipated, highlighting the need to support the development of young scientists. It may be better to prepare young scientists to work in more than one field, rather than expecting a scientist to master one field before working in another. Keith Yamamoto, chairman of the National Academy of Sciences Board on Life Sciences and professor of cellular and molecular pharmacology at the University of California, San Francisco, alluding to the long wait many scientists must endure before receiving their first grant, told the subcommittee that increasing the training period for scientists is not the way to proceed. He suggested that new scientists should be grounded in one discipline but able to work and communicate with colleagues from other fields. Although the subcommittee hearing was a signal that lawmakers are interested in the recommendations outlined in A New Biology, it remains to be seen whether the scientific community is ready to embrace the report’s findings. Moreover, are the federal agencies that fund scientific research and education prepared to implement the recommendations?

Guest Editorial: Is care still the ‘essence’ of nursing?

Much has been written about care and nursing and care in nursing. Caring has been defined in numerous ways. Do we ‘care about’, ‘care with’, and/or ‘care for’? Care is a word often used in most walks of life and yet nursing has claimed it as being ‘the essence’ of nursing. We all care about someone and probably most of us care for someone; we may even be quite enlightened and care with. The issue is that it is possible to feel and provide all of these types of care without touching the essence of nursing as I see it and I believe Stephen Wright and Jean Watson conceive it. Wright and Watson write eloquently about the sacredness of caring, and as I read them, the need for nurses to care and respect their own and their colleagues unique Being before they can truly care in the way that is the essence of nursing. It is that genuine connectedness –Being with another when they are Being most vulnerable, perhaps dying. It is the ‘I–Thou’ relationship rather than ‘I–It’. To me relating to a patient/resident as ‘It’ is task or disease-focused nursing practice. We may have the very best technical skills but we lack the capacity to put the person in the best healing environment. I am not suggesting that nurses all need to Be sacred in the religious sense; rather that the essence of each person is sacred and when we ‘do’ nursing without connecting with this essence we are not nurses but technicians. I have heard people say they do not ‘do’ person-centred care because they do not have time; as if it is a task to add to a busy day. If we are practising nursing and caring is the essence of nursing then how we practise by definition must be person-centred. I wonder how many nursing programmes still include the philosophy, science and art of caring. With crowded curricula this is often replaced by more high-tech skills. I would argue that the latter can easily be learned on the job but the former requires the critical enquiry, debate and personal development that a good university education offers. Certainly, it must also be learned through apprenticeship with expert practitioners; however, they are often less able to explain the philosophy, science and art that informs their expertise. With the ever-increasing e-communication and robotics invading aged care the need for human Being and Be-connection has never been greater. Of course there are great nurses and examples of nursing, but the catalysts for me considering this were, as is often the case, negative and worrying. I was told on several occasions about older patients being advised that there was not time to take them to the toilet and they should ‘use the pad’ in the bed; time and again I heard complaints of older people being unable to reach food placed too far away from them by domestic staff and taken away untouched without the nurses observing. I saw too often the clearly uncomfortable positions older people were left in as nurses walked by without apparently noticing. Still I hear people referred to by bed number! Caring for is undertaking tasks for the ‘dementia’s’; it is feeding and washing and ensuring good physical care without connecting with the humanity of the person for whom these tasks are done. One can care for and about while removing all choice, objectifying (the dementia’s) infantilising and getting the job done. Many years ago I defined this as ‘Benevolent Oppression’– or killing with kindness. Most nurses have the best will in the world but that is not enough – nor are top shelf technical skills. The caring that I see as the essence of nursing draws on all the best science and has contemporary competencies but most importantly uses this through the connectedness and caring with the patient/resident Being in the world as described by the great philosopher Heidegger. Sometimes I think better in rhyme so I will conclude my ruminating with a recent piece I wrote:

Fluid Identities: A Journey of Terminology

Fluid Identities: A Journey of Terminology

A Gender Transformation in Urology

A Gender Transformation in Urology

Bridging Cultures in the Schools

Bridging Cultures in the Schools

MODAL SPACE: What is MRIT? I Hear People Talk About it for Impact Testing

MODAL SPACE: What is MRIT? I Hear People Talk About it for Impact Testing