Variables de Estudio

Dissemination of this work has been considered throughout and a summary of the dissemination strategy can be found in Appendix 20. Although resolution can be found within this story, it has not reached its final conclusion if indeed it ever will. But what the nurses tell us is that we cannot go back to where we once were. Their stories have been performed and are now out in the public domain, so we must prepare ourselves to look to the future as there are other stories to be considered. The sixth recommendation is that further research involving male school nurses and from a broader cultural perspective should be undertaken as avenues for further study.

Throughout this performance we have heard the tale from Nicholas Nickleby’s perspective, but what about Smike (Dickens, 1839)? What of the children and young people themselves, their families and carers in the performance? If evidence as to how services are achieving, is to be embedded in key performance indicators, quality assurances processes and commissioning targets, then the seventh and

final recommendation is that the evidence contained in their stories about what

it is like for the young people themselves to receive support from school nurses should not go unheard but also be performed. This would provide a cyclical perspective to the overall study, as it would involve all of the characters within the performance. Yi Hsu and McCormack (2011) postulate that collecting stories from service users need to be built into quality improvement mechanisms within clinical settings, as they are an effective means of gathering information about client experiences.

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Summary of recommendations

1. Offer action learning sets for alumni students for one year post completion of SCPHN course to build personal resilience.

2. Introduce storytelling and poetics within curricula to encourage reflexivity on practice.

3. Provision of workshops on using social media within practice settings to build confidence and to explore potential ethical issues.

4. Include opportunities with curricula for students to develop additional skills to use cognitive behaviour therapy, solution focused therapy, motivational and promotional interviewing.

5. Sharper focus on developing clinical leadership skills to bring about political transformation.

6. Undertake further research with male school nurses and a broad cultural perspective about their experiences of providing support.

7. Undertake further research with children, young people and families to hear their stories.

SCENE 6: Exodus

“Give the customer, the consumer, the client, the hope and a witness with

whom to write their story and promise nothing more.” (Holyoake and

Golding, 2012 p.6).

As this performance reaches its exodus we must ask “What has this performance

accomplished”? Actions in everyday life can be undertaken unthinkingly, but

voicing them consciously (as in the form of these stories) brings a tangible quality to the performance and makes them accessible to others. Some of these stories remain ‘unsorted and untold’ but this is the messiness of professional practice.

176 However, these interpretations have raised a new consciousness in the form of intuitive knowledge within practitioners who have (re)discovered their own stories, and a richer understanding of the world in which they practice. The responsibility of nurturing such insight within newly qualified school nurses is the privileges of nurse educators who are able to create new spaces for learning.

The conceptual framework used to support this study focused on ‘performance as

the story of identity, illumination and emancipation’; each has been explored in

some detail, to remind us that the work is grounded, contextual and offers a creative analysis of school nursing practice. Within this performance, space has been provided for managers, commissioners, policy makers and others to witness and engage with these stories thus providing some hope in terms of changes in practice.

Indeed the real value of nursing research lies in its contribution to the development of nursing practice and the improvement in patient or client care (Fairbairn and Carson, 2002). Therefore this study must also be judged by how the findings have engaged practitioners in a dialogue and impacted on practice thus far, as well as how its recommendations will prepare school nurses to enhance and find meaning in the support they can offer to young people. Casting a new gaze on school nursing practice, developing learning and encouraging reflection has enabled “thinking with stories” (Bleakley, 2005, p.535) and ‘new’ stories have been (re)created. This collaboration with the narrators has enabled it to become ‘my story’ to tell, demonstrating the fluidity of my positioning as shown in Figure 2 (page 19) as I too have become a narrator (Chase, 2005; Bonis, 2009) School

177 nurses perform under difficult circumstances, but they also describe how fulfilling and personally satisfying the role can be, and this study has opened up new possibilities and opportunities to develop the role further.

But ultimately the final tribute must go to the supporting cast, those children and young people who are quietly and silently standing in the ‘wings’ of the performance; waiting for someone to come and find them, to help and support them through their difficult and traumatic times. They are central to the performance, yet their involvement is not based upon characters created by others, but on their own actual life events and circumstances in which they have found themselves. It is such circumstances which cause them to reach out to someone who can help and support them, and who will lead them to a place of safety, emotionally or physically, or both. School nursing is a speciality that requires a unique set of skills and abilities (Sendall et al., 2014) and these nurses remain ideally placed professionals to be the ‘hands that catch’ and support vulnerable young people. As this performance has shown us they do this daily within their everyday practice; at times almost subconsciously and almost always invisibly; yet it is their raison d’etre for who they are as school nurses. More investment in the way of additional staff, resources and ongoing support and training for qualified school nurses is long overdue to allow promotion of the service. All those young people who need help in times of adversity, crisis and distress, wherever they are, must be able to access the right type and amount of emotional support. Until this is in place there are too many who will continue to experience unhappiness, distress, health inequalities and social injustice just as Charles Dickens described in 1839.

178 “What happens when the light first pierces…the dark dampness in which

we have waited? We are slapped and cut loose. If we are lucky someone is there to catch us….and persuade us that we are safe. But are we safe? What happens if, too early we lose a parent? That party on whom we rely for not only everything? Why, are we cut loose again …and we wonder, even dread…whose hands will catch us now?”14

As some young people continue to cope alone with life’s difficulties and traumas, we are still left asking “whose hands will catch them?” Some recommendations have been made as to how we need to respond to this question in the light of these narratives. The stories do not cease to perform when a specific performance (such as this study) ends. The stories will continue to resonate. School nurses perform in order to be that ‘safe pair of hands who can catch them’, and provide the necessary emotional support to those who are distressed, fearful and lonely. Therefore school nurses deserve help and support to be able to perform what may be at times a life changing role.

“It’s always something. To know you’ve done the most you could. But, don’t leave off hoping, or it’s no use doing anything. Hope, hope to the last!”15

CURTAIN

14 _{Extract from screenplay performance of Life and Adventures of Nicholas Nickleby (2002) based on the}

novel by Charles Dickens (1839).

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