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Luxford, Yoni
- PublicationCome walk with me: Homelessness, nursing and engaged care
To be without a home and live in public spaces or a rooming house is to experience chaos in one’s daily life with compromised food, medication, income, and physical security. This, in turn, leads to a compromised ability to foster and maintain linkages with mainstream health services. Health outcomes for homeless individuals in Australia are shocking, or at least they should be.
How do nurses work with people experiencing homelessness in Australia? What does person-centred care look like for a person who is homeless and for those who work with them? These are fundamental questions about nursing as skillful relational work in marginalised spaces with vulnerable people. Specialist nursing roles are relatively rare in these spaces.
Creative non-fiction is a reflexive writing approach that portrays the complexity and humanity of persons who are key subjects in the narrative. A community health nurse uses it in an ordinary day at work as she engages with “Lisa”, a young homeless woman, throughout a health intervention that doesn’t end when she is admitted to hospital. The broader social aspects integral to working with this marginalised group are included to support the narrative. Suggestions are made regarding future research into this complex area of nursing practice and health care.
- PublicationVideo: A decolonising strategy for intercultural communication in child and family health within ethnographic researchThe subject of this paper is the use of video as a decolonising tool in ethnographic research into intercultural communication in child and family health settings. Women and children who are migrants or new arrivals to Australia continue to experience health inequities. Communication is at the heart of these problems. In the practice setting, communication is inherently difficult to critique, particularly when working with vulnerable families. We describe how video was used by the first-named author in her doctoral research exploring intercultural communication between child health nurses and mothers who were migrants or new arrivals to South Australia. In particular, we describe how the use of video becomes a decolonising strategy when the focus of critique is placed on the health professional, rather than on a parent from a potentially vulnerable group. Video enables the researcher to bridge the gap between what health professionals say they do, and what they 'actually' do in their practice.
- PublicationCritical Thinking and the Nursing ProcessAlthough critical thinking has many definitions, one of the most useful for nursing is from the North American National League for Nursing (2000): 'Critical thinking in nursing practice is a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns' (p. 2). The Australian Nursing and Midwifery Council (2006) national competency standards indicate the need for registered nurses and midwives to be able to think critically about client care and to have the skills to contribute to the evidence-based practice framework through research and to apply research to their practice.
- PublicationEnvironmental Sustainability and Social Work: A Rural Australian Evaluation of Incorporating Eco-Social Work in Field Education(Routledge, 2015)
; ; ; Climate change poses significant threat to the wellbeing of global society. Addressing this change has as yet generated no fixed blueprint for social work practice and education. This paper reports on a formative evaluation of one Australian initiative to address this transformative opening in social work field education. Prompted by service users' and workers' experience of the impact of drought, a rurally located social work course team amended the field education curriculum to include a focus on Environment and Sustainability. This learning goal was added to the existing learning goals derived from the Australian Association of Social Workers (AASW) Practice Standards. Students and field supervisors were surveyed on their experience of meeting this new learning goal. While most expressed confidence in understanding the concepts involved, they clearly lacked assurance in interpreting these in practice encounters. Considering their qualitative input suggests that this topic is making a transition from being on the margins of social work to becoming mainstream. Their open-ended responses indicate that the incorporation of environmental sustainability into practice is at a threshold stage of development. Further enactment of eco-social work at the local level is concluded to be supported by using a transformative learning framework in facilitating critical reflection and collaborative dialogue for effective change. - PublicationRural Volunteer Community Transport Drivers: The Need for Greater Participation in the Policy Process(Southern Cross University, Centre for Policy Research, 2011)
; Volunteers form the backbone of rural community transport services. They deliver a range of services including driving transport-disadvantaged clients to essential health and social care appointments. While trips for social care are usually local, trips for health appointments often involve long distances, long days, and out of pocket expenses for the drivers. In these situations volunteers and their passengers are exposed to increased levels of risk. Governments at all levels consider volunteer involvement as civic participation or social capital, yet little is known about the experiences of rural volunteer community transport drivers or local policy that governs their work. This paper describes a study that conducted an analysis of policy documents related to volunteer activity in four community transport organisations in rural NSW. The study explored variations in policies, whether volunteer drivers had participated in their development or revision, and whether the government models of the service agency was related to volunteer policy. Key findings include: that operational policies lack consistency across the services; that the role of volunteer drivers varies across services located in the same region; that participation of volunteers in either developing or reviewing local policies that govern their work was evident in the policies of only one of the four services; and that governance models do not appear to be related to volunteer participation. - PublicationKozier and Erb's Fundamentals of Nursing: First Australian Edition(Pearson Education, 2010)
; ; Moxham, LornaContemporary nursing in Australia and internationally is challenging, complex, dynamic and very rewarding. Many of our clients are older and sicker that they were a decade ago, often with complex health and psychosocial needs. This means that nurses today must be clinically competent, flexible and knowledgeable. They must have a broad and deep knowledge of Physiology, pathophysiology, pharmacology, epidemiology, therapeutics, culture, ethics and law, as well as an understanding of evidence-based practice. Today's nurses have many roles and functions - clinician, educator, manager, researcher, to name just a few. They must be highly skilled with the ability to problem solve and they must possess sophisticated critical thinking skills. They must be life-long learners and confident in the use of information and communication technology. Nurses must be able to communicate effectively, with their clients, with each other and with other members of the health care team. Above all, they must care for their patients in ways that signify respect, acceptance, empathy, connectedness, cultural sensitivity and genuine concern. Against this background, the first Australian edition of 'Kozier and Erb's fundamentals of nursing' will be of immense benefit to both beginning students and those who are more advanced. This comprehensive textbook, with its unique Australian perspective, introduces the reader to vitally important nursing issues, concepts, practices and theories. The book will prepare students for practice in a range of diverse clinical settings and help them understand what it means to be a competent professional nurse in the twenty-first century. - PublicationCulture, communication and child healthCultural beliefs and values implicitly and explicitly shape every aspect of the way we parent our children and how we communicate about parenting. To support parents appropriately in this new and challenging role, child health services for parents in Australia need to do more than acknowledge a diverse range of cultural practices. While many health professionals believe they act in culturally sensitive ways, we need to closely examine this belief, question the cultural assumptions implicit in the information we give, and assess the extent to which our interactions are culturally appropriate. In this paper, we present a critical review of the literature on health care provision for migrant women and families. We then suggest a need to re-examine the values, beliefs and attitudes within cultural frameworks that inform how child health professionals communicate. Specifically, communication between child health professionals and migrant parents requires further analysis. We suggest that professionals need to reflect on the cultural self rather than solely on the culture of others.
- PublicationDisruption and Reconstruction: Stories of Psychotherapists' Sense and Use of Self with Life-Threatening Illness(2018-04-14)
; ; Psychotherapy is a highly relational endeavour. The use of self is psychotherapists' primary therapeutic tool in their professional relationship with clients. Therapists' life experiences can influence their sense and use of self in therapeutic work. For some, this includes the experience of a life-threatening illness. The experience of life-threatening illness in psychotherapists and the effect this has on their work is not well understood. The limited literature about this topic tends to be concerned with clinical issues about practice and self-disclosure. What is known is primarily available through therapists' personal accounts of illness published in scholarly literature. This study aimed to investigate the type of stories psychotherapists have told about their sense and use of self in therapeutic work when they experience a lifethreatening illness.
Twenty-one therapists' personal accounts were examined using narrative analysis, and two core narrative themes were identified. The first, Narratives of Disruption, comprised three subthemes: therapists' Emotional Responses, Unconscious Denial and Physical and Psychosocial Losses. Core theme two, Narratives of Reconstruction, also contained three subthemes: therapists' Sense Making, Finding Benefits and Learning Life Lessons and Identity Change. Based on the limited literature about psychotherapists with life-threatening illness, the narrative analysis of these therapists' personal published accounts provides new insights into therapists' sense and use of self. The key findings of this study indicate that psychotherapists' stories reveal that their sense and use of self is disrupted by the diagnosis and treatment of their life-threatening illness. The study also shows that, given the passage of time, some therapists are able to reconstruct their sense and use of self as they learn to live with the consequences of their illness. These findings have practice implications for psychotherapists, psychotherapists' supervisors and the profession.
- PublicationUnderstanding Older Chinese Immigrants' Perceptions of Ageing and their Health-Related Help-Seeking Behaviours in Rural Australia(2016)
; ; The number of Chinese immigrants in Australia has increased significantly over the past two decades, and their ageing issues have gradually become the focus of concern. This study aims to fill the literature gap by investigating older Chinese immigrants' experiences and perceptions of growing older in rural Australia in order to gain an understanding of their health-related help-seeking behaviours in this context. This study is situated in a qualitative interpretive paradigm. It uses a transcultural perspective to inform a case study methodology, and it adopts the Theory of Planned Behaviour as an interpretive framework to guide the study. A combination of purposive sampling and snowball sampling strategies was used in recruitment, and six Chinese immigrants aged 60–85 years who resided in rural Australia were invited to participate in the study. Individual semi-structured, in-depth interviews were used to gather data, and thematic analysis was applied to analyse the interview data. This study found that the older Chinese immigrants were living in two cultures, and this forced them to reconstruct their cultural beliefs, especially in relation to filial expectations and maintaining harmony in the family. Further, because of a lack of English proficiency, they had greater difficulties dealing with ageing, especially in accessing health care services in rural Australia. These findings have implications for policy and practice related to migrant health care and rural community health practice. - PublicationEstablishing an Australian Nurse Practitioner-Led Colorectal Cancer Screening ClinicIn Australia, colorectal cancer is the most commonly occurring internal cancer affecting both men and women, and the second most common cause of cancer-related death. Flexible sigmoidoscopy has not been commonly used as a screening tool in Australia due primarily to lack of resources. Until now, people at average risk of developing bowel cancer frequently undergo colonoscopy after referral to a specialist. To fill an identified need, a nurse practitioner-led colorectal screening service providing fecal occult blood testing and flexible sigmoidoscopy, health education and promotion, patient counseling, information and a referral point for general practitioners, and a referral service for above average-risk patients was established in a South Australian metropolitan teaching hospital. Establishment of this clinic required advanced and extended theoretical and clinical preparation for the nurse practitioner, as well as development of interdisciplinary relationships, referral processes, clinical infrastructure, and a marketing strategy. An audit of the first 100 flexible sigmoidoscopy patients revealed service and procedural outcomes that compared favorably with other colorectal screening services as well as a high level of patient satisfaction.