RETICALLY BASED PRACTICUM PROJECT
This project was created for the purpose of ful- filling a clinical practicum requirement for a grad- uate course in a community health nursing pro- gram that focused on crisis in the community. The project consisted of six interactive group sessions designed to provide children with verbal and non- verbal skills to enhance self-esteem and to protect against negative peer pressure influence. Session plans, parental consent, and child assent were re- viewed and approved by the Graduate Director of Nursing, a doctorally prepared nurse with holistic nursing expertise, and by the course instructor, a doctorally prepared nurse with pediatric expertise. A convenience sample of four preadolescent chil- dren aged 10 to 12 years old were recruited from a local middle school. Tenets from Nightingale’s teachings were used to structure the group ses- sions. In the following sections, Nightingale’s key components are highlighted (see Table 2).
CONFIDENTIALITY AND TRUST
Parents were called and verbal consent was ob- tained before each group session took place. Pa- rental support was enhanced by giving them an opportunity to ask questions and voice any con- cerns prior to the sessions. In addition to parental consent, verbal assent was obtained from each child participating in the group before each session began.
In order to build trusting relationships among the members in the group, the meaning and impor-
tance of confidentiality was reviewed with the chil- dren during their first group session. Throughout the sessions, group exercises were devoted to es- tablishing trusting and confidential relationships, and the children grew increasingly comfortable with sharing experiences and offering advice. Nightingale (1860/1998) strongly believed in the importance of confidentiality, stating:
And remember every nurse should be one who is to be depended upon, in other words, capable of being a “con- fidential” nurse. She does not know how soon she may find herself placed in such a situation; she must be no gossip, no vain talker; she should never answer questions about her sick except to those who have a right to ask them (p.125).
Nightingale (1860/1998) also addressed the im- portance of building trusting relationships with her patients, stating:
If you go without his knowing it, and he finds it out, he never will feel secure again that the things which depend upon you will be done when you are away, and in nine cases out of ten he will be right (p.39).
LEADERSHIP AND COMMUNICATION
The nurse, as a group facilitator/leader, must be able to sit back and listen to what is being said to plan and implement future sessions according to the group’s stated needs, while helping to promote healthy and positive group working skills. With reference to leadership, Nightingale (1860/1998) stated:
To be “in charge” is certainly not only to carry out the proper measures yourself but to see that everyone else does so too; to see that no one either wilfully (sic) or ignorantly thwarts or prevents such measures. It is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed (p.33).
Nightingale was also a strong advocate for the use of proper communication skills, which in- cluded eye-to-eye contact in addition to being at the patient’s side. With regard to communication techniques, Nightingale (1860/1998) stated:
Always sit within the patient’s view, so that when you speak to him he has not painfully to turn his head round in order to look at you. Everybody involuntarily looks at the person when speaking. . .So also by continuing to stand you make him continuously raise his eyes to see you . . . Never speak to an invalid from the behind, nor from the door, nor from any distance from him, nor when he is doing anything (p.38).
To enhance communication techniques with the children, group sessions were designed to take