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Sarah Field Richards

Research Fellow, Faculty of Medicine & Health Sciences

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Biography

Prior to registration as a nurse, I worked for six years as a Health Care Assistant in the specialties of healthcare of older people, palliative care and dementia. I also worked as a Support Worker in the area of mental health, challenging behaviour and learning disabilities.

I graduated from the Master of Nursing Science awarded by the University of Nottingham in 2009, following which I worked in clinical practice as a Staff Nurse in Post-Anaesthetic Care, where I held several practice development and quality improvement roles. After working as a Research Associate on a National Institute for Health Research grant-funded study, I commenced a PhD Studentship with the University of Nottingham School of Health Sciences and Business School. I was awarded my doctorate in 2017. My doctoral thesis explored the lived reality and meaning of a management philosophy called Lean Thinking, for nurses and nursing at a University Hospitals NHS Trust. I currently work as a Research Fellow on a national longitudinal mixed-methods Department of Health grant-funded study which aims to explore the impact of care experience prior to undertaking nurse training, on students' caring and compassionate skills, values and behaviours, and service users' experiences of care.

My research interests include (but are not limited to) healthcare of older people, palliative care and dementia care, organisational change (particularly nurses' perspectives and experiences), nursing as a profession (e.g. contemporary developments and changes, organisation of care, careers and roles, nursing education, experiences of nursing, professional identity and boundaries, power and empowerment, holistic person-centred care, compassion), and nurses' health and wellbeing. I focus particularly on qualitiatve research and sociological approaches.

I teach Undergraduate nursing students within the School of Health Sciences in areas including critical thinking, qualitative and quantitative research, evidence-based practice and person-centred care. I hold personal tutoring and academic supervisory roles at Undergraduate, Graduate Entry and Doctoral levels. I have completed the Intensive Teaching and Learning Programme and am currently studying towards a Post Graduate Certificate for Higher Education qualification.

Expertise Summary

Qualifications

Doctor of Philosophy

Master of Nursing Science (MNurSci Hons)

Registered Nurse (Adult)

Level 2 Award in Understanding Health Improvement. Royal Society for Public Health.

Certificate in Infection Control. People's College Nottingham.

Working with Older People. National Open College Network.

Intensive Learning and Teaching Programme. University of Nottingham.

Good Clinical Practice Certification. University of Nottingham.

Professional Awards

2001 Boots Science Award

2007 School of Nursing Academic Award

2014 Dean Moore Postgraduate Endowed Scholarship Award

Professional memberships

Local

Centre for Health Innovation, Leadership and Learning (CHILL), Nottingham University Business School

National/international

Nursing and Midwifery Council

Royal College of Nursing

British Sociological Association

European Sociological Association

European Association of Palliative Care

Funding secured

2010 Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care. Full funding associated with European Association of Palliative Care conference presentation.

2011 PhD Studentship. School of Health Sciences, Nottingham University Business School

2014 Co-applicant on successful grant application to the Department of Health Policy Research Programme. Evaluation of the Impact of Care Experience Prior to Undertaking NHS Funded Education and Training.

Conference presentations

Local

Field-Richards, S.E. (2012). Negotiating the boundary between Paid and Unpaid Hospice Workers: A Qualitative Study of how Hospice Volunteers Understand their Work. Nottingham University Hospitals NHS Trust 2nd Engage, Empower, Enthuse Conference.

Field-Richards, S.E., Timmons, S. (2013). Getting to grips with the basics of research; qualitative research, examples and approaches. Nottingham University Hospitals NHS Trust 3rd Engage, Empower, Enthuse Conference. Workshop.

Field-Richards, S.E. (2014). The Trust-Nurse Game in the context of organisational change. Nottingham University Hospitals NHS Trust Nursing and Midwifery Research Strategy Group. Seminar presentation.

Field-Richards, S.E. (2015). Changing professionalism; new directions in the 'New NHS'. Theorising the professional (identity) project of nursing the context of Lean. Nottingham University Business School 'CHILL' Research Centre (Centre for Health Innovation, Leadership and Learning). Invited speaker seminar presentation.

National

Field-Richards, S.E. (2013). 'Lean on me; nurses' emotional work and labour in Lean times'. British Sociological Association Medical Sociology Annual Conference, York.

Timmons, S., Field-Richards, S.E. (2012). A technical solution to a sociological problem? Predicting mortality post-cardiac arrest. Oral presentation at British Sociological Association Medical Sociology Annual Conference, York.

Field-Richards, S.E., Lymn, J. (2015). The impact of care experience prior to NHS funded education and training. Pre-Nursing Degree Care Symposium. Royal College of Nursing, London. Invited speaker.

International

Field-Richards, S.E. (2010). Negotiating the boundary between paid and unpaid hospice workers: a qualitative study of how hospice volunteers understand their work. 6th Research Congress of the European Association for Palliative Care, Glasgow.

Field-Richards, S.E. (2013). 'Lost amidst Lean? A critical analysis of the implications of crisis-driven change for the profession of nursing'. 11th conference of the European Sociological Association 'Crisis, Critique and Change', Turin, Italy.

Field-Richards, S.E. (2014). The Trust-Nurse Game in the context of organisational change. 8th International Conference on Healthcare Systems and Global Business Issues. Grantham. (Invited speaker and expert panel member).

Field-Richards, S.E., Andrews, S., Callaghan, P., Keeley, P., Redsell, S., Spiby, H., Stacey, G., Lymn, J. (2016). Care experience prior to entry into undergraduate nursing degrees: the recommendation, rhetoric and reality. Royal College of Nursing International Research Conference. Edinburgh.

Field-Richards, S.E., Andrews, S., Callaghan, P., Keeley, P., Redsell, S., Spiby, H., Stacey, G., Lymn, J. (2016). Help, hindrance or indifference? The impact of care experience prior to commencing nurse training, on caring and compassionate practice. Royal College of Nursing International Research Conference. Edinburgh.

Field-Richards, S.E., Andrews, S., Callaghan, P., Keeley, P., Redsell, S., Spiby, H., Stacey, G., Lymn, J. (2016). The impact of care experience prior to commencing nursing education on students' academic competence. NET Conference. Cambridge.

Bond, C.A.E., Stacey, G., Field-Richards, S., Callaghan, P., Keeley, P.N., Lymn, J., Redsell, S., Spiby, H. (2017). A discourse analysis exploring the construct of compassion within UK discourse and whether prior care experience is an effective strategy to enhance compassion amongst the nursing profession. NET NEP. Canada.

Field-Richards, S.E., Redsell, S., Simpson, A., Callaghan, P, Keeley, P., Lymn, J., Spiby, H., Stacey, G. (2018). Of dice and dominos; a methodological analysis of challenges encountered during research exploring the impact of care experience prior to commencing nurse training, on caring and compassionate practice. Sigma Theta Tau International 4th European Conference.

Field-Richards, S.E., Redsell, S., Simpson, A., Callaghan, P, Keeley, P., Lymn, J., Spiby, H., Stacey, G. (2018). Prior care experience as prescription for nursing's caring and compassionate ills: weighing up the benefits, risks and side-effects. Royal College of Nursing International Research Conference.

Field-Richards, S.E., Bond, C., Kelly, A., Stacey, G., Callaghan, P., Keeley, P., Lymn, J., Redsell, S., Simpson, A., Spiby, H. (2018). (Three paper Symposium) Providing a 'compass' for 'compassion' - exploring orientations and new directions for navigating the landscape of compassion in nursing. NET conference.

Teaching Summary

I teach Undergraduate nursing students within the School of Health Sciences in areas including critical thinking, qualitative and quantitative research, evidence-based practice and person-centred… read more

Research Summary

Title of research: Evaluation of the impact of care experience prior to undertaking NHS funded education and training.

Researchers: Professor Joanne Lymn (PI), Dr Sarah Field-Richards (Research Fellow), Professors Patrick Callaghan, Helen Spiby, Sarah Redsell, Sharon Andrew, Philip Keeley, Dr Gemma Stacey.

Project completion date: March 2019

Introduction: The quality of nursing care in England has recently come under increased scrutiny following the identification of failings in care by the Mid Staffordshire inquiry. Findings included shortcomings in nurses' standards of care, values, attitudes, and emphasised the need for an NHS culture which prioritises and values compassion. With regard to pre-registration nursing, it recommended that individuals undertake Health Care Assistant (HCA) training and experience before commencing a nursing degree.

In 2013 the Department of Health introduced a pilot programme providing individuals intending to study nursing, with hands-on care experience in NHS Trusts, prior to commencing their training. It was envisaged that students would acquire real-life experience and first-hand knowledge of the reality and entailments of healthcare before commencing their course. This also provided employing healthcare organisations with opportunities to ensure that prospective students possessed appropriate caring values and behaviours, before commencing study. There is little evidence however, to suggest that the Government's response will adequately address concerns highlighted, or otherwise. Nor is there evidence to suggest which particular model of prior care experience might be most efficacious in terms of developing the skills, values and behaviours conducive to the provision of compassionate care. This DH-funded study aims to systematically investigate the effect of care experience prior to entering nurse training, upon nursing students' caring skills, values and behaviours.

Aims: To evaluate the impact of care experience prior to undertaking NHS funded education and training, on pre-registration nursing students' skills, values and behaviours, and service users' experiences of care.

Objectives: 1. To investigate the effect of prior experience of care on pre-registration students' caring approach. 2. To determine the longer-term benefit to students upon qualification of formal paid prior experience of care. 3. To identify if, and how, the values and behaviours that students learn during prior care experience are sustained throughout their education and training. 4. To elucidate which model of prior care experience best enhances the newly qualified workforces' caring and compassionate behaviours.

Methodology: Longitudinal study incorporating convergent parallel mixed-methods design. Methods include a systematic search and critical review of published evidence surrounding the impact of prior care experience. The caring and compassionate skills, values and behaviours of students who participated in the DH pilot project, will be compared with three other cohorts of students who did not participate in the pilot, at various intervals over a four year period. Participants will complete questionnaires designed as proxy measures of the 6C's, participate in focus groups and their University academic records will be analysed. The influence of educational attainment and empowerment upon the development of caring skills, values and behaviours, and the influence of a compassion-focussed clinical supervision model, will be explored. Finally, patients' experiences of care received from participants and student-patient interactions will be analysed.

Findings: The findings of the research will inform and advise policy makers, the NHS, clinicians and educators about the effect and value of prior care experience on student nurses' skills, values and caring behaviours. It will help to identify the best model of providing this experience to individuals wishing to train as nurses, so that they can then deliver high quality, compassionate care to patients upon graduation and beyond. Evidence of this nature has the potential to improve quality of care, patient safety and ensure that services meet patient need and regulatory standards, providing reassurance to the public regarding nursing practice. The study has the potential to significantly influence decisions surrounding future nurse education and the quality of patient care.

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I teach Undergraduate nursing students within the School of Health Sciences in areas including critical thinking, qualitative and quantitative research, evidence-based practice and person-centred care. I hold personal tutoring and academic supervisory roles at Undergraduate, Graduate Entry and Doctoral levels. I have completed the Intensive Teaching and Learning Programme and am currently studying towards a Post Graduate Certificate for Higher Education qualification.

Past Research

Doctoral research: The lived reality and meaning of Lean Thinking for nurses and nursing at an NHS Hospitals Trust.

Supervisors: Professor Stephen Timmons (School of Health Sciences), Dr Hannah Noke (Nottingham University Business School)

Doctorate awareded 2017

Lean Thinking (Lean) is a management philosophy originating from the Toyota automobile manufacturing company in Japan. Lean has been widely adopted in the United Kingdom (UK) National Health Service (NHS) as a panacea for addressing challenges that threaten its sustainability. Attempts to evaluate the outcomes of Lean implementation, in order to assess its claims to improve efficiency, quality and safety, have proved challenging owing to ambiguity surrounding the definition of Lean, differences in approaches to, and the poor quality of literature reporting, implementation. Lean continues to be adopted in healthcare regardless however, and a body of literature considering the consequences of Lean more broadly, is suggestive of implementation holding other, far-reaching implications.

In attempting to transform healthcare culture and the way in which work is physically and socially structured, managed, organised and delivered, Lean can be understood as a socio-cultural intervention, holding the potential to transform the socio-cultural milieu of healthcare practice. There is, however, a dearth of research considering the nature of this transformation, the interaction between Lean and the socio-cultural context of practice, healthcare professionals' experiences, understandings and interpretations of implementation, and the implications that it holds for them. This is especially true in the context of Lean applied to nursing. Theoretically, owing to its managerialist associations, Lean presents challenges to essential facets of nursing as a profession, its socio-cultural foundations and identity. Other 'empowering' characteristics of Lean philosophy however, are congruent with increasing autonomy and control over practice, associated with nursing's professional agenda. Lean implementation can therefore be conceived of as representing both a challenge to, and as proffering opportunities for, the nursing profession.

Underpinned by feminist philosophy and employing an ethnographic methodology, the thesis explores the lived reality of Lean implementation for nurses working in three settings at an NHS Hospitals Trust, and its meaning for nursing's professional project, identity and mandate. The lived reality of Lean is conceptualised as a game played between the Trust and nurses, for power and control over nursing practice. The organisational rationale for, and mechanisms of, exercising power under the guise of Lean are explored, together with the nursing response, incorporating strategies to preserve the socio-cultural status quo and protect nursing knowledge, autonomy and practice.

The notions of 'power' and 'holistic, person-centred theory' are employed as conceptual vehicles, through which the lived reality of Lean and its meaning for nursing, are critically explored and understood. The traditional 'powerless' depiction and 'project' of nursing, are challenged in light of empirical findings. The positioning of Lean as a contemporary scapegoat for a theory-practice nexus, and the role of antagonising factors intrinsic to nursing itself, are considered. The utility and feasibility of the nursing project and identity, predicated on a holistic, person-centred model, is also questioned. In this context, the notion of 'organisational collaboration work' is introduced, and advanced as a recommendation of the thesis, as a potential means of extending nursing's mandate, to better meet the needs of organisations, patients and nurses in contemporary healthcare

School of Health Sciences

B236, Medical School
Queen's Medical Centre
Nottingham, NG7 2HA

telephone: +44 (0)115 95 15559
email: mhssupport@nottingham.ac.uk