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Leading conversations: A reflection on building nurse manager's leadership capacity

An exploration of the role that expert knowledge plays in the assessment of undergraduate clinical competence: registered nurses' experiences

  • Authors: Paliadelis, Penny , Cruickshank, Mary
  • Date: 2003
  • Type: Text , Journal article
  • Relation: Rural and remote health Vol. 3, no. 2 (2003 2003), p. 191-191
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  • Description: INTRODUCTION: This phenomenological study, conducted in rural Australia, explored the experiences of registered nurses (RNs) responsible for assessing the clinical competence of undergraduate nursing students. The purpose of the study was to gain insight into the experiences of a group of registered nurses who assess student competence by exploring how they perform the assessment process. A key assumption on which this study was based is that the participants are 'expert nurses', as defined by Benner. METHOD: Participants were recruited using purposive sampling from a population of registered nurses who assessed the clinical performance of undergraduate nursing students studying at a rural university in New South Wales, Australia. Individual unstructured interviews were conducted and audiotaped with the participants' permission. The analysed data were given to all participants to check for accuracy and validation and a thematic analysis of the data was conducted. RESULTS: Four themes were identified; the major theme, described in this article, was identified in all the narratives. The participants all acknowledged that they use their expert nursing knowledge to assist them when assessing the clinical competence of nursing students. The participants used a variety of terms to describe this type of knowledge such as intuition, instinct, gut feeling and 'just knowing'. CONCLUSION: While the findings of this study confirmed that experienced nurses unconsciously use their expert nursing knowledge when making decisions about students' competence, the findings also indicated a lack of awareness or underestimation of the value of expert clinical knowledge. These findings reinforce the need for further investigation to determine the role of expert nursing knowledge in the clinical competency assessment process. This is particularly significant for rural registered nurses employed in small health-care facilities, who often assume the role of assessors of student clinical competence.

The development and evaluation of online stories to enhance clinical learning experiences across health professions in rural Australia

'Right' for publication: Strategies for supporting novice writers across health and medical disciplines

The working world of nursing unit managers

  • Authors: Paliadelis, Penny
  • Date: 2008
  • Type: Text , Journal article
  • Relation: Australian Health Review Vol. 32, no. 2 (2008), p. 256-264
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  • Description: his paper seeks to explore the responsibility and power of the role of nursing unit managers (NUMs) in rural New South Wales using Kanter's theory of organisational power as a framework. Using in-depth individual interviews with twenty NUMs, data were analysed from four perspectives to gain a deep understanding of the NUMs' working world. The findings show that the NUMs' role is substantive, encompassing both clinical and managerial functions. Overall, the findings indicate that the participants lacked power commensurate with their role responsibilities.

Developing clinical judgement : a case scenario approach

Exploring understandings of chronic-care self-management models in a rural context

Implementing and evaluating

Implementing and evaluating

Rural nursing unit managers : Education and support for the role

  • Authors: Paliadelis, Penny
  • Date: 2005
  • Type: Text , Journal article
  • Relation: Rural and remote health Vol. 5, no. 1 (January 2005), p. 325
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  • Description: INTRODUCTION: Nursing unit managers (NUMs) occupy the often unenviable position of first-line management in many health services in Australia. As such, their role is complex and multifaceted requiring an intertwining of their clinical and managerial responsibilities. While there is an abundance of studies that explore and describe the various management roles in many professions and industries, little is known about the experiences of nurses as managers, particularly in rural settings. This article focuses on the education and support needs of rural nursing unit managers. METHODS: A qualitative study design was used to explore the stories of a number of nursing unit managers in rural New South Wales, Australia. Data was collected using semi-structured individual interviews. Data was analysed using a voice-relational method as a framework for more clearly hearing the voices of participants. This method of data analysis is particularly useful for hearing from those who do not usually have a 'strong' voice, for gaining an understanding of the context of the interviews, and for acknowledging the role of the researcher in the research process. All NUMs employed in a single regional health authority in rural Australia were invited to participate. RESULTS: Out of 42 NUMs in the region, 20 agreed to be interviewed. Nursing unit managers were asked to reflect on their experiences prior to and during the early days within the position. In summary, all the NUMs: believed they were promoted because of their clinical expertise; felt unprepared for the managerial and administrative aspects of their role; continued to identify as nurses rather than as managers; found the role isolated them from their former peer group. Those employed in small facilities had limited opportunities for education and peer support. CONCLUSIONS: Based on the NUMs' experiences and suggestions, the following information would have helped them to cope with the demands of their new role: information and discussions about the role expectations of first-line manager, from both an employee and employer perspective; human resource and financial management skill development; leadership skills; negotiation and conflict resolution; a clear and realistic role description.

Nurses as managers; Education and support for the role

All together now! – An exploration of the value of a simulated interprofessional learning program for a range of rural health students

A person-centred approach to assessing the cardiovascular and lymphatic systems

Nurse managers don't get the corner office

Students, faculty and local community health professionals learning together

Implementing family-centred care : An exploration of the beliefs and practices of paediatric nurses

  • Authors: Paliadelis, Penny , Cruickshank, Mary , Wainohu, Donna , Winskill, Rhonda , Stevens, Helen
  • Date: 2005
  • Type: Text , Journal article
  • Relation: Australian Journal of Advanced Nursing Vol. 23, no. 1 (2005), p. 31-36
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  • Description: Objective: This study explored paediatric nurses' perceptions of how they include and involve parents in the care of hospitalised children. Design: This qualitative study used individual unstructured interviews to gather data, the data was analysed using thematic coding. Setting: Paediatric wards within two regional area health services of New South Wales, Australia. Subjects: Fourteen paediatric nurses were asked to describe their beliefs and practices regarding the clinical application of family-centred care. Main outcome measure: Paediatric nurses' beliefs and practices about family-centred care were explored in an effort to explain how the concept was implemented. Results: The findings are presented as four interconnected themes. The first describes how participants either allocated tasks to parents or retained them, the second relates to the nurses' professional identity, the third theme identifies barriers and constraints to the implementation of family-centred care, while the fourth describes the nurses' beliefs about their responsibilities when delivering family-centred care. Conclusions: Together these findings suggest that while nurses endorse the concept of family-centred care, the implementation into practice is more problematic. While it is not possible to generalise these findings to other paediatric nurses, the authors believe the insight gained will resonate with paediatric nurses internationally. The findings from this study are being used as the basis for the development of clinical practice guidelines to assist paediatric nurses to more consistently apply the concepts of family-centred care to their practice.

Looking after yourself: Understandings of chronic-care self-management models in rural and urban contexts of UK and Australia

  • Authors: Paliadelis, Penny , Carr, Susan , Lhussier, Monique , Forster, Natalie , Eaton, Simon , Parmenter, Glenda , Death, Catharine
  • Date: 2014
  • Type: Text , Conference paper
  • Relation: NET 2014
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  • Description: This paper reports on the outcomes of a two related projects undertaken during 2011-2012 in Australia (Rural Northern NSW) and the UK (Urban Northern UK) that sought to identify the strategies that clinicians employ to actively involve patients with chronic conditions in the planning and delivery of their care1,2,8. This study was informed by the global shift to partnership approaches in health policy and the growing imperative to deliver patient or client-centred care3,4,9,10. Support for self-management refers to the role that clinicians play in building client knowledge, skill and confidence to effectively manage their own healthcare concerns and treatments6. A qualitative methodology was used, with focus groups and interviews conducted to explore the strategies used by a range of primary healthcare providers, such as general practitioners, nurses, social workers, diabetes educators, dieticians and occupational therapists, to support clients to effectively manage their own chronic conditions. In particular this study aimed to understand the models and contexts of care that impacted on the participants’ practices and identify barriers and enablers to supporting client self-management from the participants’ perspective5,7. This paper presents the results of these studies and identifies the similarities and differences between the two contexts that have either facilitated or blocked clinicians’ efforts to support their clients to adopt self-care strategies7. We are not claiming national commentaries but are drawing on two studies that we consider provide insight into ‘typical’ practices in both countries. The finding of both studies identified that supporting patients/clients to engage in actively managing their health care needs requires changes to client and clinicians traditional perspectives on their role, practice and education, as well as developing more integrated health policies to better support clients with complex health care needs, who want to adopt self-management practices.

Disseminating research

Promoting team health – an exploration of the value of a simulated interprofessional learning program for rural health students

  • Authors: Paliadelis, Penny , Stupans, Ieva , Fagan, Anthea , Lea, Jackie , Turner, Linda , Puxty, Maree
  • Date: 2012
  • Type: Text , Conference paper
  • Relation: SimHealth 2012
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  • Description: Synopsis: This paper reports on the innovative design and outcomes of a short learning program undertaken by a range of rurally based undergraduate health students. The medical, nursing, pharmacy and social work students worked through two case scenarios via high and low fidelity simulations, using actors, and supported by an online learning site. The program was designed to enhance effective interprofessional teamwork and communication skills prior to graduation. The attitudes and experiences of students who completed the program were explored via pre and post program questionnaires, audience response software and qualitative feedback. Purpose: The international literature clearly identifies the needs for greater integration of interprofessional education into the curricula of entry-level health professions to enhance mutual respect, effective team-work and patient-centred care across all practice settings. This paper will report on the design and outcomes of an interprofessional learning program that involved undergraduate students of medicine, nursing, pharmacy and social work learning together via a range of simulations and panel sessions to enhance their teamwork and communication skills. Methods: The learning program was developed by a team of academic and clinical health professionals around the care of two clients with chronic conditions and a range of social problems, within a rural health context. An evaluation methodology was chosen to explore the students' attitudes and experiences of participating in this program. Data consisting of pre and post program surveys, audience response data and qualitative comments, which was analysed to determine the effectiveness of the program in using simulations to promote interprofessional learning.
  • Description: E1

Implementing and evaluating