Bush Battles: The Challenges of Providing Acute Health Care in Rural Contexts in Australia
- Authors: Parker, Vicki , Giles, Michelle , Parmenter, Glenda , Higgins, Isabel , Paliadelis, Penny , White, Angela
- Date: 2010
- Type: Text , Conference paper
- Relation: The 16th International Interdisciplinary Conference Vol. 9, p. 377-377
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- Description: Introduction. In Australia, the rural health care environment is characterized by increasing disadvantage in relation to access to services and resources. Within this context, health professionals are challenged to provide what they feel is good-quality health care in a community of which they are a part. This paper presents the results of a study which aimed to • identify challenges confronting health care professionals in rural acute care settings and • facilitate interprofessional collaboration in working toward improved patient outcomes and staff participation. Method. A mixed method approach involved a consultative, participatory process. An initial survey was followed by focus groups and workshops. The target population was health care professionals across disciplines, in rural acute care facilities within one large Area Health Service in NSW, Australia. Workshops facilitated interdisciplinary collaboration to identify strategies for addressing concerns with the aim of developing priorities for practice change projects. Results. Results highlighted issues to do with staffing, isolation and communication as most significantly impacting on staff and patient outcomes. Access to resources and support services was the most frequently cited challenge. Results were consistent across professions and sites within the Area Health service. Focus groups identified a range of issues related to geographic and professional isolation, working with and apart from larger centers, generalist practice, and insufficient services and staff. Conclusion. Findings point to the urgent need to support clinicians through the mobilization of strategies that are context specific, locally based and led, but at the same time transferrable across sites.
Implementing and evaluating
- Authors: Paliadelis, Penny
- Date: 2010
- Type: Text , Book chapter
- Relation: Kozier & Erb's Fundamentals of nursing p. 461
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Leading conversations: A reflection on building nurse manager's leadership capacity
- Authors: Paliadelis, Penny , Campbell, S
- Date: 2010
- Type: Text , Conference paper
- Relation: National Australian Conference on Evidence-based Clinical Leadership
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- Description: E1
Nurse managers don't get the corner office
- Authors: Paliadelis, Penny
- Date: 2010
- Type: Text , Conference paper
- Relation: 7th Biennial International Conference in Organisational Behaviour in Health Care
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Overcoming writers' block: The development of a new collaborative nursing and midwifery journal that encourages and supports novice writers to publish research projects
- Authors: Parmenter, Glenda , Paliadelis, Penny , Parker, Vicki , Giles, Michelle , Turner, Catherine
- Date: 2010
- Type: Text , Conference paper
- Relation: 21st international nursing research congress
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An exploration of the capacity of general practice nurses to improve the prevention and management of childhood obesity
- Authors: Paliadelis, Penny , Parmenter, Glenda
- Date: 2009
- Type: Text , Conference paper
- Relation: Primary Health Care Conference
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- Description: E1
The lived experience of venous access
- Authors: Robinson-Reilly, Melissa , Paliadelis, Penny , Cruickshank, Mary
- Date: 2009
- Type: Text , Conference paper
- Relation: Supportive Care in Cancer Vol. 17
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- Description: E1
Developing clinical judgement : a case scenario approach
- Authors: Paliadelis, Penny
- Date: 2008
- Type: Text , Book
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Nursing unit managers: Responsibility without power?
- Authors: Paliadelis, Penny
- Date: 2008
- Type: Text , Conference paper
- Relation: NSW Rural and Remote Health Conference
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The lure of the bush : Do rural placements influence student nurses to seek employment in rural settings?
- Authors: Lea, Jackie , Cruickshank, Mary , Paliadelis, Penny , Parmenter, Glenda , Sanderson, Helena , Thornberry, Patricia
- Date: 2008
- Type: Text , Journal article
- Relation: Collegian Vol. 15, no. 2 (May 2008), p. 77-82
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- Description: The aim of this study was to investigate whether rural clinical placements for student nurses at a rural university in New South Wales influence their decision to join the rural and remote Registered Nurse workforce. The study utilised a convenience sample of final year Bachelor of Nursing students at a rural university campus, and consisted of two stages of data collection. Stage One employed a pre- and post-clinical placement survey design that elicited both demographic and qualitative data. Stage Two consisted of individual interviews with a sample of final year nursing students while they were on a rural clinical placement. The findings highlight the factors that influence final year students' decisions to seek employment in rural healthcare facilities. These findings will be of interest to nurse academics concerned with ensuring that undergraduate nursing curricula relate to rural nursing practice in Australia and to those involved in recruitment of new graduate RN's to rural nursing practice.
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.
Using a voice-centered relational method of data analysis in a feminist study exploring the working world of nursing unit managers
- Authors: Paliadelis, Penny , Cruickshank, Mary
- Date: 2008
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 18, no. 10 (2008), p. 1444-1453
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- Description: In this article, we discuss the application of a data analysis method used in a feminist study that explored the working world of nursing unit managers in Australia. The decision to use a voice-centered relational approach to the data was based on a desire to delve into the working world of nursing unit managers and uncover the layers within the narratives that specifically related to their perceptions of themselves, their world, and the context in which they work. Throughout this article, the focus is on how this method was applied to uncover multiple layers of meaning within the data, rather than on the researchers' and participants' roles in the coconstruction of interview data. An excerpt from an interview transcript is used to illustrate how the stories of the participants were explored using this method.
Caring for each other: How do nurse managers 'manage' their role?
- Authors: Paliadelis, Penny , Cruickshank, Mary , Sheridan, Alison
- Date: 2007
- Type: Text , Journal article
- Relation: Journal of Nursing Management Vol. 15, no. 8 (November 2007), p. 830-837
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- Description: Aim: This article will report on one aspect of a larger study that explored the working lives of nursing unit managers in Australia. The support of nursing unit managers is the focus of this article. Background: There is evidence in the recent literature that nurses are not generally supportive of each other and that nursing unit managers are not adequately supported to manage their expanding administrative and managerial responsibilities. Method: A qualitative feminist approach was used to conduct individual interviews with 20 nursing unit managers employed in the public healthcare system in Australia. Results: The results indicated that participants did not feel supported by the wider organization, but gained support from within their own ranks. Conclusions: The results showed a strong support system within the participant group, despite evidence in the literature that nurses, generally, are not supportive of each other. The results of this study may be used in the development of more effective support mechanisms for nurse managers.
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.
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
- Authors: Paliadelis, Penny
- Date: 2004
- Type: Text , Book chapter
- Relation: Education: Concepts and practices p. 775
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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.