Description:
This article reports on a pilot vocational study programme for provision of antenatal services in the general practice environment. The concurrent evaluation study assessed practice nurses' experiences of undertaking the pilot programme, the level and applicability of the content, and the mode of delivery. General practitioners' understanding of the role of the nurse in providing antenatal services, and the actual and potential impact of this new role on models of service delivery and care were also investigated. Women receiving care from practice nurses within this new model of service delivery and care were also of interest in this study. Findings showed that the current role of the general practice nurse in caring for pregnant women is restricted to assisting the general practitioner to complete their assessment of clients. Organizing clinical placement with a midwife was a major barrier to completing the pilot programme.
Description:
Nurses and midwives are the largest group of health providers in Australia (60%), and with increasing remoteness, this proportion increases substantially.1 The recruitment and retention of nurses, and more specifically midwives in rural health services, is at crisis point. Sustainable birthing services will be reliant on a stable, regenerative workforce. Key to this goal is the education of nurses, midwives and doctors, all of whom have stringent pre-service professional placement quotas in order to meet required competencies to practice. The rural workforce crisis in maternity care has been a driving force in health care reform.2 Rural innovation has involved negotiating the space between increased medical risk and the need for a healthy pregnant woman to have the option of staying within her local community to have her baby.3,4 Rural nurses and midwives together with rural doctors agree that continuity of care, irrespective of how it is achieved, is associated with the best outcomes for women and their families in rural locations.4–6 Continuity of care can be achieved using a shared-care medical model involving obstetricians and general practitioners, or midwifery-led primary maternity care services. In the process of securing maternity services that provide continuity of care, the influence of specialist obstetricians, a limited resource in rural locations, has been moderated, and unique solutions to local problems have resulted in the formation of collaborative relationships involving rural nurses, midwives and general practitioners. This polemic makes an argument for a review of the current regulatory requirements for both the education of undergraduate rural nurses and midwives, and the continuing registration of rural midwives who work predominantly in nursing roles. In doing so, the authors provide an overview of the dilemmas facing policymakers, educators, health services managers and clinicians in the provision of sustainable maternity services in rural and remote Australia.
Description:
Objective The purpose of the paper is to introduce illicit drug use as a societal problem and describes the response of the Australian Government. Specifically the paper examines the use of illicit drugs by pregnant women and the role of midwives in supporting these women throughout pregnancy and birth. Setting Maternity services, specifically antenatal care clinics. Conclusion In Australia the rate of pregnant women who use illicit drugs is escalating. These pregnancies are high obstetric risk with potential for harm to both the mother and the baby. Pregnancy however is seen as 'window of opportunity'; a time to provide education, choices and support. The literature describes that for health professionals working with pregnant women who are illicit drug users is challenging and for some health professionals their interaction can be negative. Australia advocates harm minimisation and encourages harm reduction strategies. Midwives are in a position to implement these strategies within the maternity setting. Further research is recommended as well as professional development programs for midwives to upgrade knowledge and cultivate engagement skills to enable appropriate and positive interaction with pregnant women who use illicit drugs.
Description:
Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses’ (RNs) needs and not simply organizational requirements.
Description:
Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses’ (RNs) needs and not simply organizational requirements.
Description:
Background Heideggerian hermeneutic phenomenology has been used widely to understand the meaning of lived experiences in health research. For midwifery scholars this approach enables deep understanding of women's and midwives’ lived experiences of specific phenomena. However, for beginning researchers this is not a methodology for the faint hearted. It requires a period of deep immersion to come to terms with at times impenetrable language and perplexing concepts. Objectives This paper aims to assist midwives to untangle and examine some of the choices they face when they first come to terms with an understanding of this methodology and highlights the methodology's capacity to reveal midwifery authenticity and holistic practice. Discussion The illumination of a selection of various concepts underpinning hermeneutic phenomenology will inform midwives considering this methodology as suitable framework for exploring contemporary midwifery phenomena.
Description:
Hermeneutic phenomenology has been used widely by researchers to understand lived experiences. This methodology asserts that individual people are as unique as their life stories. The practice of midwifery is underpinned by a philosophy that values women and the uniqueness of their child-bearing journey. The tenets of hermeneutics phenomenology align with those of contemporary midwifery practice, making it a useful research methodology for providing insights into issues relevant to the profession. The purpose of this paper is to unravel some foundational concepts of hermeneutic phenomenology and recommend it as a methodology of choice for midwives to apply to their application to midwifery-in-action.
Description:
AIM: This article describes the experiences of midwives who choose to work with pregnant women who use illicit drugs. BACKGROUND: Pregnant women who use illicit drugs present complex challenges for those who choose to work with them. Society's views on illicit drug use fluctuate from acceptance and harm minimization to reprimand and retribution. METHOD: Qualitative interviews were conducted between June and August 2009 with 12 Australian midwives. A thematic analysis method informed by hermeneutic phenomenology was applied to interpret this data to explicate lived experiences and gain deeper understanding and meanings of this phenomenon. FINDINGS: Three major themes encapsulated the experience: making a difference, making partnerships, and learning to let go. The focus of this article, “making a difference,” included two subthemes of “working on the margins” and “transition and transformation.” The midwives were both rewarded and challenged by the needs of women who use illicit drugs and by the systems in which they worked. CONCLUSIONS: The midwives acknowledged that their aspirations “to make a difference” was not always sufficient when working with women who use illicit drugs. They also require the establishment of maternity services that are compassionate and accessible, including woman–care provider partnerships and continuity of the care environments.
Description:
Each year registered nurses apply for registration renewal. The Nursing and Midwifery Board of Australia stipulate all nurses and midwives are expected to take responsibility and accountability for participating in continuing professional development (CPD) as a declaration that their practice is current, safe and competent. The code of professional conduct and Australian Nursing and Midwifery Council (ANMC) competencies governing registered nurses and midwives, outline the professional and personal responsibility nurses hold in order to maintain clinical competence; which may be achieved through continuing nurse education and professional development. As the health care industry shifts focus to keep up with changes in technology, economics, demographics and culture, the nursing profession must respond accordingly. With the implementation of a national registration scheme in Australia, this paper provides a review of the literature relating to mandatory CPD and how CPD may assist nurses to respond to the changing needs of the health care system and its consumers, to ensure the best possible health outcomes. Suggestions of possible avenues of research into the concept of CPD are also offered.
Description:
Nurses represent the largest occupational group of health care professionals in Australia. The ratio of nurses to population is relatively consistent, unlike other health care professional groups (including medical doctors and allied health staff) whose numbers decline as population density and distance from metropolitan areas increases. Nurses working in areas where other health care professionals are limited or absent have expanded scopes of practice with their work being more generalist than specialist. The role of nurses in remote and isolated areas of Queensland, Australia was the focus of a commissioned multi-case research project. Findings reported in this paper relate to the position of registered nurses as part of an interprofessional team. These findings indicated that, in some instances, local health care teams were limited to a single nurse and Indigenous health care worker/s, while in others the teams were more diverse. In all cases collegial support was available either locally or via telecommunication technology. Understanding the role of each team member, having useful strategies to enhance communication and work collaboratively were identified as essential criteria for "good practice".
Description:
Interviewing is a key strategy used to elicit data in qualitative research. Whilst many nurse researchers are cognizant of the skills required to conduct a successful research interview, researchers may be less comfortable with the notion of interviewing a participant with whom the researcher claims a pre-existing, or dual relationship; a phenomenon becoming more apparent as the volume of researchers escalates especially in rural settings or smaller, heavily specialized fields. Issues pertaining to this particular situation are analyzed, debated and discussed. Furthermore tactics designed to enhance the research process whilst upholding the well-being of the researcher will be illustrated and elucidated.
Description:
Nursing education in Australia has been provided in the tertiary sector since the mid 1980s although the complete transfer of hospital based programs was not finalised until 1993.1,2 Pre-service nursing programs produce and graduate nurses who are generalist prepared and able to work in any practice context as novice registered nurses. Specialist education that traditionally incorporated midwifery was undertaken following registration and after a period of practice as a nurse.3 In recent years, views regarding midwifery as a specialism of nursing have been challenged by champions including the peak professional body representing midwifery, the Australian College of Midwives. Advocates maintained that women desire choices regarding birthing options and that midwives have, and continue to be dissatisfied with the current health care system that restricts their practice.4 By the beginning of the 21st Century, direct entry midwifery programs were part of the educational landscape
Description:
This paper describes a project to promote a research culture amongst nurses in Malaysia. The project, funded by the Australian Government’s Australia Malaysia Institute, and implemented by a group of Australian nurse academics, provided a rare professional development opportunity to nurses in urban and remote areas of Malaysia
Description:
The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently.