An exploratory study of factors influencing pakistani physicians' retention and resettlement career decisions
- Authors: Arif, Muhammad , Fraser, John , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Ayub Medical College, Abbottabad : JAMC Vol. 34 , no. 3 (2022), p. S649-S659
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- Description: Background: The recruitment, retention and migration of health workers is a global phenomenon. The literature shows push factors associated with leaving rural areas and developing countries in general are explored in depth. However importantly, some health workers behave differently and decide to stay in or return to a developing country. Less is known about the reasons/ pull factors of this groups' decision making. Methods: This paper aims to explore the perceptions of Pakistani physicians regarding their career decisions to remain in their country, or resettle back after working abroad for some time. Thirteen Pakistani physicians were interviewed via telephones who were working in Pakistan and Australia. Results: The motivation for Pakistani physicians to remain or resettle back into their country stems from the perceived better quality of life in Pakistan compared to the better standard of life overseas. Other reasons include a perceived differentiation between locals and non-locals abroad and the availability of a permanent job in Pakistan. Conclusion: The main factors that contributed to Pakistani physicians' retention and resettlement decisions were mostly personal and family or societal factors and there was a minimal role for professional or health system related factors in their career decisions, except for the availability of permanent jobs in Pakistan.
Models and interventions to promote and support engagement of first nations women with maternal and child health services : an integrative literature review
- Authors: Austin, Catherine , Hills, Danny , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Children Vol. 9, no. 5 (2022), p.
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- Description: Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practise within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, the nursing practice, and public health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Home-based care for people with disabilities : role of registered nurses within the district health system in Thailand
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Collegian Vol. 27, no. 1 (2020), p. 18-22
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- Description: Background: In Thailand, the number of people with physical disabilities (PwD) has been increasing. Following sweeping health care reforms in 2002, efforts were made to improve accessibility to health care by greatly increasing the number of Registered Nurses (RNs) working in local community health centres. Little is known, however, about the role of RNs in improving accessibility to home-based care and the outcomes of care for PwD in Thailand. Aim: To explore the role of RNs in providing high quality home-based services for PwD who have severe limitations in movement. Methods: A case study design was used to explore and describe the role of RNs in home-based care for PwD in one rural and one urban area in lower north Thailand. There were 73 participants, including PwD and their family members, community health volunteers, primary care providers, local government officers and members of the District Health management team. Data were collected from in-depth interviews and focus groups, which were analysed using thematic analysis. Results: The roles of RNs in home-based care for PwD were found in four domains, as case manager, rehabilitation care provider, manager of the community health volunteers and broader care coordinator. Conclusion: The full scope of the RN role in the provision of home-based care for PwD, in the district health system of Thailand, not only involves direct nursing care. The role also encompasses planning and co-ordination of the broad range of professional and non-professional services to meet the needs of PwDs in rural and urban settings. © 2019 Australian College of Nursing Ltd
Public perception of medical errors : experiences and risks shared in Australia
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
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- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
Motivational factors influencing retention of village health workers in rural communities of Bhutan
- Authors: Tshering, Dolley , Tejativaddhana, Phudit , Siripornpibul, Taweesak , Cruickshank, Mary , Briggs, David
- Date: 2019
- Type: Text , Journal article
- Relation: Asia-Pacific Journal of Public Health Vol. 31, no. 5 (2019), p. 433-442
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- Description: Village health workers (VHWs) are the first contact extending vital health services to unreached and underserved communities in Bhutan. VHWs truly embody the principles of primary health care and are effective catalysts in promoting community health. This study identifies and confirms factors motivating VHWs to remain in the health care system. This is a quantitative study with a cross-sectional survey design. Two-stage cluster sampling was used with VHWs from 12 districts representing 3 regions of Bhutan. Data were collected using pretested semistructured questionnaires. Confirmatory factor analysis was used for data analysis. Findings reveal a 4-factor model of motivations among VHWs that includes social, personal, job related, and organizational factors. Among these, the social factor most significantly motivates VHWs to remain in the health care system. VHW motivation can be further fostered by providing a holistic combination of financial and nonfinancial incentives that recognize intrinsic needs and empower innate altruism. What We Already Knowwe already know that there are varied of motivating factors for village health workers to remain in the health care systems in different countries. What This Article Adds This article adds a new body of knowledge. The current study found that social factor is the main motivating factor for village health workers in Bhutan, which requires due consideration by health managers and policymakers during the decision-making process.
The history and evolving image of nursing
- Authors: Cruickshank, Mary , Paliadelis, Penny , Gazula, Swapnali , McAllister, Margaret
- Date: 2019
- Type: Text , Book chapter
- Relation: The road to nursing Chapter 7 p. 99-116
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- Description: The traditional stereotypical image of a nurse is closely linked to that of Florence Nightingale, the founder of modern nursing, who established a training system for nurses to teach them how to be completely dedicated to the taskes of care regardless of personal needs; dependent on and deferential to authorities such as medical doctors and matron supervisors; and modest and feminine. Of course, contemporary nursing is no longer a profession exclusive to females, and nor does nursing work predominantly involve dependent actions. However, these old ideas remain strong in the minds of the public and are often repeated in popular culture.
To remain, migrate abroad or resettle : a complex dynamic process affecting Pakistani physicians' career decisions
- Authors: Arif, Muhammad , Cruickshank, Mary , Fraser, John
- Date: 2019
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 14, no. 3 (2019), p.
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- Description: OBJECTIVE This study investigated Pakistani physicians' decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. METHODS This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as 'stayers', 'leavers' and 'resettlers' were interviewed via telephone to explore their lived experience in 2008-2009. RESULTS Results show a dynamic nature of the physicians' career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians' can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. CONCLUSIONS The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals. © 2019 Asia Pacific Journal of Health Management. All Rights Reserved.
Understanding self and others
- Authors: Arnott, Nick , Paliadelis, Penny , Cruickshank, Mary , Williams, Danielle
- Date: 2019
- Type: Text , Book chapter
- Relation: The road to nursing Chapter 10 p. 152-167
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- Description: As a society, we generally expect those working in professional roles to be 'professional', but this term is difficult to define. What does it actually mean to be professional? How can students develop their personal sense of self, and how might this interact with their professional identify and performance? This chapter explains self-awareness and the importance of understanding your own values, beliefs and motivations, which in turn will assist you to better understand the unique experiences and 'world-views' of others, and to develop and nurture the therapeutic and professional relationships that are essential for successful nursing practice.
Using the lens of enablement to explore patients’ experiences of Nurse Practitioner care in the Primary Health Care setting
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary , Northam, Holly
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 193-199
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- Description: Background: Patient enablement is a patient-centred concept reflecting a patient's ability to cope, understand and manage their own health. It can be used as a measure of the quality of care and has been linked with improved patient outcomes. While there have been studies into patient enablement following consultations with General Practitioners (GPs) and practice nurses, Nurse Practitioners’ (NPs) role in enabling patients remains unexplored. Aim: To use the lens of enablement to explore patients’ lived experience of NP care in a Primary Health Care (PHC) setting in Australia. Methods: Using a qualitative approach, 12 patients who had consulted an NP in PHC participated in unstructured interviews. An interpretative phenomenological approach was used to inform the study. A secondary analysis was conducted to explore possible synergies and resonance between the data and the constructs of the Patient Enablement Instrument (PEI). Findings: This small qualitative study found that, following consultations with NPs in PHC, patients reported personal approaches and behaviours consistent with enablement. Three key existential themes appeared to contribute to patient enablement: the way NPs used consultation time (temporality), the building of partnerships between NPs and patients (relationality) and through NPs’ holistic and hands-on consultation approach (corporality). The effective use of time in the consultation was seen as particularly important. Conclusion: The findings from this study suggest consultations with NPs do enable patients. This is a previously undocumented strength of NP care. Further research, using a variety of settings, methods and patient and health care provider populations, is recommended. © 2017 Australian College of Nursing Ltd
The experience of enablement within nurse practitioner care : A conceptual framework
- Authors: Frost, Jane , Currie, Marian , Northam, Holly , Cruickshank, Mary
- Date: 2017
- Type: Text , Journal article
- Relation: Journal for Nurse Practitioners Vol. 13, no. 5 (2017), p. 360-367
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- Description: Patient enablement after consultations has not yet been adequately investigated among patients of nurse practitioners (NP) in primary health care. The lens of enablement and a qualitative parallel multistrand approach were used to explore patients’ experiences and NPs’ perspectives of consultations. Metainferences made from this study suggest NPs enable patients by creating opportunities for education and knowledge transference and building on patients’ strengths and promoting self-efficacy. Three existential components of the experience of consultations (ie, relationality, temporality, and corporality) also played a role. These findings were used to develop a conceptual framework of how patient enablement is experienced within an NP consultation. © 2017 Elsevier Inc.
Viewing nurse practitioners' perceptions of patient care through the lens of enablement
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary , Northam, Holly
- Date: 2017
- Type: Text , Journal article
- Relation: Journal for Nurse Practitioners Vol. 13, no. 8 (2017), p. 570-576
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- Description: Research conducted in primary health care (PHC) shows the value of patient enablement. Although nurse practitioners (NPs) are increasingly playing a role in PHC, limited research exploring their contribution to enabling patients exists. This article describes a qualitative descriptive study in which enablement was used to explore PHC NPs' perceptions of the care they provide to patients. Analysis of the focus group data identified 3 primary themes: patient centeredness and bespoke care; reciprocity, trust, and acceptance; and knowledge transference. Relating these themes to the constructs of the Patient Enablement Instrument demonstrated a clear link between NP care and patient enablement. © 2017 Elsevier Inc.
Venous access : The patient experience
- Authors: Robinson-Reilly, Melissa , Paliadelis, Penny , Cruickshank, Mary
- Date: 2016
- Type: Text , Journal article
- Relation: Supportive Care in Cancer Vol. 24, no. 3 (2016), p. 1181-1187
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- Description: The evolution of venous access via peripheral cannulation, particularly in relation to the risks and the benefits of this procedure, is reported widely in the literature. However, there is limited research specific to the patient experience of undergoing venous access. The intent of this qualitative study was to understand patients' experience of venous access, with the aim of bringing forth their voices about the experiences of repeated venous access/cannulation attempts. This qualitative study used a hermeneutic phenomenological approach to explore the experiences of 15 participants in two rural oncology units in Australia. The participants had experienced repeated peripheral cannulation in order to receive chemotherapy. Study participants were asked to describe what it was like for them to be repeatedly cannulated. Data were collected via audiotaped individual interviews, the participants' stories were transcribed and analysed thematically. Themes emerged from the participants' stories that provided insights into their perceptions of the experience of being cannulated and the decision-making processes regarding how and where the procedure occurred. The findings suggest that a holistic approach to care was often missing causing the participants to feel vulnerable. Gaining insight into their experiences led to a greater understanding of the impact of this procedure on patients and the need to improve care through encouraging more collaborative decision-making processes between clinicians and patients. The implications for policy and practice focus on improving patient outcomes via procedural governance and education, with the intent of translating the findings from this research into evidence-based practice.
A model of home-based care for people with disabilities : Better practice in rural Thailand
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
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Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
An integrative review of enablement in primary health care
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Primary Care & Community Health Vol. 6, no. 4 (2015), p. 264-278
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- Description: Objectives: To review how enablement is conceptualized and practiced in primary health care and to explore the factors that influence patient enablement in this setting. Method: A narrative integrative literature review was undertaken. Results: Twenty-four articles specifically relating to enablement in primary health care were identified. Three literature reviews, 4 qualitative studies, and 17 quantitative studies were included in the analysis. Conclusions: In the primary health care setting, the concept of enablement is well defined as an outcome measure of quality. The literature exploring the practice of enablement is sparse, but 2 randomized controlled trials suggest enablement is linked to better outcomes for patients with asthma and diabetes. Primary factors influencing enablement included the practitioners’ open communication style, the degree to which the practitioner is patient centered, and longer consultations. Other factors found to be associated with enablement were the presenting health issue, general state of health, ethnicity, the patient’s own coping strategies and degree of independence, and socioeconomic status. The association between enablement and patients’ expectations and satisfaction is less clear. The majority of research on enablement was carried out among general practitioners. Further research into the degree to which patients are enabled by a wider range of health care providers is needed. Additional qualitative research would provide a deeper understanding of the attributes of enablement in the primary health care setting.
Supporting new graduate nurses making the transition to rural nursing practice : Views from experienced rural nurses
- Authors: Lea, Jackie , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 24, no. 19-20 (2015), p. 2826-2834
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- Description: Aims and objectives. To present the findings from the experienced rural nurse participants of a larger study that explored the transitional experiences of newly graduated nurses making the role transition in rural health care facilities in Australia. Background. There are specific and unique aspects of rural nursing practice that influence the nature and timing of support for new graduate nurses that have not been explored or acknowledged as influencing the new graduate nurses’ experience of transition. Specifically, the difficulties and challenges that experienced rural nurses face in providing effective and timely support for new graduate nurses who are making the transition to rural nursing practice is yet to be explored. Design. Using a qualitative case study framework, this study specifically aimed to investigate and describe the nature and timing of support required during the transition to nursing practice that is specific for the rural context and capacity. Methods. Individual in-depth interviews were conducted with 16 experienced rural nurses who, at the time of the study, worked with new graduate nurses in the rural practice environment. Results. The findings from this study showed that the provision of timely on-ward support for new graduates making the transition to rural nursing practice is affected and influenced by the skill mix and staffing allocation within the rural environment. As well, there is a lack of awareness by rural nurses of how to meet the on-ward support needs of new graduate nurses. Conclusions. This study has identified the specific and unique aspects of the rural nurse’s role and responsibilities for which the new graduate nurse requires incremental learning and intensive clinical support. Relevance to clinical practice. The findings can be used by rural health services and experienced rural registered nurses to assist in implementing adequate and timely support for new graduate nurses.
The support needs of new graduate nurses making the transition to rural nursing practice in Australia
- Authors: Lea, Jackie , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 24, no. 7-8 (2015), p. 948-960
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- Description: Aims and objectives. The aim of this paper is to present the findings from the new graduate nurse participants of a larger study that explored the transitional experiences of newly graduated nurses making the role transition in rural health care facilities in Australia. Background. Evidence indicates that workload, skill mix and organizational pressures are still of concern for new nursing graduates within the Australian context and internationally. Many graduates are expected by employers to have high levels of independence, well developed problem solving abilities and be able to assume management and leadership responsibilities early in their graduate year. Design. An exploratory, descriptive, qualitative case study design was utilised to determine the particular support needs over time that would assist with a safe transition to the rural nursing workforce. The aims of the study were to: (1) Explore the new graduate nurses’ perceptions and experience of the nature and timing of support throughout their Transition to Practice Program in a rural setting; (2) Identify the functional elements of rural graduate nurse transition programs and develop guidelines that will assist in the design of Transition to Practice Programs that match the rural context and capacity. Methods. A purposive sample of 15 new graduate nurses who had commenced a 12 month Transition to Practice Program within a rural health facility from northern New South Wales, Australia, participated in this study. In-depth individual interviews with the new graduate nurses were conducted at time intervals of three to four months, six to seven months and 10 to 11 months. Results. One of the key findings of this study is that as the new graduate nurse making the transition to professional rural nursing practice moves along the transition continuum, there are particular and unique aspects of the rural nurse’s role and responsibilities for which the new graduate nurse will require specific learning support during their transition. Conclusions. When the new graduate moves from the role of the student to the less familiar role of professional practitioner, it is important that a rural Transition to Practice Program offers an incrementally staged workload and responsibilities that recognises the graduate’s beginning nurse status. Relevance to clinical practice. The study contributes new knowledge to the discussion of issues concerning support mechanisms for new graduate nurses as they make the transition to rural nursing practice.
"This is how it's got to happen"
- Authors: Northam, Holly , Cruickshank, Mary , Hercelinskyj, Gylo
- Date: 2014
- Type: Text , Journal article
- Relation: Transplant Journal of Australasia Vol. 23, no. 1 (2014), p. 9-13
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- Description: Organ transplantation is the most effective treatment for end-stage organ failure and is a much sought-after therapy. Efforts are under way to maximise the number of families who agree to organ donation on behalf of a newly deceased relative in Australia, with the hope of easing the burden for dying and incapacitated patients and to reduce health care costs. Objective: To present initial findings from a study which asked families who had been required to make a deceased organ donation decision about their experience, and the factors that contributed to their decision to either agree to or decline organ donation. Methods: Following ethics approval, an exploratory multiple case study was conducted. Twenty-two family members from nine families who had experienced the death of a relative within the previous three years from five of Australia's state and territories contributed to the study in 17 recorded, transcribed and analysed interviews. Findings: Broad themes emerged that included the importance of time and location, perceptions of suffering, information and help for the families, and the need for families to assure themselves that the deceased's needs were addressed before and after death. Conclusion: The findings suggest families require trust that their family member was not suffering before and after death. The affirmation of this trust was helped by prior information about the organ donation process and sensory affirmation that their loved one was at peace. Family decisions about organ donation, hopes and 'deep hopes' were dependent on this trust.
Perceptions from the front line : Professional identity in mental health nursing
- Authors: Hercelinskyj, Gylo , Cruickshank, Mary , Brown, Peter , Phillips, Brian
- Date: 2014
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 23, no. 1 (2014), p. 24-32
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- Description: In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses () in ictoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of : (i) the ambiguity of the role; (ii) the weak definition and lack of understanding of the scope of the role by nursing students; and (iii) a lack of communication about as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of ; and (iii) more accurately defining the role of the MHN.
Reviewing tribunal cases and nurse behaviour : Putting empathy back into nurse education with Bloom's taxonomy
- Authors: Doyle, Kerrie , Hungerford, Catherine , Cruickshank, Mary
- Date: 2014
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 34, no. 7 (2014), p. 1069-1073
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- Description: Recent events in the UK and Australia have shown howpoor patient outcomes are achievedwhen the behaviour of nurses lacks empathy. The UK's Francis Inquiry and the Keogh Report both call for an increase in the ‘caring and compassion’ of health careworkers. A reviewof cases presented to the nurses’ disciplinary tribunal in NewSouth Wales' (Australia) also suggests that the majority of complaints against nurses in this jurisdiction is the result of callousness or lack of empathy. Such events reinforce the need for nurse educators to support nursing students to develop the affective attributes of caring and empathy. This paper considers howto raise the awareness of undergraduate students as a first step to developing empathy by using Bloom's Taxonomy of Educational Objectives; and includes a description of how to facilitate interactions with undergraduate nursing students about caring with empathy. Enculturating empathy is an evidence-based method of increasing compassionate care in health organisations generally.
Identifying challenges and barriers in the delivery of primary healthcare at the district level : A study in one Thai province
- Authors: Tejativaddhana, Phudit , Briggs, David , Fraser, John , Minichiello, Victor , Cruickshank, Mary
- Date: 2013
- Type: Text , Journal article
- Relation: International Journal of Health Planning and Management Vol. 28, no. 1 (2013), p. 16-34
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- Description: In 2001, the universal health coverage policy was adopted by Thailand with primary healthcare (PHC) as the major focus of the policy. In order to understand the structural and institutional factors affecting the implementation of PHC in rural Thailand, a qualitative study, utilising individual interviews with national and provincial policy decision makers, community health directors, heads of hospital primary care units, chiefs of district health offices, heads of health centres and community representatives, from one rural province was undertaken. Findings showed that the sustainability of PHC service provision under the administration of community hospitals is problematic as barriers exist at the policy and operational levels and access to PHC for all citizens may not be achieved until these barriers are addressed. Furthermore, although PHC needs to be acknowledged and implemented by all stakeholders within the health industry and government, the roles and responsibilities of the stakeholders in health services management at the district level need to be clarified. Copyright © 2012 John Wiley & Sons, Ltd.