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
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.
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.
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.
Experiences of families who help young rural men with emergent mental health problems in a rural community in New South Wales, Australia
- Authors: Wilson, Rhonda , Cruickshank, Mary , Lea, Jackie
- Date: 2012
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 42, no. 2 (2012), p. 167-177
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- Description: A qualitative study was conducted in rural New South Wales, Australia, to understand the barriers to helpseeking among young rural men with emergent mental health problems. Participants who had real life experiences of these problems within their families were interviewed. Themes emerged from the data which explained some barriers to early intervention. Despite these barriers, families had developed skills in helping and in providing early mental health help to their sons. The findings of this study showed that a substantial burden on the emotional and social integrity of the family, combined with diminished psychological well-being, caused some parents to question how long they could cope before they reached ‘the end of their strings’. This downward spiralling trajectory of mental health and well-being for both the young men and their families has implications for clinical practice. Current models of mental health service delivery do not adequately capture the early help-seeking dynamics of young rural men and their families. A more flexible approach is needed to identify and help the family and the young men, without the pre-requisite for a formal medical diagnosis. Future research should involve health and well-being solution focused service delivery. Language
Stereotyping stigma: undergraduate health students' perceptions at handover
- Authors: Doyle, Kerrie , Cruickshank, Mary
- Date: 2012
- Type: Text , Journal article
- Relation: The Journal of nursing education Vol. 51, no. 5 (2012), p. 255-261
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- Description: The World Health Organization (WHO) has recognized that errors in communication are one of the leading causes of adverse patient outcomes. Consequently, the WHO developed the High 5s Project to review, among other variables, handover of patients between shifts, professionals, and organizations. Seven countries were involved in the initial project. Australia responded by using the ISOBAR (Identify, Situation, Observations, Background, Agreed plan, and Read-back) tool as a template. However, none of the countries involved considered the social and emotional effects of handover on the staff or patients, although research has demonstrated that attitudes and values can be handed over from one nurse to another during this process. This article shows how the nurse who hands over care from one shift to the next can transfer stigma and labeling and offers suggestions for nurse educators and clinicians to apply national standards and core values to clinical practice and education.
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.
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.
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.