Are laboratories useful fiction? A comparison of Norwegian and Australian undergraduate nursing skills laboratories
- Authors: Wellard, Sally , Heggen, Kristin
- Date: 2010
- Type: Text , Journal article
- Relation: Nursing & Health Sciences Vol. 12, no. 1 (2010), p. 39-44
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- Description: Drawing on the findings from studies in Australia and Norway that explored the use of laboratories in the preparation of nursing students for entry to practice, this article identifies the pedagogical challenges for the undergraduate education of nurses. The findings from both countries are compared and, in spite of distinct differences in the level of financial investment, there are striking similarities between the ways in which laboratories are used in the two countries. The laboratories were designed to predominately represent acute care hospital environments. The participants demonstrated a high level of commitment and strongly held beliefs in the laboratory as a safe place to facilitate self-paced learning and as an environment where students can practice until they become competent and confident. However, at the same time, there was a striking lack of evidence to support these views. The participants in both countries reported a common approach to instruction: a proce! ss of teacher demonstration, followed by student repetition and practice. Variability in students' motivation also was reported and the participants especially expressed concern for those students with a low level of interest in the basic skills associated with personal care. The possibilities and limitations of using skill laboratories as part of the practical preparation for nursing are discussed, using the metaphor of laboratories as "fiction".
Assessment of learning in contemporary nurse education : Do we need standardised examination for nurse registration?
- Authors: Wellard, Sally , Bethune, Elizabeth , Heggen, Kristin
- Date: 2007
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 27, no. 1 (2007), p. 68-72
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- Description: In Australia and Norway final examinations to determine eligibility for registration as a nurse were discontinued during the period when nurse education moved into the higher education sector. In response to recent calls for the reintroduction of final examinations we explore the range of knowledge needs for the practice of nursing. These various forms of knowledge demand different forms of mediation and acquisition as well as assessment. There are numerous problems identified in the literature about the shortcomings of examinations as the foundation of assessing clinically based professions. There is a need to develop systems of appropriate assessment to ensure that graduates of nursing demonstrate adequate knowledge and competence to enter their profession. © 2006 Elsevier Ltd. All rights reserved.
- Description: C1
- Description: 2003002546
Clinical nursing professoriate : Reflections on Australian experiences
- Authors: Wellard, Sally , Heggen, Kristin
- Date: 2006
- Type: Text , Journal article
- Relation: Norwegian Journal of Nursing Research Vol. 2, no. 8 (2006), p. 13-21
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- Description: Nursing, as a new discipline in the academic world, has to combine scientific traditions with its identity as a clinical profession. Joint clinical professorial appointments have been established in order to combine these two worlds.
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- Description: 2003001976
Constructions of chronic illness
- Authors: Wellard, Sally , Beddoes, Lenore
- Date: 2005
- Type: Text , Book chapter
- Relation: Living with illness : Psychosocial challenges for nursing Chapter 8 p. 97-113
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- Description: 2003001054
Consumer participation in acute care settings : An Australian experience
- Authors: Wellard, Sally , Lillibridge, Jennifer , Beanland, Chris , Lewis, Michele
- Date: 2003
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 9, no. 4 (2003), p. 255-260
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- Description: Consumer partnerships have been embraced as an important component of building high quality health care services. While nurses have the greatest contact with clients in hospital, little is known of their views about consumer participation or how they facilitate that participation at the bedside. Using focus group interviews and participant observation methods, this project explored nurses' approaches to working with consumers to support their participation in health care delivery. Findings indicate a sharp contrast between the ideas that nurses expressed and the actions observed in practice. It was clear from the interviews that nurses had adopted the rhetoric surrounding consumer participation, yet observational data revealed nursing practices that excluded active participation by consumers. Factors influencing nurses' facilitation of consumer participation were identified as the division of nursing labour in the setting, limited communication between nurses and patients and environmental constraints.
- Description: C1
- Description: 2003000409
Development and validation of the human activity profile into Chinese language : Lessons in determining equivalence
- Authors: Bonner, Ann , Wellard, Sally , Kenrick, Marita
- Date: 2006
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 8, no. 1 (2006), p. 36-43
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- Description: The Human Activity Profile (HAP), and associated Dyspnea Scale, is a self-report instrument for assessing levels of human activity. Although it has been used in studies examining the levels of activity in people, it is limited to people who are only able to understand English. However, many countries are multicultural with significant numbers of people whose native language is not English. This study sought to demonstrate the equivalence between the Chinese and English versions of the HAP and Dyspnea scales.Thirty-five bilingual university students completed both the Chinese and English versions of each questionnaire. There was 89% and 85% agreement between items across the HAP and Dyspnea Scale questionnaires, respectively. Although the psychometric evaluations suggested there was equivalence between the Chinese and English versions of both the HAP and Dyspnea Scale, lessons have been learnt regarding the different written forms of Chinese. © 2006 The Authors Journal Compilation © 2006 Blackwell Publishing Asia Pty Ltd.
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- Description: 2003001972
Discursive influences on clinical teaching in Australian undergraduate nursing programs
- Authors: McKenna, Lisa , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 24, no. 3 (2004), p. 229-235
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- Description: Clinical teaching is a vital, yet multidimensional component of Australian undergraduate nursing courses. Unlike other parts of curricula, clinical teaching relies on the both higher education and health care sectors to meet prescribed goals and for effective student learning to occur. As such it is influenced by discourses from within both education and health. Whilst there is considerable literature related to undergraduate nursing clinical teaching; it mainly deals with practical aspects such as effectiveness of clinical teaching or discussions of models employed. Only a small pool of literature exists that discusses the construction of clinical teaching including the factors that have influenced the development of practices both in the past and present. Using the work of Foucault, this paper examines dominant and competing discourses influencing clinical teaching through their constructions within the literature. These are discourses of academia, nursing, and economics. The discussion situates these discourses and discusses how some of the resultant issues surrounding clinical education remain largely unresolved. Crown Copyright © 2004 Published by Elsevier Ltd. All rights reserved.
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- Description: 2003000838
Editorial: Challenges for health professionals in working with consumers in partnership
- Authors: Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 16, no. 11C (2007), p. 245-246
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- Description: C1
- Description: 2003002996
Evidence-based practice, risk and reconstructions of responsibility in nursing
- Authors: Heggen, Kristin , Wellard, Sally
- Date: 2011
- Type: Text , Book chapter
- Relation: Professional responsibility new horizons of praxis p. 144-158
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- Description: "Professional Responsibility: New Horizons of Praxis addresses the manifold and complex challenges inherent in professional responsibility. Since the beginning of the 20th Century, professions have been accorded a conjoined mandate - political and moral responsibility - to serve the interests of individual's and society. The quality of professional work, how professionals understand and live out their responsibilities in practice, is a matter of pervasive concern since increasingly they have such a prominent presence in most people's lives. Until the late 1960's, professionals' roles and responsibilities were rarely questioned, but such trust has since given way to collective scepticism concerning their commitment and willingness to live up to their moral and societal obligations. Abuse of power and privilege by some professionals has contributed to decline in trust by publics, the concept of 'good work' is increasingly challenged, and politicians and policy-makers have sought to regulate and hold professions to account. It is timely, therefore, to investigate critically conflicting discourses and practices on what counts as professional responsibility, to question how professionals understand and are prepared for a life of professional responsibility, and what acting with integrity and authority looks like in practice. One of the distinctive features of this book is the combination of normative and empirical dimensions that are used to dissect this question. The authors indicate from a diversity of disciplinary perspectives how professional responsibility includes particular thoughts and warranted actions yet remains multifaceted and inarticulate"-- Provided by publisher.
- Description: 2003009457
Exploring staff diabetes medication knowledge and practices in regional residential care : Triangulation study
- Authors: Wellard, Sally , Rasmussen, Bodil , Savage, Sally , Dunning, Trisha
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1933-1940
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- Description: Aims and objectives: This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. Background: With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. Design: A triangulation strategy consisting of three phases. Methods: A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Findings: Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. Conclusions: The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Relevance to clinical practice: Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice. © 2013 John Wiley & Sons Ltd.
- Description: 2003011093
Exploring the use of clinical laboratories in undergraduate nursing programs in regional Australia
- Authors: Wellard, Sally , Woolf, Rhonda , Gleeson, Lynne
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Education Scholarship Vol. 4, no. 1 (2007), p.
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- Description: Preparation for clinical practice is arguably a vital component of undergraduate nursing education with clinical laboratories widely adopted as a strategy to support student development of clinical skills. However, there is little empirical evidence about the role laboratories play in students' learning or how they assist in linking theory to practice. This study aimed to explore the current clinical laboratory practices in Schools of Nursing in regional Victoria, Australia through site visits, interviews and review of curricula. Findings revealed that approaches to laboratory learning are based on traditions rather than evidence, and have evolved in response to fiscal and environmental challenges. The predominance of teacher talk in the laboratory, has lead to acute care over other areas of practice. This study indicates a need for rigorous investigation of pedagogies that can support nursing students in preparation for clinical practice. It remains unclear if laboratory learning experiences assist students in the translation of theoretical knowledge to practice. Copyright ©2007 The Berkeley Electronic Press. All rights reserved.
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- Description: 2003005867
Framework of intent for selecting research approaches in nursing
- Authors: Wellard, Sally , Ordin, Yaprak
- Date: 2011
- Type: Text , Journal article
- Relation: Deuhyo Edergi Vol. 4, no. 4 (2011), p. 189-195
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- Description: Research in nursing is growing rapidly, and there is increased use of qualitative and mixed methods approaches to investigations. However, frequently researchers’ adopt a research approach with little understanding of the philosophical assumptions underpinning their choice. Using a framework of research intent, this paper aims to identify the different philosophical assumptions associated with different research intents and therefore provide a foundation for more informed decision making in selection of methodologies.
- Description: 2003009387
Globalisation of chronic illness research
- Authors: Wellard, Sally
- Date: 2010
- Type: Text , Book chapter
- Relation: Translating chronic illness research into practice Chapter 1 p. 1-16
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- Description: 2003008029
Hearing what older consumers say about participation in their care
- Authors: Penney, Wendy , Wellard, Sally
- Date: 2007
- Type: Text , Journal article
- Relation: International Journal of Nursing Practice Vol. 13, no. (2007), p. 61-68
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- Description: A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.
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- Description: 2003002538
Increased unintended patient harm in nursing practise as a consequence of the dominance of economic discourses
- Authors: Heggen, Kristin , Wellard, Sally
- Date: 2004
- Type: Text , Journal article
- Relation: International Journal of Nursing Studies Vol. 41, no. 3 (2004), p. 293-298
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- Description: Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
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- Description: 2003000837
Integrating renal and palliative care project : A nurse-led initiative
- Authors: Smith, Vicky , Potts, Carita , Wellard, Sally , Penney, Wendy
- Date: 2015
- Type: Text , Journal article
- Relation: Renal Society of Australasia Journal Vol. 11, no. 1 (2015), p. 35-40
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- Description: Renal nurses working in dialysis settings in Australian regional and rural locations face challenges in facilitating advance care planning (ACP) and providing quality physical and psychological symptom care at the end of life (EOL) for a growing population of older and sicker people with end-stage kidney disease (ESKD). Following concerns raised by patients, families, renal and palliative care nurses early in 2009 in one regional setting, gaps in service delivery were identified. These identified gaps were supported by an emerging literature that identified the need for integrated, palliative, supportive care earlier in the disease trajectory. This care, provided on a needs basis, incorporates ACP, and identifies and addresses complex symptom and psychological issues to improve quality of life (QOL) and planning EOL care for patients and their families/carers. This approach to care, now called renal supportive care, is in varying stages of implementation across Australia for all renal patients, predominantly in metropolitan centres. With limited financial resources, a successful multi-professional collaboration and coordinated approach was established in January 2009 in Ballarat, a large regional setting in Victoria. An implementation framework was developed, addressing the continuum of care from pre-dialysis to withdrawal/cessation from renal replacement therapy (RRT), with an integrated palliative supportive approach during active treatment or EOL care. This project has provided a step forward in improving confidence and responsibility for palliative care by renal nurses working in dialysis settings, helping them to address the challenges faced in evaluating symptom burden, facilitating ACP and delivery of quality EOL care for patients, their families and carers with ESKD.
Investigation of adaptation after liver transplantation using Roy's Adaptation Model
- Authors: Ordin, Yaprak , Karayurt, Özgül , Wellard, Sally
- Date: 2013
- Type: Text , Journal article
- Relation: Nursing and Health Sciences Vol. 15, no. 1 (2013), p. 31-38
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- Description: In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients. © 2012 Wiley Publishing Asia Pty Ltd.
- Description: 2003010860
Issues in the provision of nursing care to people undergoing cardiac surgery who also have type 2 diabetes
- Authors: Wellard, Sally , Cox, Helen , Bhujoharry, Claire
- Date: 2007
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. 13, no. 4 (2007), p. 222-228
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- Description: There has been little investigation of the issues associated with caring for patients presenting for cardiac surgery with a comorbid diagnosis of diabetes although there is some evidence that the diabetes management is suboptimal. This study aimed to identify issues that patients and cardiac specialist nurses experience with the provision of inpatient services for people undergoing cardiac surgery who also have type 2 diabetes. A qualitative interpretive design, using individual interviews with patients and nurses, provided data about some of these issues. The study found that nurses had high levels of confidence in their cardiac care but little confidence in diabetes management. Patients described concerns about their diabetes care and treatment regimens. A 'typical journey' for a person with diabetes undergoing cardiac surgery was identified. The findings support the need to build increased capacity in specialist nurses to support diabetes care as a secondary diagnosis.
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- Description: 2003005865
Juggling type 1 diabetes and pregnancy in rural Australia
- Authors: King, Rosemary , Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: Midwifery Vol. 25, no. 2 (2009), p. 126-133
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- Description: Objective: to explore the experiences of women with type 1 diabetes, living in rural Australia, while preparing for pregnancy and childbirth. Additionally, we aimed to describe the women's engagement with, and expectations of, health-care providers during this period, and subsequently highlight potential service and informational gaps. Design: qualitative research using a collective case-study design; seven women with type 1 diabetes who had given birth within the previous 12 months participated in in-depth interviews about their experiences of pregnancy and birth. Data were analysed thematically. Setting: The experience of type 1 diabetes, preconception preparation and pregnancy among rural Australian women was explored, including interactions with health professionals. Participants: seven women aged between 26 and 35 years agreed to be interviewed. The woman had one or two children and had given birth within the past 12 months. Findings: rigid narrow control of blood glucose levels before conception and during pregnancy created unfamiliar body responses for women, with hypoglycaemic symptoms disappearing or changing. For example, some women mentioned developing tunnel vision or numbness and tingling around their lips and tongue as different symptoms of hypoglycaemia. Women needed information and support to differentiate between what might be normal or abnormal bodily processes associated with pregnancy, diabetes, or both. The women's preparation for conception and pregnancy was reliant on the level of available expertise and advice. Participants' experiences were coloured by their limited access and interactions with expert health professionals. Conclusion: women with type 1 diabetes experienced significant hardship during their pregnancy, including a higher incidence of hypoglycaemic episodes, a loss of hypoglycaemic symptom recognition and weight gain. These difficulties were compounded by a scarcity of available information to support the management of their pregnancy and a lack of availability of experienced health professionals. Implications for practice: national and international consensus guidelines emphasise the importance of preconception and pregnancy care for women with type 1 diabetes. Close clinical supervision and the development of closer co-operation and partnership between the women and health-care providers before conception and during pregnancy may improve outcomes for these women and their babies. Building confidence in professional care requires increased access to specialist services, increased levels of demonstrated knowledge and expertise and better general community access to information about preparation for pregnancy and birth among women who have type 1 diabetes. © 2007 Elsevier Ltd. All rights reserved.
Levels of fatigue in people with ESRD living in far North Queensland
- Authors: Bonner, Ann , Wellard, Sally , Caltabiano, Marie
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 17, no. 1 (Jan 2008), p. 90-98
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- Description: Aims. Levels of fatigue as experienced by people with end stage renal disease (ESRD), were assessed using the Fatigue Severity Scale (FSS). Background. Fatigue, a common symptom reported by people with ESRD, is a multifaceted, subjective experience, which is readily understood by individuals but difficult to measure. There is limited understanding of the level of fatigue experienced by people with ESRD, with research currently limited to people treated with haemodialysis. Method. The FSS was completed by 92 people with ESRD who were patients of a renal service in far North Queensland, Australia. Demographic and renal health history data were also collected with the self-report survey. Results. Comparisons were preformed between overall fatigue levels and different renal disorders, genders, ethnicity and renal replacement therapy (RRT). Participants in this study were more fatigued than the general population; there was no difference in levels of fatigue between gender and ethnicity. Participants with diabetic nephropathy and those who were predialysis were the most fatigued. A significant difference between mean fatigue scores was found for type of RRT [F(3,88) = 2.4, p < 0.05], with participants using peritoneal dialysis reporting the most fatigue. Additionally, participants categorized according to type of RRT, erythropoietin replacement therapy and current haemoglobin levels revealed significant mean differences on fatigue levels [F(3,88) = 2.74, p < 0.05]. Relevance to clinical practice. People with ESRD experience considerable fatigue; it is particularly important for nurses to understand this level of fatigue impacts on the daily life of patients. These findings provide the preliminary evidence to support the development of renal nursing practice guidelines related to symptom recognition and management of fatigue.
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