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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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More than 500 New Zealand nurses served overseas in World War 1. At the end of the war, nearly a quarter of the country’s nursing workforce was still overseas. Most nurses served with the New Zealand Army Nursing Service (NZANS) but, in the early months of the war, before the NZANS had been sufficiently organised to send nurses, some joined the Australian service. Others went independently to Britain or were already there and joined services such as the Queen Alexandra’s Royal Army Nursing Corps (QAs), the French Flag Corps and Red Cross, or worked in British military hospitals or hospitals in France run by wealthy British women.
Description:
Caring for patients with a diagnosis of Borderline Personality Disorder (BPD) has been identified as a problem area for mental health professionals with some studies suggesting that a diagnosis of BPD will influence the level and quality of interaction staff have with patients. It is inherent to psychiatric nursing that practitioners are able to establish rapport, develop trust and demonstrate empathy with consumers of mental health services. Despite the importance of this issue for psychiatric nurses and for consumers, the perceptions and attitudes of psychiatric nurses towards patients diagnosed with BPD have received almost no research attention. This paper describes findings from a study of attitudes held by 65 registered nurses employed in a psychiatric inpatient unit and psychiatric community service where individuals with a DSM-IV diagnosis of BPD received treatment. In particular, findings relating to Clinical Description, Emotional Reactions, Concerns and Management of patients with BPD are reported. Results show that a proportion of psychiatric nurses experience negative emotional reactions and attitudes toward people with BPD with the majority of nurses perceiving people with BPD as manipulative, almost one third reporting that patients with BPD made them angry and over one third either 'strongly disagreed' or 'disagreed' that they know how to care for people with BPD. Although psychiatric nurses face many challenges in providing care for patients with BPD, it is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them. Further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD.
Description:
Caring for patients with a diagnosis of Borderline Personality Disorder (BPD) has been identified as a problem area for mental health professionals with some studies suggesting that a diagnosis of BPD will influence the level and quality of interaction staff have with patients. It is inherent to psychiatric nursing that practitioners are able to establish rapport, develop trust and demonstrate empathy with consumers of mental health services. Despite the importance of this issue for psychiatric nurses and for consumers, the perceptions and attitudes of psychiatric nurses towards patients diagnosed with BPD have received almost no research attention. This paper describes findings from a study of attitudes held by 65 registered nurses employed in a psychiatric inpatient unit and psychiatric community service where individuals with a DSM-IV diagnosis of BPD received treatment. In particular, findings relating to Clinical Description, Emotional Reactions, Concerns and Management of patients with BPD are reported. Results show that a proportion of psychiatric nurses experience negative emotional reactions and attitudes toward people with BPD with the majority of nurses perceiving people with BPD as manipulative, almost one third reporting that patients with BPD made them angry and over one third either 'strongly disagreed' or 'disagreed' that they know how to care for people with BPD. Although psychiatric nurses face many challenges in providing care for patients with BPD, it is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them. Further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD.
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As many students begin to undertake their third year of study, the prospect of registration becomes imminent. Most students will be wondering how they will cope when they don their staff nurse uniforms for the first time.
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AIMS: To investigate job satisfaction and confidence levels of graduate nurses during their first year of employment and the impact various training programmes have on these factors. BACKGROUND: The transition from nursing student to practising nurse can be a challenging and stressful time for new nurses. Healthcare organizations provide transition programmes to support nurses through this vulnerable time and to assist in increasing graduates' job satisfaction and retention rates. However, no systematic review of transition programme outcomes has been undertaken to determine the impact of these programmes on improving satisfaction levels and on easing the challenges faced by nursing graduates in their new roles as Registered Nurses. DESIGN: Systematic review of effect using narrative synthesis. DATA SOURCES: Quantitative studies published between 2000-December 2012 were identified using electronic databases and reference lists and by searching 'grey literature'. Primary search terms were 'new graduate nurse' and 'transitional programmes'. REVIEW METHODS: The three authors, guided by standardized procedures, performed independent, blinded data extraction and quality assessment. RESULTS: From 338 studies initially identified, eleven studies were included in this review. These studies used a variety of study designs including quasi-experimental and pre- and posttesting. CONCLUSION: Evidence suggests that transition programmes are necessary in creating working environments that support new nurses in the clinical environment and this is demonstrated by increased job satisfaction and retention rates. However, optimum programme length and structure are unclear.
Description:
Objective This integrative review identified, critically appraised and synthesised the existing evidence on the barriers and enablers to using high-fidelity Human Patient Simulator Manikins (HPSMs) in undergraduate nursing education. Background In nursing education, specifically at the undergraduate level, a range of low to high-fidelity simulations have been used as teaching aids. However, nursing educators encounter challenges when introducing new teaching methods or technology, despite the prevalence of high-fidelity HPSMs in nursing education. Design An integrative review adapted a systematic approach Data source Medline, CINAHL plus, ERIC, PsychINFO, EMBASE, SCOPUS, Science Direct, Cochrane database, Joanna Brigge Institute, ProQuest, California Simulation Alliance, Simulation Innovative Recourses Center and the search engine Google Scholar. Keywords were selected and specific inclusion/exclusion criteria applied. Inclusion criteria The review included all research designs for papers published between 2000 and 2015 that identified the barriers and enablers to using high-fidelity HPSMs in undergraduate nursing education. Review methods Studies were appraised using the Critical Appraisal Skills Programme criteria. Thematic analysis was undertaken and emergent themes were extracted. Results Twenty-one studies were included in the review. These studies adopted quasi-experimental, prospective non-experimental and descriptive designs. Ten barriers were identified, including ‘lack of time’, ‘fear of technology’ and ‘workload issues’. Seven enablers were identified, including ‘faculty training’, ‘administrative support’ and a ‘dedicated simulation coordinator’. Conclusion Barriers to simulation relate specifically to the complex technologies inherent in high-fidelity HPSMs approaches. Strategic approaches that support up-skilling and provide dedicated technological support may overcome these barriers.
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The article reports on research which was conducted through RMIT University, or the Royal Melbourne Institute of Technology, in an effort to investigate the factors which influence Taiwanese women’s decision to have children. A discussion of a decline in childbirth which has been seen in Taiwan, and of incentives and policies which the Taiwanese government has established to encourage Taiwanese women to have children, is presented.
Description:
The article reports on research which was conducted through RMIT University, or the Royal Melbourne Institute of Technology, in an effort to investigate the factors which influence Taiwanese women’s decision to have children. A discussion of a decline in childbirth which has been seen in Taiwan, and of incentives and policies which the Taiwanese government has established to encourage Taiwanese women to have children, is presented
Description:
Background: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. Objectives: To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. Design: The educational process of FIRST2ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Settings: Clinical laboratories at each of three participating universities. Participants: Ninety-seven nursing students from three Australian universities. Methods: Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Results and Conclusions: Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%).Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.
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Nursing practice underpinned by humanistic values may promote presence experiences within nurse-patient interactions. These interactions are powerful and beneficial both to nurse and patient. However, the phenomenon of presence is surrounded by competing and confused definitions. Whilst presence is arguably a core aspect of nursing practice, current health care environments significantly influence nurses' opportunities to experience presence.
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Objective: To quantify the relationship between examiners’ global rating and checklist scores and to identify the factors influencing examiners’ decisions in Masters Level Objective Structured Clinical Examinations (OSCEs). Methods: A quantitative and qualitative focus group design; including a retrospective review of OSCE results (n = 561) and four focus groups with experienced clinical examiners. Results: There was a strong positive correlation (rho 0.75) between global ratings and checklist scores. However, borderline checklist scores tended to be higher than the global rating category and more experienced examiners tended to allocate lower global ratings (p = ≤0.001). Data obtained from the focus groups helped elucidate the reasons for these findings and suggested that examiners may utilize Recognition Primed Decision Making (RPD) as a method of assessing a candidates overall performance during OSCE. Conclusion: Global rating scales are an appropriate assessment scale and improve the validity and reliability of OSCEs in this setting. Methods for incorporating these findings into future OSCE marking criteria are discussed.
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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.
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Background: Collaboration between education providers and clinical agencies to develop models that facilitate cross-disciplinary clinical education for students is essential to produce work-ready graduates. Methods and Findings: This exploratory study investigated the perceptions of and opportunities for interprofessional education (IPE) from the perspectives of 57 clinical staff from three regional/rural health services across Victoria, Australia. Data were collected through a semi-structured questionnaire, interviews, and focus group discussions with staff from 15 disciplinary groups who were responsible for clinical education. Although different views emerged on what IPE entailed, it was perceived by most clinicians to be valuable for students in enhancing teamwork, improving the understanding of roles and functions of team members, and facilitating common goals for patient care. While benefits of IPE could be articulated by clinicians, student engagement with IPE in clinical areas appeared to be limited, largely ad hoc, and opportunistic. Barriers to IPE included: timing of students’ placements, planning and coordination of activities, resource availability, and current regulatory and education provider requirements. Conclusions: Without the necessary resources and careful planning and coordination, the integration of IPE as a part of students’ clinical placement experience will remain a largely untapped resource.
Description:
Background: Collaboration between education providers and clinical agencies to develop models that facilitate cross-disciplinary clinical education for students is essential to produce work-ready graduates. Methods and Findings: This exploratory study investigated the perceptions of and opportunities for interprofessional education (IPE) from the perspectives of 57 clinical staff from three regional/rural health services across Victoria, Australia. Data were collected through a semi-structured questionnaire, interviews, and focus group discussions with staff from 15 disciplinary groups who were responsible for clinical education. Although different views emerged on what IPE entailed, it was perceived by most clinicians to be valuable for students in enhancing teamwork, improving the understanding of roles and functions of team members, and facilitating common goals for patient care. While benefits of IPE could be articulated by clinicians, student engagement with IPE in clinical areas appeared to be limited, largely ad hoc, and opportunistic. Barriers to IPE included: timing of students’ placements, planning and coordination of activities, resource availability, and current regulatory and education provider requirements. Conclusions: Without the necessary resources and careful planning and coordination, the integration of IPE as a part of students’ clinical placement experience will remain a largely untapped resource.
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Delayed assessment and mismanagement of patient deterioration is a substantial problem for which educational preparation can have an impact. This paper describes the development of the FIRST2ACT simulation model based on well-established theory and contemporary empirical evidence. The model combines evidence-based elements of assessment, simulation, self-review and expert feedback, and has been tested in undergraduate nurses, student midwives and post-registration nurses. Participant evaluations indicated a high degree of satisfaction and substantial self-rated increases in knowledge, confidence and competence. This evidence-based model should be considered for both undergraduate and post-registration education programs.
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An Australian Institute of Criminology report (1999) highlighted the health industry as the most violent industry in Australia with registered nurses recording the second highest number of violence. related workers compensation claims, ranking higher than prison and police officers. Workplace violence has become such a common phenomenon that many nurses accept it as a part of nursing. Nurses employed in emergency departments (EDs) are considered to be especially vulnerable to workplace violence. Although there have been a number of studies reporting on the incidence of workplace violence and its consequences upon nurses, to date there have been no empirical studies that have evaluated interventions which are thought to reduce its occurrence and impact. This study investigated the effectiveness of a oneday training program in which ED nurses participated. In particular, their knowledge, skiUs and attitudes relating to management of workplace violence were examined. Results show that a training program has many positive outcomes which enhance nurses' ability to manage aggressive behaviours. With some basic training, ED nurses can be more prepared to manage violent and potentially violent situations, and by doing so may in fact reduce the incidence of aggression in their workplace by 50%. This has largely been achieved by raising the awareness of ED nurses to the nature of the problem, developing their knowledge and skills in managing aggressive behaviour, and improving their attitudes toward potentially violent patients.