Development of a professional qualification and associated training program in New Zealand

Employers need to understand the level and complexity of the work of occupational health nurses. Nurses need to demonstrate competencies and convince tertiary education bodies to provide post-basic education for them. The New Zealand Occupational Health Nurses Association published standards for occupational health nursing practice based on ILO and primary health care recommendations. The document includes self evaluation to determine the education needs of the occupational health nurses. This led to development of an education program which provides a career pathway with recognition of different levels. In New Zealand, occupational health nurses are well on the way to demonstrating that occupational health nursing services are accessible, acceptable, affordable, and achievable.     

Evaluating a Web-based graduate level nursing ethics course: thumbs up or thumbs down?

BACKGROUND: This article discusses the course design, experiential findings, and evaluation of a Web-based course for graduate nurses examining professional health care practice and ethical issues. METHOD: Using course input and evaluative data, the article addresses student and teacher perceptions of use of a Web-based delivery mode for graduate level courses and the appropriateness of this ethics course for graduate level students. RESULTS: Evaluative data supported existing knowledge concerning pros and cons of Web-based education. New insights concerning the Web's ability to foster critical thinking skills and supports for continuing ethics education for nurses are reported. All students assessed this ethics course as being of considerable value to their professional practice. CONCLUSION: Students evaluated the pros of Web use for the course as far outweighing the cons. The students' substantial interest in and critical thinking about appropriate knowledge bases to underpin effective ethical decision-making strongly supports the need for continuing ethics education for practicing nurses.     

Win-win-win: collaboration advances critical care practice

Against a background of increasing interest in education post registration, New Zealand nurses are working to advance their professional practice. Because the acquisition of highly developed clinical capabilities requires a combination of nursing experience and education, collaboration between clinicians and nurse educators is essential. However, the accessibility of relevant educational opportunities has been an ongoing issue for nurses outside the country's main centres. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) developed between Auckland University of Technology and two regional health providers is one such example. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This paper provides an overview of the structure and pr month, distance education course focused on developing the context of critical care nursing.     

Nursing first year of practice, past, present and future: documenting the journey in New Zealand

Aim  Documenting the journey of graduate nurse support in New Zealand from local programmes to a nationally consistent framework.
Background  Education of nurses in New Zealand has changed over the decades, from apprenticeship-style hospital-based training to academically prepared registered nurses. Newly graduated nurses require time to become confident within the clinical setting. To achieve this, a well-supported graduate nurse programme is required.
Evaluation  The authors utilized historical reviews of nursing education within New Zealand and current work being undertaken by a national working party to implement a nationally consistent graduate nurse programme.
Key issues  Disparity between locally delivered graduate programmes. Lack of funding to provide a well-structured programme and the impact on the recruitment and retention of new nurses.
Conclusions  It was identified that there was a strong need to ensure graduate nurse programmes were consistent across New Zealand in order to support graduate nurses and retain them in the workforce.
Implications for nursing management  The first year of practice remains a challenging transition time with a need for a well-structured and supported programme. Key needs include learning activities grounded in practice experience, robust programme coordination, skilled clinical educators, preceptors, and a structured learning framework.     

Preregistration nursing education in Australia, New Zealand, the United Kingdom, and the United States of America

The debate concerning nurses' diverse entry into practice was enlivened in 1995, when the American Nurses Association reaffirmed its contention that a baccalaureate degree was necessary for professional nursing practice. This debate may be informed by an appreciation of the educational routes taken by other countries that have changed from hospital-based to college-based nursing education. This paper describes and analyzes preregistration nursing education in Australia, New Zealand, the United Kingdom, and the United States, from the late nineteenth century to the present. Nurses in Australia and New Zealand are currently educated entirely at the baccalaureate level. In the United Kingdom, nursing education is in the process of becoming completely university-based, resulting in a diploma or degree. In the United States, the majority of nurses graduate from two-year associate degree programs. This level of education, briefer than in the other countries described, potentially limits nurses' professional contributions.     

Building capacity for nurse‐led research

Aim: To discuss factors that have influenced the development of research capacity among nurses in lower and middle‐income countries (LMICs). Background: Concerned health scientists have addressed the importance of building research capacity among health professionals. Strengthening capacity specifically among LMIC nurses has been infrequently discussed. Without the requisite educational preparation or an enabling environment for research, nurses are unlikely to either demand research capacity‐building opportunities or initiate research examining nursing practice and health system challenges. Methods: A scan was conducted of nine internationally funded research capacity‐building initiatives to identify programme targeting and the proportion of nurse trainees. A literature review examined graduate and post‐graduate training opportunities for LMIC nurses, and barriers and enablers to nurses' involvement in research. Informal consultations were held with nurse leaders in 15 LMICs and leaders of eight LMIC nursing organizations. Findings: The scan found a generic targeting of health professionals with a very low percentage of nurse trainees. Programmes specifically targeting nurses did attract and prepare a significant number of nurses. Factors limiting nurses' involvement in research include hierarchies of power among disciplines, scarce resources, a lack of graduate and post‐graduate education opportunities, few senior mentors, and prolonged underfunding of nursing research. Conclusions: Fully engaging LMIC nurses in health services research may yield pragmatic and evidence‐informed service delivery and policy recommendations. Investments in supports for nursing research capacity may enrich global health policy effectiveness and improve quality of care.     

Critical thinking as an outcome of context-based learning among post RN students: a literature review

Increasingly complex needs and expanding roles in the delivery of health care require professional nurses to be capable critical thinkers and self-directed learners. Problem-based learning (PBL) is promoted as a mean to facilitate critical thinking (CT) in nursing students attending generic and post RN baccalaureate programs. The authors summarize and analyze nursing research and theoretical literature (1992-2005) related to four key topic areas: critical thinking, nursing education, PBL, and post RN education, to determine what is known about the impact of PBL on CT among post RN students. CINAHL, ERIC, Medline and PsychINFO databases were searched and based on the literature retrieved, there is no strong research evidence to suggest changes occur in baccalaureate nursing students' CT during their educational programs, including those using PBL. Similar results were found among post RN students although the literature on this topic is sparse. There is a need for additional research and ongoing development of valid and reliable instruments to measure CT in nurses to guide teaching and learning strategies that effectively facilitate CT among nursing students.     

Advancing health policy in nursing education through service learning

Knowledge of health policy is an increasingly important aspect of nursing practice and education, especially as nurses strive to improve the rapidly changing health care delivery system. At the same time, many educators, researchers, foundations, and government officials are touting the benefits of service learning. In particular, service learning offers ways to enhance partnerships between academia and community agencies and to extend learning beyond the traditional classroom. We present a model for educating nurses as advanced practice nurses in health policy that links service learning with a framework for the political development of nurses. Under the rubric of service learning, the curriculum is based on the overlap among health policy, the role of the nurse as consultant, and community-based care. After discussing the importance of health policy for graduate nursing education and reviewing the essentials of service learning, we describe a three-semester graduate sequence in health policy service learning. The focus is on the clinical and classroom components of both individual and group practica and their relationship to stages of nursing's political development. The article concludes with evaluation considerations and the implications of our work for nursing theory, research, practice, and education.     

Critical care concepts in baccalaureate nursing education

The high response rate of 65.1 percent to this survey suggests nurse educators across the country are interested and involved with the incorporation of critical care concepts in baccalaureate nursing education. Nurse educators are conscientiously working to provide an educational basis for graduate nurses to adequately address the complex healthcare needs of our society. Cooperative efforts between nurse educators and practicing critical care nurses can make a difference in the future delivery of healthcare.     

Development of a postbasic critical care program for registered nurses: a collaborative venture between education and practice

This article describes a collaborative venture between nursing education and nursing practice focused on continuing education. A province-wide assessment of the educational needs of registered nurses identified the need to create a critical care education program. A critical care project team was established to develop a Postbasic Critical Care Program for registered nurses. The development of the project team, initiation of the program, and the mutual benefits and challenges posed by this collaborative venture are presented.     

The professional self-concept of new graduate nurses

The purposes of this study were to: (1) describe the level of professional self-concept among new graduate nurses working in critical care and general medical surgical unit six months after completing a nursing program, (2) examine the professional self-concept in relation to age, marital status, and educational level of new graduate nurses, and (3) examine graduate nurses' perceptions of their nursing educational preparation for their clinical area. One hundred thirty two (n=132) new graduate nurses completed the professional self-concept nurses instrument (PSCNI) and answered two open ended questions focused on their educational preparation. Scores on the PSCNI ranged 58-106 with an overall mean of 83. There was a positive correlation between age and level of professional self-concept. Single factor ANOVA showed no statistical differences between levels of professional self-concept, marital status (p=0.43), and educational level (p=0.09). New graduate nurses identified themes as they assessed their educational preparation for their work experiences.     

The education of advanced practice nurses: a contemporary approach

The Advanced Practice Nursing of Adults and the Elderly graduate program at San Diego State University School of Nursing prepares experienced professional nurses with primary and specialized care (acute or critical care) knowledge and skills to deliver health care to adults and elders across practice settings as nurse practitioners and clinical nurse specialists. Emphasis is placed on health care that is research based and congruent with national standards of practice. This approach to graduate education is congruent with recommendations of professional nursing organizations and responds to the educational needs of professional nurses and the health care needs of adult and elders.     

发展以角色为基础的护理研究生教育

虽然大多数护士在临床一线工作,但卫生事业的发展要求护理专业能具有不同角色的专业人才,如教育者、高级实践者和管理者.护理教育和实践发展的密切结合才可加速护理专业的发展.发展以角色为基础的护理研究生教育可促使护理专业角色的发展.教师需要掌握教育理论和方法以提高教学质量,高级实践护士需要掌握以实证为基础的临床知识和技能来提高护理质量,管理者必须了解如何与大环境协调及卫生保健的重点以确保优质服务.本文的目的是介绍美国以角色为基础的研究生课程设置包括护理教育、高级护理实践和护理管理.     

Educating nurses for the 21st century

The current and projected demand for nurses and nursing services worldwide, coupled with dramatic changes in the delivery of health care, require nurses with more knowledge, more education, and more skills. Issues facing nursing require a reconceptualization of the approach and expectations for nursing practice and for the educational models and processes that lead to reformed nursing practice. New initiatives such as the Clinical Nurse Leader and the Doctor of Nursing Practice may lead the transformational process that is needed.     

Critical care nursing education and practice in Canada and Australia: a comparative review

Critical care nursing is an area of policy concern with respect to staffing projections, skill mix and educational preparation in both Canada and Australia. Despite many similarities between the health systems of these two countries, differences exist in both undergraduate and graduate specialty nursing education. In Australia, specialist education is primarily delivered via the tertiary sector as a formalised qualification, whereas the current Canadian model displays significant variation in duration, content, and mode of delivery. This paper provides a comparative perspective on the educational preparation of critical care nurses in these two countries. Consideration of alternative models of specialty nursing education may provide a method to improve recruitment and retention of staff while maintaining quality of care.     

Nursing workforce,education, and training challenges to implementing extracorporeal membrane oxygenation services in Australian intensive care units: A qualitative substudy

BackgroundThe use of extracorporeal membrane oxygenation (ECMO) is increasing in the management of critical care patients. ECMO service delivery requires an organisation-supported approach to ensure appropriate resources to deliver training, equipment, capacity, staffing, and the required model of care for quality care delivery. The aim of this nested substudy was to explore challenges specific to nursing staff in ECMO services in Australian intensive care units.MethodsThis was a nested substudy within a qualitative study using semistructured focus group discussions conducted with 83 health professionals, which included 40 nurses. There were 14 focus groups across 14 ECMO centres participating in the binational ECMO (EXCEL) registry of Australia and New Zealand. An inductive thematic analysis focused on the nurse's experiences of the barriers and facilitators for nursing in providing an ECMO service.ResultsFour themes emerged relating to the nurse's experience of implementing ECMO services: workforce requirements, workload demands, models of care, and level of experience. The complexity and intensity of caring for ECMO patients may need to be considered an additional factor in the burnout in critical care nurses. Current nursing ratios and responsibilities in critical care need to be considered, with the opportunity for the development of specialist advanced practitioner nursing roles.ConclusionThis study highlights the challenges for nursing in providing ECMO services in the intensive care setting. The complexity and intensity of ECMO is challenging and leads to concerns regarding burnout and workforce preparedness. New models of care need to be considered to mitigate the barriers for nursing identified across ECMO centres.