A comparative study of the course-related family and financial problems of mature nursing students in Scotland and Australia

This study reports a comparative survey of mature students undertaking pre-registration undergraduate nursing education in Australia and Scotland. The study aimed to explore comparisons between the course-related and course-related financial difficulties faced by mature students in two very different educational and funding systems. Financial stress is a predictor of both physical and mental health problems. A similar pattern of course-related problems were reported by both Australian and Scottish students with the exception that Scottish students experienced more problems with childcare and caring for elderly relatives. Course-related problems may be inherent in the nature of undergraduate nursing education although the relatively time-intensive nature of Scottish curricula may explain the childcare and elderly relatives difference. Scottish students reported higher overall financial-related problems but Australian students reported more problems with funding placements. These findings have implications for both curriculum designers and policy makers.     

Changes in nurse education and the facilitation of nursing research: an exploratory study

This study is concerned with exploring nurses' attitudes and knowledge of nursing research, together with their perception of research priorities. A sample was drawn from five nursing groups, these being Assistant Directors of Nursing Services (ADNS), Ward Sisters, Student Nurses undertaking a conventional educational programme, students undertaking the Diploma in Professional Studies in Nursing Course (DPSN) and student nurses undertaking an ENB pilot scheme in general nursing. Whilst the results suggest that all groups held favourable attitudes towards nursing research, significant differences emerged with respect to knowledge of such research and perception of research priorities. Of particular interest are the differences observed in comparing the nursing groups who have had experience of higher education with those who have not. The former generally had more positive attitudes, a better knowledge base and clearer priorities for nursing research. Given that many countries now provide nurse education in such centres and that nurse education in the United Kingdom is steadily moving in this direction, the results are important in suggesting some of the benefits which can accrue from collaboration between schools of nursing and centres of higher education.     

Critical care education: an examination of students' perspectives

Specialist nursing education at the tertiary level is a relatively recent occurrence in Australia. With this move to higher education a variety of issues such as course duration, award level and clinical versus theoretical outcomes provided the impetus for this study. This study examined critical care nursing students' perceptions of undertaking post-graduate education within the higher education sector. Four themes arose from analysis of eight focus group interviews with a total of 42 students from 35 courses offered in eight universities across Australia. The first theme, student burden, included subthemes of financial, heavy workload and student-work conflicts. Student benefits, the second theme, encompassed financial and other benefits. The third theme, clinical experience, incorporated clinical capability, synthesizing, support required and clinical learning. The final theme of student attitude included the subthemes of individual, technology and course. Without student evaluations, curricular improvements including assessment and clinical experience will not evolve to the best of their potential.     

Taking on the student role: how can we improve the experience of registered nurses returning to study?

Regardless of the number of nurses who undertake graduate certificate courses in critical care nursing in Victoria, Australia, there is still a shortage of skilled nurses in the critical care areas.Preparation for practice in this specialist field has moved from hospital-based programs to tertiary-based courses during the past decade. As a consequence, there has been scrutiny of the clinical ability of graduates to perform the role function. Although this is understandable, anecdotal evidence to date indicates that students in these courses experience many difficulties, yet very little is written about the stressors they encounter. As the future of the critical care work force depends on a constant supply of students undertaking courses, it is essential to gain insight into the student experience, with a view to optimising it for future students and perhaps preventing attrition from courses.This paper describes a qualitative research study involving 14 students undertaking a graduate certificate course in critical care nursing. The aim of the study was to document the students’ experience in relation to factors they identified as helping or hindering their progress on the course. Data were obtained at three points during the academic component of the course: on entry, at the end of semester 1 and at the end of semester 2. Interviews and questionnaires were used as the data collection methods.Results indicate that for this group of students, the experience of undertaking the course was adversely affected by stress related to three factors: change of role from clinician back to student; unmet expectations, and exhaustion. Recommendations related to preparation for study, curriculum timelines and peer support are included in this paper.     

Nursing students assess nursing education.

This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.     

Australian evidence for interprofessional education contributing to effective teamwork preparation and interest in rural practice

A pilot interprofessional education (IPE) placement for undergraduate health care professional students was undertaken in rural Victoria, Australia from 2001 to 2003. Medical, nursing, physiotherapy and pharmacy students were involved, and the project is ongoing. This paper briefly outlines the educational model, then focuses on the evaluation methods and results obtained from student evaluations. The placement experience improved self-reported teamwork skills and knowledge, and supported participating students' belief in the value of interprofessional practice. Placements strengthened nursing and allied health students' intention to work in rural health settings after graduation. The rural interprofessional educational experience improved interprofessional abilities in a group of students who have the potential to influence change towards collaborative practices in their future workplaces. The results obtained provide sufficiently strong evidence to justify the continuation and expansion of this educational model in the Australian setting. Pedagogical and evaluation modifications are discussed that may benefit future IPE programs.     

Managing change in nurse education: the introduction of Project 2000 in the community

The United Kingdom Central Council's proposals for nurse education (Project 2000: A New Preparation for Practice) were implemented in 13 demonstration districts in England in 1989. In 1991, as part of an English National Board-funded research study, the author conducted 15 interviews with first line managers from three of these demonstration districts. The data were reinterpreted in 1995; the experience of implementing educational change in the community setting was discovered to be a complex and difficult process for the managers involved. They found themselves confronted with sometimes conflicting responsibilities; their perception of their role encompassed the meeting of a range of needs, which are presented in this paper within three categories. Firstly, the managers felt they had an obligation to meet the needs of students and of education in general in order both to provide an adequate experience for each individual student and to safeguard standards in community nursing in the long term. Secondly, they were confronted with the need to mitigate the pressures Project 2000 placed on'their'staff. The new educational programme meant that community nurses spent much more time with students than formerly, and the difficulties they encountered were exacerbated by uncertainty about their role with these students. Finally, and most importantly, managers were responsible for ensuring that clients'needs were met. In particular, they saw it as their role to ensure that the presence of large numbers of students in the community for long periods of time did not compromise standards in the delivery of community nursing services.     

Shared teaching in health care ethics: a report on the beginning of an idea

In the majority of academic institutions nursing and medical students receive a traditional education, the content of which tends to be specific to their future roles as health care professionals. In essence, each curriculum design is independent of each course. Over the last decade, however, interest has been accumulating in relation to interprofessional and multi-professional learning at student level. With the view that learning together during their student training would not only encourage and strengthen future collaboration in practice settings but also enhance patient care, the University of Dundee decided to run a pilot study to explore shared teaching in ethics between medical and nursing students. This article presents a report on the reasons for selecting health care ethics as a precursor for shared teaching, the educational tool used for the sessions, and the results of student and facilitator evaluation of the short course. Overall, despite problems such as poor attendance by some students, and facilitation and timetable difficulties, most of the feedback from students and facilitators has been positive. In essence the 'idea' has gone from strength to strength and there are now three levels of shared teaching in ethics between nursing and medical students, with plans to include further sessions with students from other disciplines. Within the text, 'health care ethics' will be referred to as 'ethics'; nursing students/nurses encompasses midwifery students/midwives.     

Nursing student attrition and implications for pre-admission advisement

The current shortage of nurses and the decreasing student applicant pool supports the need for institutions of higher education to examine the problem of nursing student attrition and possible solutions. This study surveyed 227 non-returning students to identify attrition factors. The results implicate problems with class scheduling, inadequate financial resources, and employment responsibilities. Twenty four nursing faculty members were additionally surveyed to identify factors. The faculty respondents target poor study skills as the primary problem, a finding not agreed on by the former students. These identified problem areas implicate inadequate preadmission advisement. Students should be made aware of the personal and financial costs of a nursing education prior to admission. Preadmission advising that provides an applicant with a more complete understanding of the nursing educational process may help prevent student attrition and the loss of new nurses to the profession.     

Australian evidence for interprofessional education contributing to effective teamwork preparation and interest in rural practice

A pilot interprofessional education (IPE) placement for undergraduate health care professional students was undertaken in rural Victoria, Australia from 2001 to 2003. Medical, nursing, physiotherapy and pharmacy students were involved, and the project is ongoing. This paper briefly outlines the educational model, then focuses on the evaluation methods and results obtained from student evaluations. The placement experience improved self-reported teamwork skills and knowledge, and supported participating students' belief in the value of interprofessional practice. Placements strengthened nursing and allied health students' intention to work in rural health settings after graduation. The rural interprofessional educational experience improved interprofessional abilities in a group of students who have the potential to influence change towards collaborative practices in their future workplaces. The results obtained provide sufficiently strong evidence to justify the continuation and expansion of this educational model in the Australian setting. Pedagogical and evaluation modifications are discussed that may benefit future IPE programs.     

Work-related stress and intention to quit in newly graduated nurses

Hospitals are fast paced health care environments that currently staff with Registered Nurse (RN) workforce comprised of more than 10% new graduate nurses. Past research has indicated that newly graduated nurses encounter stressful challenges transitioning from student (graduate) to the professional RN in the workforce. This issue must be given unabated priority, because loss of the new graduate has financial and patient safety implications. The purpose of this research study was to investigate work-related stress among recent nursing graduates and identify factors that influence their stress levels, as well as their intention to resign from their employment. Potential factors include gender, program type, work unit and duration, graduation time, and orientation. The study results indicate that junior RNs and BSN graduates are more likely to experience stress. Of all the stressors identified, equipment issues was the only factor that correlated both statistically and significantly to the participants' intention to quit. By investigating specific work-related stressors and coping strategies that these newly graduated nurses experience, this research may provide important information to better prepare and support future nursing students successfully transitioned to practice.     

Using International Videoconferencing to Extend the Global Reach of Community Health Nursing Education

Travel abroad provides college students with a unique learning experience. When plans to take undergraduate community health nursing students from the United States to Haiti were cancelled due to health and safety concerns, faculty piloted international videoconferencing with a nursing program in Haiti as an alternative. During this semester‐long course, students in both countries assessed a local community using the Community as Partner framework and compared findings during videoconferences with their international peers. Despite communication challenges such as language barriers and limited internet access in Haiti, evaluative data suggests that all students valued learning with their nursing student peers in another country. For future international videoconferencing endeavors, especially with under‐resourced communities, we provide recommendations in the following categories: 1) Building relationships with a partner school, 2) Technology, 3) Pedagogy, and 4) Facilitating interactions between students.     

Diversity, attrition and transition into nursing

Title. Diversity, attrition and transition into nursing. Aim. This paper is a report of a study to explore the relationship between selected diversity variables (sex, country of birth, ethnicity, age, educational qualifications, and additionally visa status, application route, absence rates), and nursing students’ progression and attrition. Background. Debates on levels, forms and causation of nursing student attrition have been professional, academic and political concerns for some time on an international level. However, a more systematic approach to studying the topic is needed. We lack commonly operationalized national and international data on the relationship between attrition and diversity variables, and their implications for cost, social justice and demographic representativeness in nursing. Methods. A longitudinal cohort design was used. Data were collected from 2003 to 2005 from routinely collected data in student records. Results. Males had lower odds of completing the programme than females, as did younger students. Compared with United Kingdom‐born students, those born in Ireland, Zimbabwe, or other English‐speaking countries were more likely to complete the programme. Students born overseas in non‐English‐speaking countries did not differ statistically significantly from United Kingdom‐born students. Those at all qualification levels had similar odds of completion, except students already qualified at degree level, who were less likely to complete. Conclusion. Further national and international research is needed to understand better the causal variables underpinning differential attrition rates, with particular regard to understanding how different groups may experience the relationship between education and their broader circumstances and between the theoretical and the clinical elements of nurse education itself.     

Coping strategies in clinical practice: the nursing students' lived experience.

This phenomenological study was designed to understand the lived experience of nursing students coping with the demands of their clinical practice. The Husserlian phenomenological approach was used. The data revealed several strategies that fourteen student nurses utilised to cope with the demands of their undergraduate clinical program. The participants discussed having a strong determination to complete their course and talking things over with family, friends, and other students as means of helping them get through it. They considered that only other nursing students could really understand the experience of being a student nurse. Therefore, a very effective student grapevine operated in their undergraduate program. The grapevine was used to disseminate information about all aspects of the course. Other strategies discussed by the participants were 'playing the game' and doing only what was necessary to complete the undergraduate program. This paper describes the learning strategies used by nursing students during their clinical practice, which has implications for clinical teachers and schools of nursing.     

Swimming without the water: A critical perspective on mental health experience for adult nursing students

Adult nurses and adult field nursing students come into contact with a diverse range of other patient groups in their practice but perhaps none more so than those who have co-existing mental health issues. Consequently adult field student nurses must be equipped with the requisite knowledge and skills to competently care for their patients who also experience mental health problems. Given the pressure on placements many education providers have developed alternatives to direct mental health experiences. The authors review their own experience of some of the modalities that higher education institutes (HEI) use to instruct their students in this field. They argue that, ideally, there is no substitute for the practical experience of placements in the mental health sector, particularly if these include contact with mental health nursing. The paper concludes with some recommendations for nursing education and our professional body that could help equip adult field nursing students with the necessary experience and skills of mental health to support them into their future careers.     

Developing A&E nursing responses to people who deliberately self-harm: the provision and evaluation of a series of reflective workshops

Accident & Emergency (A&E) departments and Medical Admission Units (MAUs) are an essential part of emergency mental health care in the UK. Deliberate self-harm and attempted suicide are particular challenges to nursing staff in such departments. Two registered mental nurses with experience of education facilitated a series of workshops with nurses from four A&E departments, two Minor Injuries Units and two MAUs. These were focused upon the assessment and management of deliberate self-harm and attempted suicide. During the workshops, participants provided systematic information on presentations of deliberate self-harm and attempted suicide, and on their professional responses to such presentations. These accounts provided invaluable information on deliberate self-harm and attempted suicide as seen by nursing staff in A&E and MAUs. Critical reflection upon nursing responses to these presentations revealed particular concerns nurses had relating to their experience with this client group which might inform future practice. Evaluation of the workshops indicated a subsequent decrease in work-related stress, which was probably a consequence of improved professional coping responses by the nurses concerned.     

Nurse Education Tomorrow Conference 1991. An examination of selected current student nurse issues.

Clinical teaching has become increasingly complex and difficult for nursing instructors. Pressures for public accountability in nursing education and patient care, economic stresses, marked changes in the nursing curricula, and the growth of collective bargaining units have all complicated the task of educating student nurses. Traditional issues focusing on teaching strategies, academic and clinical evaluation concerns have been extensively researched. What are the current issues facing nurse educators? Our project aimed to identify some current student nurse issues in selected nursing programmes. Using a convenience sample, data were collected from the chairmen of nursing education in selected agencies. Analysis following the Fox and Diamond framework (1965) revealed recurring issues relating to mature students, stress and the clinical environment, and the mentor needs are a few of the issues discussed in this paper.     

A study of an ethics education topic for undergraduate nursing students

The study aims to explore nursing students' perceptions of the relative value of various aspects of the ethical component of the undergraduate topic, 'Ethics and Law applied to Nursing' (topic NURS2104). To enable time for reflection on ethics in nursing, sampling occurred 1 year after successful completion of the above-mentioned topic and after successful completion of all but the final clinical experience components of the Bachelor of Nursing (BN) degree. A significant proportion of respondents perceived ethics education as relevant to professional practices. It is also noteworthy that the ethical decision-making strategies that had been incorporated into the topic (NURS2104) became transformed by the clinical experience of each particular student. While results of this study are not conclusive, they nevertheless provide important information for future nursing students on the evolutionary development of ethics education.