Nursing home employment for nursing students: valuable experience or a harsh deterrent?

AIM OF THE STUDY: The primary aim of the study was to examine the attitudes of undergraduate nursing students at the both the beginning and end of their nursing course. BACKGROUND: Throughout Australia there is increasing awareness of the ageing of the population and the widespread implications this will have for the future. The ramifications for the health system are expected to be wide and far-reaching. For the nursing profession the increase in the number of aged people will increase the demand for nurses to practice within the aged care area. This raises serious concerns in light of the negative attitudes that Registered Nurses and undergraduate nursing students hold towards working with older people. METHODS: This paper reports the results of a longitudinal study of undergraduate nursing students at the start (n = 793) and at the end (n = 524) of their nursing education programme. FINDINGS: The findings support the literature in demonstrating that working with older people is the least preferred area of practice for students, and that its popularity actually declines during the education process. One interesting finding from this research suggests that part-time employment of student nurses in nursing homes can further influence students' negative attitudes. CONCLUSIONS: If nursing students are to continue working in aged care, strategies to address the potential detrimental impact need to be identified and developed as a matter of urgency.     

How do nursing students regard their future career? Career preferences in the post-modern society

This article presents findings from a study of 301 Norwegian nursing students' opinions of their future career. The initial survey took place 7 months after the commencement of nursing training in 1998/99 with a follow-up after 2 1/2 years. Data was collated using a questionnaire with closed questions and supplemented by semi-structured in-depth, audio taped interviews concerning the students' professional socialisation. The findings from the initial survey indicate that motives like human contact, helping others and job security (i.e. low risk of being laid off) were important. Plans for further education after finishing the bachelor programme in nursing were abundant. Analysis of the second data-set will show whether there is a change in the students' plans for their future education and career. For nearly 80% of the students it was very important that the bachelor degree could serve as a basis for further education. Multiple regression analysis showed that nursing students who emphasise this importance are less interested in giving care and help to others, and this attitude is confirmed in the interviews. Career preferences were often midwifery, public health or practice in high tech areas like anaesthetics, and not care for chronically ill or elderly patients; areas where there is a shortage of nurses.     

The role of nursing education in the perpetuation of inequality

A growing body of literature now strongly supports the view that undergraduate nursing students commence their education program with firm views about the most desirable and undesirable areas of practice. This paper reports the results of a longitudinal study of undergraduate nursing students' career preferences in which attitudes on commencement are compared to attitudes immediately prior to the completion of the course. Differences in preferences were found between student choices at the beginning and end of the course, however the tendency for students to prefer areas of high technology and working with children and babies remains high despite some changes within these groupings. Similarly the unpopularity of psychiatric nursing, aged care, and community health remains an issue of concern despite some significant changes within these areas. The results are interpreted through a discussion of the role of nursing education in perpetuating the prejudices of students through portraying some areas of practice as inherently more desirable than others.     

Career in mental health still an unlikely career choice for nursing graduates: A replicated longitudinal study

The lack of qualified mental health nurses is at critical level with the problem likely to worsen as the aging mental health nursing workforce retires. This study investigates the career preferences of undergraduate nursing students by comparing preferences at the start, middle, and end of the Bachelor of Nursing program. The comparison of the cohorts gave an indication of the change in preferences over the intervening years. It replicates research completed in 1992, 1997, and 2001, and develops a profile of nursing career preferences and the rationale underpinning those preferences in a cohort of students (n = 150) who began their Bachelor of Nursing studies in 2007 and completed in 2009. The main findings included that, like the previous studies, mental health nursing is one of the least desirable career choices for most nurses at the start of their course and remains so as they approach graduation. The reasons change but the outcome remains the same. The current system of using the Bachelor of Nursing award to produce mental health nurses in Australia does not encourage nurses to consider a career in mental health nursing. Which begs the question: where will mental health nurses in the future come from?     

Change in career aspirations and job values from study time to working life

AIM: The main aim of this paper is to uncover whether the actual career choices and job values of newly qualified nurses are in accordance with the predictions they made at the commencement of their nursing education. BACKGROUND: A cohort of Norwegian nurse students was followed from the beginning of their education in 1998 through nursing school and 2,years after graduating. METHODS: Questionnaire data from 221 nursing students at three points in time: 1998, 2001 and 2003 were analysed with frequency distributions and paired samples t-tests. For 140 respondents data from all three points were available. RESULTS: Initially motives like human contact, helping others, job security were important, and 92% had a wish for further education. Career preferences were often midwifery, public heath and nursing practice in high tech areas. Towards the end of the bachelor course (2001), there was more ambiguity in the helping motives. On one hand, the students wanted to be altruistic but on the other hand, they wanted gratitude in return when giving help to patients. Seventy five per cent of the students had plans for further education within a period of about 2 years after graduation. Midwifery, public health work and high tech practice were still preferred. Findings from 2003 indicated only 16% had started or finished further education 2 years after graduation. When appraising future job challenges in 2001 and 2003, there is a decrease in emphasis on the values human contact and part-time work and an increase in emphasis on high salary and job security. CONCLUSIONS: During the student period, the bachelor programme was regarded as a basis for further education, but 2 years after graduation only 16% had realized further education. Preferences related to job values regarding a prospective job reveal a decrease in the importance of human contact and an increase in the importance of a high salary and job security from 2001 to 2003.     

Paths to nursing leadership

AIM: The aim was to explore why nurses enter nursing leadership and apply for a management position in health care. The study is part of a research programme in nursing leadership and evidence-based care. BACKGROUND: Nursing has not invested enough in the development of nursing leadership for the development of patient care. There is scarce research on nurses' motives and reasons for committing themselves to a career in nursing leadership. METHOD: A strategic sample of 68 Finnish nurse leaders completed a semistructured questionnaire. Analytic induction was applied in an attempt to generate a theory. FINDINGS: A theory, Paths to Nursing Leadership, is proposed for further research. Four different paths were found according to variations between the nurse leaders' education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path. CONCLUSION: Situational factors and role models of good but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment to nursing management positions need serious attention in order to develop a competent nursing leadership.     

Developing and testing instruments for improving cooperation and patient's participation in mental health care

The main purpose of the project was to develop computerized instruments that could be used by nurses and patients to assess their cooperation and mutual contributions to care. This paper presents a part of the project: the reliability and validity testing phase of a process of instrument development. To test the validity and reliability of the instruments, data were collected with questionnaires from nurses (n = 146) and patients (n = 286). The validity evaluated as construct validity and the reliability evaluated as internal consistency of the instruments were quite good. Construct validity was tested by factor analysis, and internal consistency was tested by Cronbach's alpha coefficient, which varied from 0.69 to 0.79. The instruments, which consisted of a software application that can be operated in a www environment, were meant to be used as tools in the psychiatric nursing context for assessing the cooperation between the nurses and patients and the patient's participation in his/her care. Furthermore, the computer programme can be used as a tool for developing and assessing the patient orientation in nursing.     

Babies and machines that go ‘beep’: First‐year nursing students’ preferred areas of future practice

Students of nursing enter their programmes of study with preconceived ideas of what a career in their chosen profession will entail. The literature suggests that images from the media and past experiences contribute to these perceptions. Although it is positive images of the profession that will usually attract an individual to a career in nursing, often more negative perceptions will direct students away from potentially rewarding areas of specialization. This paper describes career projections of nursing students enrolled in the first year of four preservice nursing programmes at the rural campus of one Australian university. Part of a larger study, the data reported here indicate that most respondents intend to practice in the areas of midwifery, paediatrics and emergency nursing. Oncology, community nursing, aged care and mental health nursing all ranked poorly across three rounds of surveys. These findings have implications for practicing nurses and nurse educators who seek to dispel inaccurate images of these important specializations.     

'I don't want to be a psychiatric nurse': an exploration of factors inhibiting recruitment to psychiatric nursing in Ireland

Ireland has experienced a decline in recruitment to preregistration psychiatric nursing programmes (An Bord Altranais 1999). Social care workers often do similar psychosocial work with similar client groups served by psychiatric nurses. In marked contrast to psychiatric nursing, Irish social care diplomate and degree programmes are generally over subscribed. Yet graduates working in social care often experience inferiority in terms of pay, conditions and career structure compared to their psychiatric nursing counterparts (McElwee 1998). The question that therefore needs to be asked is why school leavers opt for such courses in preference to psychiatric nursing. This article describes the results of a pilot study, utilizing a focus group approach, to examine reasons for course and career choice among school leavers, psychiatric nursing students and social care students. Results indicate that school students rely on stereotypical views as part of their decisionmaking process in shaping occupational decisions. School students tend to conceptualize psychiatric nursing as being a job involving menial and physical tasks. Social care students saw psychiatric nursing as lacking autonomy and to be institutional in nature. Psychiatric nursing students themselves felt exploited and 'second class' compared to general nurses. Current recruitment campaigns and careers guidance within schools need to be more targeted on differentiating psychiatric nursing from its general nursing counterpart.     

老年护理院护士职业吸引力影响因素的质性研究

目的：探讨影响老年护理院护士职业吸引力的因素。方法：采用半结构质性访谈的方法对苏州市3家老年护理院的16名护士进行访谈。结果：通过Colaizzi分析法提炼出3个主题。主题1,护士选择老年护理院工作的因素是亲戚或同学介绍、老年护理院就业门槛低;主题2,影响老年护理院护士职业吸引力的积极因素是认识和接受老年护理、工作相对大医院轻松、快速自我成长;主题3,影响老年护理院护士职业吸引力的消极因素是护士职业认可度低、生活婚恋压力大、外出培训机会少。结论：苏州市老年护理院护士职业吸引力低,建议政府相关部门通过开展护理专业学生的老年护理教育、提高老年护理人员薪酬待遇、提升老年护理人员职业发展空间等策略来提高老年护理院护士的职业吸引力。     

Bullying in the nursing profession

BACKGROUND: Self-esteem is a major predictor of behaviour. Nurses with healthy self-esteem are likely to deliver therapeutic patient care, while those with low self-esteem are less likely to do so. AIM: The aim of the 3-year study discussed here was to explore students' self-esteem and how their experiences of preregistration education influenced its development over the period of the programme. RESEARCH METHODS: Students participated in unstructured qualitative interviews at the beginning and end of their 3-year preregistration course and a grounded theory approach was used for data collection and analysis. FINDINGS: Bullying was found to be commonplace in the transition to becoming a nurse. Students were bullied and also witnessed patients being bullied by qualified nurses. The internalization of nursing norms meant that students then bullied others. Students' self-esteem was low. CONCLUSION: Bullying, and its effects on self-esteem, are perpetuated by practices within nursing. This situation will only be changed if nurses and educators transform their practice and the context in which bullying occurs. Otherwise, each new generation of nurses will continue to be socialized into negative practices which undermine both their own feelings of self-worth and standards of nursing care.     

From novice to competent practitioner: tracking the progress of undergraduate mental health nursing students

This study explores the perceptions of, and outcomes for, a group of undergraduate mental health nursing students over a 3-year period from the point at which they made their choice to take the mental health branch of a 4-year degree programme in nursing, to working in the practice setting as registered nurses. Semi-structured interviews were completed at three points in their career: (a) at the end of the common foundation programme, when students had made their choice to take the mental health option; (b) at the end of the fourth year of the undergraduate programme; and (c) 1 year post-qualification. Questions were generated around five main themes: career choice, personal change and development, evaluation of the curriculum, ideas about mental health nursing and career plans. Despite some initial ambivalence at the start of the branch, students were happy with their career choice at follow-up, which was reinforced by significant clinical progress. All of the group were working in acute hospital settings despite being in possession of the community mental health qualification. Substantial evidence of these students' 'fitness for purpose' is offered, although some disillusionment with the contrast between student life and the real world of work is noted. Questions are posed as to the role of clinical supervision and education in preventing negative professional socialization. Recommendations are also made about recruitment to and design of mental health nursing courses.     

Peer review in nursing and midwifery: a literature review

Aims and objectives. The Clinical Education Project investigated clinical education in nursing and midwifery settings. The aim of this phase was to investigate and evaluate the processes and outcomes of clinical assessment of preregistration nurses and midwives, focusing on the assessment interview, and to evaluate the feasibility of introducing peer review of the clinical assessment interview in acute clinical settings. Background. Peer review is common in many professional areas. The literature describes various applications of peer review and makes recommendations for its use. However, there is a shortage of studies investigating the use of peer review in nursing and midwifery education and practice. Design. The project involved a systematic literature review and a qualitative exploratory study. This article describes the first part of the study: a systematic literature review of peer review. The second part of the study is reported elsewhere. Methods. The systematic literature review investigated international articles written since 1994 that contained information on peer review in pre/post registration nursing and midwifery within higher education or practice. Results. From the available literature, 52 specific initiatives were analysed. The majority of articles originated in America and involved nursing staff working in secondary care settings. Fifty‐one articles had missing information varying from not stating the sample size to not including information about evaluations. Conclusions. The literature review found that whilst peer review is commonplace in nursing and midwifery practice, there is a lack of robust literature about its use. Relevance to clinical practice. Peer review in clinical settings such as nursing and midwifery can facilitate the sharing of good practice and personal and professional growth. It allows participants to learn from each other and gain insight into their development.     

香港社区护理的概况及管理经验

从家庭健康、长者健康、学生健康、卫生防护中心、健康教育、诊所服务、普通科门诊 ,介绍了香港基层健康服务的范畴。从社康护理服务、精神科社康护理服务等方面介绍了香港社区护理的概况。从社区老人评估服务、个案管理、社康护理专科化及疾病护理规程、外展护士及私营安老院舍服务、出院后病人的支援计划、科技的运用 :社康护理信息系统及PDA系统、遥控录像和电话支持服务等方面介绍了香港社区健康服务的发展及科技的突破。以新界西社区护理模式为例介绍了联网社区的护理模式。论述了社区护士应具备的条件和社康护理服务的发展方向。     

Who wants to be a psychiatric nurse? Novice student nurses’ interest in psychiatric nursing

Available research findings suggest that nursing students do not regard psychiatric nursing as a desirable future career option. This paper addresses the results of a research project conducted by the author. This research addresses the relative popularity of psychiatric nursing in comparison to other nursing specialties, within Victoria, Australia. The research was conducted by use of a questionnaire in which commencing undergraduate nursing students were asked to rank nine areas of nursing specialty in order of preference and provide some explanation for their choices. The results indicate that psychiatric nursing emerges as the second least popular career choice for student nurses at this stage of their education.     

Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program

This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care - Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.